Month: April 2016

concussion

Appeals Court Affirms NFL Settlement For Concussions

While football is one of America’s most watched sports, the nature of the game causes repeated concussions to its players that have long-term health consequences.

Many retired football players suffer from chronic traumatic encephalopathy (CTE), along with other neurological disorders such as Parkinson’s disease, Alzheimer’s, dementia and ALS, or Lou Gehrig’s disease. While CTE was initially thought only to affect athletes like boxers who suffer repeated direct blows to the head, recent research has revealed a causal link between football players and CTE.

For many years the National Football League (NFL) was criticized for not doing enough to protect its players from CTE; and, earlier this month an appeals court upheld a settlement that provides retired football players with compensation for brain injuries sustained while playing for the league.

However, some players are concerned that the settlement doesn’t offer enough protection. The long-term effects of CTE can take years to develop, and some players argue that the settlement should protect players through the rest of their lives, rather than only provide compensation for existing injuries. Because CTE is a degenerative disease, players who receive compensation from this settlement might go on to develop more severe CTE symptoms as they age. Tragically, some players have died as a result of CTE they developed from playing professional football.

How Does CTE Affect Football Players?

CTE has a wide array of symptoms depending on the severity and number of brain injuries; but, some of the most common symptoms include memory loss, impulsive or erratic behavior, impaired judgment, aggression, depression, and gradual onset of dementia. The repeated blows to the head during play greatly increase a player’s likelihood of developing the medical condition.

How Will the Affirmation Affect Other Sports?

The National Collegiate Athletic Association (NCAA) has implemented measures for handling concussions sustained by their athletes after pressure from recent studies linked CTE to basketball players. Unfortunately, these measures come far too late for many athletes who have already sustained head trauma during play. Though far from perfect, the court’s affirmation of the NFL settlement at least sets an important precedent requiring sports organizations to take some measure of responsibility for their players’ well being.

Raizner Slania: NCAA Concussion Lawyers

Concerns regarding what the NCAA is doing to protect its players have escalated in recent years. If you were or are an NCAA athlete, and you have suffered a sports-related concussion, you may have a legal claim. Contact Raizner Slania today for a no-cost, confidential review of your individual facts.

insurance claim

How Much Time Does An Insurance Company Have To Pay An Insurance Claim In Texas?

The recent storms that have hit all over Texas – from Houston to Fort Worth to San Antonio – will have many property owners filing commercial property insurance claims. Regardless of how and when property damage occurs, insurance companies are governed by regulations that dictate how quickly they must acknowledge, investigate, and resolve claims. To best prepare for filing your business insurance claim, it’s important to know how long the claims process generally takes and what you can expect.

Step One: Providing Notice of the Claim

It may seem obvious, but it cannot be understated how important it is to immediately contact your insurance carrier once you have discovered property damage. While some damage might be obvious, like a tree falling on your roof, other damage may be harder to spot, like small holes in the roof from shingles blown off in a storm. In both cases, failing to address the damage could cause further damage to the property. To provide evidence of the damages you are claiming, take pictures and/or video of all affected aspects of the property. You must always give “reasonable notice” of a claim to your insurer, and oftentimes insurance policies specify a time period of one to two years.

Step Two: The Investigation Process

Once you have submitted your claim, your insurance carrier has 15 calendar days to 1) acknowledge the claim, 2) begin its investigation, and 3) request any additional information it reasonably requires. All of this must take place within 15 days of notice, or in the case of a surplus lines carrier, 30 days of notice.

Step Three: Approval or Denial

After the insurance carrier has received all requested documents, they have 15 days to make a determination on the claim. If the claim is approved, the carrier has five business days to issue payment. If the insurer is a surplus lines carrier, it has 20 business days issue payment.

Penalties

The insurance process in Texas is legally required to be complete within 60 days of the initial notice, unless a specific exception applies. If the insurance company fails to follow these rules, Texas policyholders have the right to collect 18% annual interest and attorneys’ fees, in addition to the claim amount.

Exceptions

In the case of a natural disaster, it may be logistically difficult for an insurance company to properly investigate and make determinations on a massive number of claims in the statutorily prescribed timeframe. An insurance carrier that needs more time address a claim can take 45 days to make its decision as long as it sends the policyholders notice explaining the delay. The Texas Department of Insurance can also grant insurance companies an additional 15 days to decide on a claim if there has been a natural disaster.

