Tag: Bad Faith Insurance

Bad Faith Insurance Lawsuit Attorneys

Homeowners Association Files Bad Faith Insurance Lawsuit

Raizner Slania filed a lawsuit on behalf of a local homeowners association against Mid-Century Insurance Company after its hail damage claim was wrongfully denied.

April 2016 Bexar County Hailstorm

On April 12, 2016, a severe hailstorm swept through Bexar County causing significant damage to the roofs, interiors, and exteriors of condominiums contained in over 50 separate buildings managed by the policyholder homeowners association . Immediately upon discovering the damage, the homeowners association filed a hail damage insurance claim with Mid-Century to cover the cost of the repairs and other damages.

In response to the claim, Mid-Century assigned adjusters, consultants, and agents to the plaintiff’s file that were inadequate and improperly trained. Specifically, the claim was assigned to two adjusters, both of whom were not properly trained to handle this type of claim and failed to perform an adequate evaluation of the damage.

After a haphazard investigation of the property, the adjuster prepared an estimate of damages to the structure that grossly undervalued and ignored obvious damages to the property. Mid-Century relied solely on the adjusters’ investigation to determine what amounts, if any, to pay on the plaintiff’s claim. Mid-Century and the adjusters represented to the plaintiff that certain damages were not covered under the policy when in fact they were.

Mid-Century denied and grossly underpaid the plaintiff’s claim. In addition, Mid-Century continued to deny and delay timely payment of the damages it did accept. This caused the plaintiff to suffer significant economic impact, worry, distress, and continuing economic and physical damage.

Mid-Century Operated In Bad Faith

Our client cites numerous violations of the Texas Insurance Code, including failure to effectuate a prompt, fair, and equitable settlement of a claim, failure to implement reasonable standards for investigation of a claim, and violations of the Deceptive Trade Practices-Consumer Protection Act (DTPA).

Bad Faith Insurance Lawsuit Attorneys

Unfortunately for Texas policyholders, bad faith insurance practices are rampant. For policyholders whose claims have been wrongfully denied by their insurance company, the only way to seek full compensation is with the help of an experienced bad faith insurance lawsuit attorney. At Raizner Slania, our attorneys can help you get what you rightfully deserve under your policy. Contact us today to schedule a free consultation to discuss your case.

Texas Wind Damage Lawyers

Harris County Windstorm Damage Lawsuit

Our client, a local multi-story hotel tower owner, was forced to file a lawsuit against Everest Indemnity Insurance Company and Engle Martin after its commercial property damage insurance claim was wrongfully denied under Texas law.

April 2016 Windstorm

On April 18, 2016, a severe windstorm swept through Harris County and caused substantial damage to the roof, exterior, and interior of the plaintiff’s property. Immediately upon discovering the damage, the plaintiff filed an insurance claim with Everest for the damages caused by the windstorm. In response to the claim, Everest assigned adjusters, consultants, and agents to the plaintiff’s file that were inadequately and improperly trained.

Specifically, Everest assigned the claim to Engle Martin, who in turn assigned the claim to an adjuster. The adjuster and Engle Martin failed to perform a thorough investigation of the claim. The adjuster performed a substandard inspection of the property and failed to prepare any estimates or scopes of damages. The employee and Engle Martin also failed to hire qualified experts to properly assess the damage.

The employee and Engle Martin performed an inadequate, incomplete, and unreasonable investigation of the plaintiff’s claim, which Everest relied exclusively on to determine what amounts, if any, to pay on the claim.

As a result of the haphazard investigation, the plaintiff’s claim was denied. Everest represented to the plaintiff that the damages were not covered under the policy, when in fact they were. The plaintiff was forced to hire its own consultant to independently evaluate the property damage because Everest and Engle Martin refused to do so.

The Insurance Carrier Violated the Texas Insurance Code

Our client cites numerous violations of the Texas Insurance Code, including failure to effectuate a prompt, fair, and equitable settlement of a claim, failure to implement reasonable standards for investigation of a claim, and refusal to pay a claim without conducting a reasonable investigation. Additionally, our client also cites violations of the Texas Deceptive Trade Practices-Consumer Protection Act.

