Articles Posted in Home Owners Policies

Not paying on an insurance claim is in simple terms, a breach of contract.  The difference is that the contract breached is an insurance contract.  The Texas Insurance Code provides for damages beyond the simple breach of contract damages.  However, as is pointed out in the 2019, opinion from the Southern District of Texas, Victoria Division, you still have to prove the insurance contract was breached.   The style of the case is, Deborah Gonzalez v. Allstate Vehicle and Property Insurance Company.

Deborah’s claim arose out of damage suffered in Hurricane Harvey in August of 2017.  Deborah filed a claim against Allstate on August 28, 2017.  Allstate’s adjuster reported damages totaling $8,596.63.  After adjustments, Allstate paid Deborah $6,062.63.

Deborah did not agree with the amount paid and on August 13, 2018, Deborah and Allstate designated appraisers.  The appraisers evaluated the loss at $23,822.72.  After applying adjustments, Allstate paid the remainder of the claim.

The U.S. District Court, Western District, Austin Division, issued an opinion on November 16, 2018, that is worth reading.  It is styled, Thomas G. Kezar and Sylva Shroyer Kezar v. State Farm Lloyds.

This is an appeal from a partial motion for summary judgement as to one issue in the case.  The issue is whether Kezars still had a claim against State Farm for breach of contract and extra-contractual damages under the dwelling coverage aspect of the claim when State Farm had already properly and timely paid that aspect of the claim after an appraisal award.  This Court ruled in favor of State Farm.

The policy language at issue states:

Insurance lawyers need to know what the policy at issue says and how the courts interpret those policies and make their rulings.

For a homeowners policy, the 2018 Eastern District of Texas, Sherman Division, opinion styled, Rainey Rogers v. Nationwide General Insurance Company, is a good read.

The Rainey case arises out of a dispute between a policyholder and Nationwide regarding the extent of damages and the amount of loss suffered to Rainey’s property.  On March 26, 2017, the property suffered damage due to storm-related conditions and Rainey made a claim for benefits.

The Southern District of Texas, McAllen Division issued an opinion in August 2018, for insurance lawyers to read that is styled, Alfredo Murillo Jr., et al v. Allstate Vehicle and Property Insurance Company.

The Murillo’s filed a lawsuit in State court against Allstate after Allstate did not handle a storm damage claim to the satisfaction of the Murillo’s.  The Murillos alleged violations of the Texas Insurance Code, the DTPA, and breach of contract.  Allstate removed the case to Federal court and filed a motion with the Court seeking dismissal of the Murillos Insurance Code and DTPA violations pursuant to Federal Rule of Civil Procedure 12(b)(6).

Rule 12(b)(6) requires plaintiff to plead “enough facts to state a claim to relief that is plausible on its face.”  The pleading requires “more than labels and conclusions” or “a formulaic recitation of the elements of a cause of action.”  Conclusory allegations are disregarded.

Insurance lawyers want to help their clients as much as possible in any given case.  The United States District Court, Western Division Texas, San Antonio Division, issued an opinion regarding recovery of attorney fees in an insurance case.  The opinion is a 2018, opinion styled, Jesus Agredano and Margaret Agredano v. State Farm Lloyd’s.

This case will be discussed in three blogs with each blog discussing the Courts ruling regarding attorney fees in insurance cases.  This is the second one.

The Agredanos prevailed at trial on their breach of contract claim against State Farm.  The remaining question was whether or not they were entitled to seek and recover attorney’s fees.

The use of drones for evaluating insurance claims has become normal.

The Claims Journal published an article on July 19, 2018, titled, Insurers’ Drone Use Picks Up After 2017 Hurricane Season.

The article says that Insurers’ use of drones to inspect property claims came into full swing in 2017, after the FAA began issuing permission allowing commercial firms to operate unmanned aerial vehicles in designated U.S. airspace.

Texas law requires pre-suit notice in many situations.  The Texas Insurance Code requires pre-suit notice before certain homeowners claims can be litigated.  An example of this is found in the 2018 opinion, Dwight Davis v. Allstate Fire and Casualty Insurance Company.  The opinion is from the Eastern District of Texas, Sherman Division.

Davis filed a first party lawsuit against Allstate.  Allstate filed a Verified Motion to Abate Pursuant to Texas Insurance Code, Section 542A.103.

The purpose of the notice requirement is to discourage litigation and encourage settlements.  The statute reads in part:

The U.S. District Court, Eastern District, Sherman Division, issued an opinion in May 2018, styled, James Cunningham and Tabatha Cunningham v. Allstate Vehicle and Property Insurance Company.

The Cunningham’s allegedly suffered damages during a hail and windstorm.  The claim was reported to Allstate and five days later Allstate inspected the property.  The Cunningham’s requested a re-inspection which was denied.  Without providing a proof of loss in accordance with policy provisions, the Cunningham’s filed suit against Allstate.

Allstate responded by filing a motion to dismiss for lack of subject matter jurisdiction due to the Cunningham’s failure to satisfy the policy proof of loss requirement.

The United States District Court, S.D. Texas, McAllen Division, denied a defense motion for summary judgment in a case where the defendant settled a claim with a homeowner who had two claims, asserting that the release covered both claims.  The case is styled, Aidee Bazan v. State Farm Lloyds.

Bazan had insurance with State Farm insuring his residential property.  Two storms are alleged to have damaged Bazan’s property – the first in March 2016, and the second in May 2016 – forming the basis of two different lawsuits against State Farm.

A dispute arose about the damages sustained by Bazan and a lawsuit was filed as to the March 2016 damage.  Bazan later filed a lawsuit on the second storm damage.   This second claim was assigned claim number 912. The pleadings on the two lawsuits are essentially the same.