Bad Faith Insurance Attorneys

More information on Texas prompt payment and unfair claims settlement practices rules can be found in Section 542 of the Texas Insurance Code, If your insurance company has unlawfully delayed your commercial property insurance claim, you have the right to seek compensation. The attorneys at Raizner Slania have extensive experience helping policyholders obtain rightful and timely payments from insurance companies around the world. Call today for a free consultation.

houston

Devastating Houston Wind and Rainstorm

Houston and Southeast Texas were relentlessly pounded by wind and rain beginning in the early morning hours of Monday, April 18, 2016. With as much as seventeen inches of rain falling before 2:00 pm, the flood damage was catastrophic. Over 1,000 homes were flooded and local authorities responded to over 1,200 flood emergencies.

Seven bayous across Harris County exceeded their banks and two dams were at risk of breaking, which could have caused devastating damages and risked thousands of lives. Governor Gregg Abbott signed a disaster declaration for the nine counties hit with flash flooding: Harris, Bastrop, Colorado, Fort Bend, Grimes, Montgomery, Waller, Wharton, and Austin.

Homes, apartment complexes, office buildings, churches, schools, hotels, convenience stores, and many other types of buildings faced flash flooding including water several feet high.

Filing Property Damage Insurance Claims

While the city of Houston and surrounding areas managed to weather the storm, the monumental task of rebuilding again, just as was done almost one year ago, will prove challenging for residents. Wind and rain can cause damage to the roof, HVAC, walls, floors, electrical outlets and wiring, and personal effects, among other items. The property damage can also cause loss of business for business owners.

The task of pursuing a commercial property claim and/or a business interruption claim might seem daunting, but the experienced litigation attorneys at Raizner Slania can help. Insurance companies receive thousands of wind and water damage claims each year, and sometimes take advantage of policyholders who are not completely familiar with all the specific terms of their policies and who are unable to fight back when claims are denied.

Raizner Slania: Houston Bad Faith Insurance Claim Attorneys

The attorneys at Raizner Slania have represented insurance companies in the past, giving us valuable insight into how they conduct business. This has allowed our law firm to achieve successful settlements and verdicts for policyholders across the country when insurance claims are wrongfully denied or grossly underpaid.

If your commercial property insurance claim has been denied, underpaid, or delayed, Raizner Slania can help you get the payments due under your policy. When an insurance carrier acts in bad faith, you have a right to hire an attorney to help you with your claim. Contact the litigation professionals at Raizner Slania today to review your claim.

London

What’s The Deal With Lloyd’s of London?

Last year, Underwriters at Lloyd’s of London wrote over $1.1 billion in premiums in Texas alone, cornering the market for commercial property insurance with a 23% market share, and making them the largest surplus lines insurer in the state. Despite this, many policyholders are discovering that their insurance claims are being unfairly denied. So what’s the deal with Lloyd’s of London?

What is Underwriters at Lloyd’s of London?

Underwriters at Lloyd’s isn’t actually an insurance company, despite the efforts to portray themselves that way. In fact, Lloyd’s is only licensed as an admitted insurer in one state, Kentucky, but nevertheless offers insurance in all other states. Lloyd’s gets away with this because it registers in these various states as a surplus lines insurer. In reality, not only is Lloyd’s not a real insurance company, it isn’t even one single entity. It is an investment market comprised of a number syndicates, each of which may be its own foreign insurance company, or just simply an institutional or even individual financial investor. These syndicates share the risk on a policy, or often a portfolio of policies, in return for the premium. When a business owner purchases commercial property insurance with Lloyd’s they are actually purchasing a policy with a cocktail of various syndicates rather than an actual insurance company itself. And most of the time, the insurance customer has no idea what they are getting into.

Consequences of a Lloyd’s Policy for Business Consumers

While the initial thought of your insurance policy being comprised of several entities might not sound too troublesome, this is far from the truth. Many of the entities that underwrite the policies aren’t even insurance businesses, but rather they are pure financial investors whose main focus is maximizing their return on investment. Fairly paying claims rarely helps the bottom line for these financial investors.

Additionally, the syndicates that are actual insurance businesses are often unlicensed, unauthorized foreign insurance entities using Lloyd’s authorization to conduct business they couldn’t normally do themselves. This allows insurance entities from all over the world to operate in the lucrative US insurance market, without actually having to comply with US laws or regulations. Basically, these foreign insurance businesses – from the United Kingdom, Germany, Bermuda, the Cayman Islands and other exotic locales – are borrowing a license to engage in the business of insurance when it would otherwise be illegal for them to do so.