Raizner Slania: Texas Wind Damage Lawyers

If your insurance carrier wrongfully denied or grossly underpaid your Texas wind damage insurance claim, the experienced attorneys at Raizner Slania can help. We’ve helped policyholders across Harris County, throughout Texas, and around the country get the rightful payments they deserve under their insurance policies. Our consultations are free and you won’t owe us anything unless we help you recover compensation. Call us today to schedule your consultation.

hail damage insurance claim

Raizner Slania Files Tarrant County Hail Damage Lawsuit

Our client, a local industrial commercial property owner, was forced to file a lawsuit against Nationwide Agribusiness Insurance Company (Nationwide) after its hail damage insurance claim was wrongfully denied under Texas law.

March 2016 Hailstorm in Tarrant County

On March 17, 2016, the plaintiff’s property, a food distributorship building, was substantially damaged by a hailstorm that swept through Tarrant County. As a result, the roof, exteriors, interiors, business and personal property, and other machinery and equipment on the property sustained damage. Immediately after the storm, the plaintiff filed a hail damage commercial property insurance claim with Nationwide.

In response to the claim, Nationwide assigned representatives, adjusters, consultants, and agents to the plaintiff’s files that were inadequately and improperly trained. Specifically, Nationwide assigned the claim to a local adjuster who was not equipped to handle this type of claim.

The local adjuster performed a haphazard inspection of the property and refused to acknowledge all of the damages despite the fact that the plaintiff pointed them out. The local adjuster also refused to retain appropriate consultants to assess the claim.

Nationwide and the local adjuster performed an incomplete and unreasonable investigation of plaintiff’s claim, which is evidenced by the undervalued estimate of damages for the necessary repairs for the property. Nationwide relied solely on the local adjuster’s substandard investigation when determining what amounts, if any, to pay out on the plaintiff’s claim. As a result of the haphazard inspection, misrepresentation, and inadequate investigation, the plaintiff’s claim was grossly underpaid.

Nationwide Violated Texas Law

Our client sites numerous violations of the Texas Insurance Code, including failure to effectuate a prompt, fair, and equitable settlement of a claim, failure to adopt and implement reasonable standards for prompt investigation of claims, and failure to promptly provide a reasonable explanation for the denial of a claim. Additionally, our client also cites violations of the Texas Deceptive Trade Practices-Consumer Protection Act.

Raizner Slania: Texas Hail Damage Attorney

If your insurance carrier denied, delayed, underpaid, or disputed a Texas hail damage claim, you need an experienced team of property insurance lawyers to help you get the compensation you deserve. The bad faith insurance lawyers at Raizner Slania have helped scores of companies across Texas and around the country get the compensation they deserve under their policies. Call us today for a free consultation.

Arbitration Endorsements

Arbitration Endorsements – The Latest Insurance Industry Overreach

The insurance industry has yet another plan to seek various immunities and avoid public accountability in the form of a proposed arbitration endorsement. The Texas Department of Insurance will conduct a hearing on July 6, 2016 to consider the proposed endorsement.

What is the proposed arbitration endorsement?

Labeled Endorsement No. HO-802, the proposed form has some troubling provisions. Initially, the endorsement requires the parties to request and then participate in the appraisal process under the policy. If a dispute continues after appraisal, the parties must attend mediation. And if the dispute still remains unresolved after mediation, the policyholder and insurer must participate in arbitration.

How would the arbitration work?

The endorsement form requires there to be a single arbitrator. There’s no three person panel to provide a semblance of a level playing field. Instead, a group called Conflict Solutions of Texas appoints the single arbitrator and manages the process. You can read more about this group on their website, but a quick review shows a panel of attorneys, largely defense lawyers, and a few former judges. The group appears to have been started by several insurance defense lawyers with the Brin & Brin firm. The Brin firm is a long-standing, well respected firm in Texas, but let’s all be intellectually honest in what is being proposed. Mr. Brin’s bio on his website discloses his membership in various defense bar organizations, such as the Texas Association of Defense Counsel, the Defense Research Institute and the International Association of Defense Counsel. The firm boasts their successes throttling Texas consumers and policyholders on behalf of corporate defendants: “Our lawyers have secured defense verdicts in traditionally plaintiff friendly areas because we try cases in those areas on a regular basis. We know the people – both judges and jurors – and we know what works in each area.” Having practiced insurance law in Texas for about 25 years, I did not recognize one single panelist to be a policyholder lawyer. Not one.