It gets worse. Because Lloyd’s isn’t a real insurance company, they don’t have anyone to handle claims. So when a policyholder submits a claim, the various syndicates at Lloyd’s operate through managing general agents, third party administrators, and independent adjusters to address the claim. Lloyd’s relies on these third parties to decide on claims without ever assessing the damage for themselves, which often causes grossly undervalued or completely denied claims.

These insurance service providers only exist because the foreign syndicates at Lloyd’s don’t actually have a human being working for them anywhere in the United States, or they don’t have the requisite authority to do the actual work in Texas. Injecting these claims handling groups into the equation also costs money, which erodes the portion of premiums that are supposed to go back to policyholders when they have a claim. Sometimes these other insurance businesses even have financial ties to the syndicates or even foreign reinsurers who have the financial risk on the claim. It’s a real conflict of interest, and it takes money away from the payment of legitimate claims and injects inefficiency and waste into the insurance system at the worst possible time.

Is the Problem Limited to Underwriters at Lloyd’s London?

It is true enough that this has been going on for many years, but the problem is getting worse and the lack of regulation over these semi-legal entities is injecting chaos into the Texas insurance market. It used to be that surplus lines insurance, like what is provided by Lloyd’s, was the exception and not the rule. But today, the insurance industry in Texas is dominated by surplus lines insurers and entities like Lloyd’s of London. The top 50 surplus lines insurers in Texas wrote over $5 billion in premiums in 2015. With nearly a quarter of that market, Lloyd’s has quickly become the largest insurer for commercial risks in Texas, without actually being an insurer.

But they aren’t alone. Most of the major insurance companies have set up their own grey market surplus lines insurer subsidiaries to operate in Texas to get in on the action. AIG created Lexington Insurance Company and AIG Specialty Insurance, and in doing so, they ran about $500 million in premiums in 2015 through their surplus lines businesses. Zurich did the same, running over $110 million in premiums through its Steadfast Insurance Company. The list goes on, and at this point, most of the major insurance groups have set up their own surplus lines entities.

For the large insurance groups, writing insurance through their surplus lines subsidiaries, rather than their legitimately admitted market insurance companies, is a great deal. It means higher profits, less regulation and accountability, and the ability to use any type of manuscripted insurance policy language they desire. Since these are usually wholly owned subsidiaries, the money flows up to the parent company anyway. It’s a great deal for the insurance industry, and one permitted by our regulators as the law stands today.

Think about that the next time someone tells you that insurance companies are fleeing Texas because of hail storms or trial lawyers.

Until regulators address the inherent abuses in the surplus lines insurance industry, many policyholders will continue to suffer unfairly denied insurance claims. And until regulators fix the problem of unauthorized foreign investors using a Lloyd’s badge to sell insurance on our shores, Underwriters at Lloyd’s London will continue to operate its grey market for insurance to the detriment of Texas business insurance consumers.

Raizner Slania Represents Lloyd’s of London Policyholders

Surplus lines insurers like Lloyd’s of London can be aggressive when handling property damage claims, but the experienced trial attorneys at Raizner Slania have successfully helped many Lloyd’s policyholders get the compensation they are owed under their policies. Based in Houston, Texas, Raizner Slania handles large commercial insurance claims throughout the country.

Hail Damage

Tarrant County Hail Damage Lawsuit

Our client, a industrial commercial property owner, was forced to file a lawsuit against The Netherlands Insurance Company (Netherlands) after its commercial property hail damage insurance claim was wrongfully denied.

April 2011 Texas Wind and Hailstorm

On April 2, 2011, there was a severe wind and hailstorm in Tarrant County. As a result, our client’s property suffered significant damage including damage to the roof, HVAC, windows, exterior, interior, ceilings, furnishings, and more. Upon realizing the damage, the plaintiff filed a claim with Netherlands to recover for its damages.

Netherlands assigned adjusters, consultants, and agents to the file that were inadequately and improperly trained to handle this type of complex commercial property damage claim. The insurer assigned a local adjuster, who retained a consultant to assess damage to the property that was insufficiently trained and experienced to evaluate this type of damage. The local adjuster refused to conduct an adequate and objective investigation, and refused to provide a damage report or findings to our client until the claim was denied. Because of this, the plaintiff was forced to hire its own consultant to assess the obvious damages.

Violations of the Texas Insurance Code

The insurance carrier wrongfully denied our client’s property insurance claim. Because of this, our client was forced to retain an attorney to prosecute its claim for insurance benefits. The insurance carrier’s delay and/or denial of payment for necessary and covered repairs under the policy caused a significant economic impact and ongoing physical damage to the commercial property.

Our client cites numerous violations of the Texas Insurance Code, including failure to perform a prompt, fair, and equitable settlement of a claim, failure to refuse to pay a claim without conducting a reasonable investigation, and misrepresenting the terms of the insurance policy under which it affords property damage coverage. Our client also alleges breach of contract, breach of duty of good faith and fair dealing, and violations of the Deceptive Trade Practices-Consumer Protection Act (DTPA).

Raizner Slania Texas Wind And Hailstorm Damage Attorneys

If your commercial insurance carrier has denied, delayed, or disputed your wind and hail damage insurance claim, the experienced litigation attorneys at Raizner Slania can help. We have helped policyholders across the nation obtain the compensation they deserve for their commercial property damage insurance claims. Call us today for a free consultation.

Corruption Inside Commercial Property Insurance

The Corruption Inside Commercial Property Insurance

From costly hail damage to a devastating water loss, a commercial property insurance plan is crucial in protecting your business from a variety of incidents; however, finding the right commercial property insurance for your business isn’t as easy as you’d think. Corruption inside commercial property insurance has left many business owners high and dry after a loss. This is particularly true in states like Texas, where the grey market surplus lines insurance industry has virtually taken over the entire market despite regulatory protections to the contrary. The best way to protect yourself from buying a bad insurance plan is to understand how, when, and why corruption happens during the insurance procurement process.

Insurance Infographic

When a business owner needs commercial property insurance, they visit a retail agent, who typically is just a sales group that does not have any authority to bind an insurance company. So, the retail agent contacts a producer, typically a licensed surplus lines broker, and this producer has the authority to bind an insurer. Under the law, the producing broker must conduct a “diligent effort” to obtain insurance from a legitimate, admitted and licensed insurer. Unfortunately, due to a lack of true oversight and financial incentives, the producing broker either skips the “diligent effort” process or just gives it a superficial lip service without truly complying. The result is that the producing broker most often obtains the policy from a surplus lines insurer, which is usually more costly and is an unregulated grey market that lacks financial guarantees.

Surplus lines insurers are typically really just a front – file drawer entity –and most or all of the true insurance risk is ceded to unauthorized foreign reinsurers that are neither licensed in the state nor legally authorized to conduct the business of insurance in the state. They are little more than offshore investment schemes. Because of this, there is no one locally available to do the work on behalf of the surplus lines insurer once a policyholder files a claim under his or her policy. The surplus lines insurers must use local managing agents, independent adjusters, and third party administrators to address the claim and any one of these individuals could have financial ties back to the surplus lines insurer or even the the foreign reinsurer.

The potential for conflicts of interest under these circumstances is rampant, and this can seriously impact whether a commercial property claim is paid or denied. Because of the parasitical structure of these financial investment schemes masquerading as insurance companies, the money flows to the various entities who all have their hands in the process instead of the business insurance customer who paid their premiums and expect protection when a catastrophe occurs. Policyholders insured through surplus lines carriers are subject to predatory practices by the insurers, they pay higher taxes and premiums, get policies that are not approved by state regulators and contain far less coverage, and their claims are often evaluated by unqualified, and sometimes unlicensed, out of state adjusters.

The market for surplus lines insurers is largely unregulated and has virtually no oversight. Many business owners unknowingly purchase policies with these insurers and suffer economic hardship when their claims are later delayed, denied, or underpaid. The various insurance entities and investors profit handsomely from this grey market structure, while business policyholders are left without the protections they have paid for.

Raizner Slania: Commercial Property Insurance Lawyers

Raizner Slania is experienced in fighting insurance companies who operate in bad faith. We handle all commercial property insurance litigation on a contingency fee basis, so you owe us nothing unless we help you recover financial damages. If your commercial property insurance claim has been denied, delayed, or underpaid, call the lawyers at Raizner Slania today for a free consultation.