To earn the right to participate in this process, a policyholder would have to travel to the closest city with a population of over 100,000. That’s fine if you live in Houston, Dallas or another larger city, but for rural policyholders, the enforcement of even a minor claim would involve a long road trip to a much larger city, and presumably one where the folks that run this arbitration “know the people.”

And if that doesn’t trigger your Spidey Sense, take an even closer look. Discovery is limited, and the insurer can refuse to produce parts of its files that it claims are privileged, with no way to address bogus privilege claims except to the single arbitrator. There are no depositions or other traditional discovery. There is no obligation to produce the critical, institutional documentation such as procedure and policy manuals that guide adjuster behavior.

The proposed endorsement even claims to be governed by the Federal Arbitration Act instead of the Texas version contained in chapter 171 of the Civil Practice and Remedies Code. Why? Because the Texas version actually has some level of protection for consumers, such as the invalidation of unconscionable arbitration provisions. Or the right to cross-examination. Or depositions. Or the basic requirement that the proceeding take place in the adverse party’s home county. The Texas act requires both the party and its attorney to sign off on an arbitration agreement if there is more than $50,000 in controversy. So, the Federal Arbitration Act it is, even for Texas insurers disputing Texas claims with Texas policyholders.

Not surprisingly, the whole process is kept secret. And if you decline to participate in the process: “we will proceed without you, and an arbitration award will be made by the arbitrator.”

What’s the purpose of this, if there’s already an appraisal provision in the policy?

Anyone familiar with Texas insurance policies and first party property insurance claims knows that most insurance policies in this state contains an appraisal clause. The past few years of court decisions have also taught us that it is nearly impossible to waive these provisions, and that they will be enforced. The appraisal process has been around for a very long time, and while it sometimes doesn’t work out to everyone’s satisfaction, it’s a fair process when everyone is following the rules. It’s quite simple: both sides select an appraiser, and if a tiebreaker is needed, either the appraisers or a court can appoint an umpire. The majority wins. According to the Texas Supreme Court, complicated causation questions can be resolved as a part of this process.

When handled competently and fairly, an appraisal is a lot like a three person panel arbitration. Frankly, appraisal and arbitration are largely indistinguishable, beyond the customary practice that appraisals are typically handled by adjusting or construction experts rather than lawyers. Any insurance company or policyholder can enforce an appraisal provision, and can compel a reluctant opponent to participate. Appraisal awards are largely enforced, with exceptions arising typically only when someone breaks the rules.

Given the presence of an effective dispute resolution process in the form of contractual appraisal, the insurance industry’s effort to trump a three person, professional, contractual process with what amounts to a star chamber – presided over by an omnipotent defense lawyer – represents a deeply cynical overreach. It is a blatant effort to nullify the appraisal process, and rewrite it with a process entailing a single arbitrator selected by the insurance industry. There is no chance whatsoever that any insurance company would pay an adverse appraisal award, if they can simply have their arbitrator overrule it.

Is there a discount for accepting this arbitration endorsement?

This is where the insurance industry really thinks that Texas consumers are just plain stupid. Recent documents obtained from TDI show that the supposed discount the industry will offer is a complete sham. The proponent of the endorsement, Texas Farm Bureau, raised its rates in the targeted counties, mostly in South Texas. If you accept the endorsement, they’ll then lower your rates by the same amount they just raised them. You read that right. They jack rates up by 25%, then lower them by the same 25%, provided you consent to the single arbitrator process. So, you pay the same as you did before, except now you’ve given up any legal leverage you ever might have to secure a fair payment.

What’s next?

The Texas Department of Insurance will conduct a hearing on the proposed arbitration endorsement on July 6, 2016 at TDI’s offices in Austin. Stay tuned, but speak up if you care about your rights. You can send TDI an email opposing this gambit by clicking on this link from the Texas Watch website.

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.