Month: April 2018

Hurricane Harvey Wind Damage Lawyer

Galveston Condominium Association Files Hurricane Harvey Insurance Lawsuit

Raizner Slania LLP has filed a lawsuit on behalf of a condominium association against Texas Windstorm Insurance Association after its Galveston County Hurricane Harvey wind damage insurance claim was wrongfully denied.

Hurricane Harvey Slams Into Texas Coast

Hurricane Harvey came ashore as a Category 4 hurricane and devastated the Texas coast. When Hurricane Harvey swept through Galveston, Texas, the city and its inhabitants experienced severe gusts of wind up to 54 miles per hour. As a result of Hurricane Harvey’s devastating winds, the building suffered damage to the interiors, exteriors, lighting, elevators, security cameras, and roofing systems, among other components. Immediately upon discovering the damage, the plaintiff filed an insurance claim with Texas Windstorm and asked that the cost of repairs be covered pursuant to the policy.

In response to the claim, Texas Windstorm sent an adjuster to the property on September 29, 2017, who personally observed substantial wind damage resulting from Hurricane Harvey. However, Texas Windstorm relied upon an engineer from BSC Forensics who concluded the damage was not storm related, but instead resulted from long-term trapped moisture, installation deficiencies, and other excuses.

Despite clear evidence of covered damage, Texas Windstorm engaged in and ratified this improper claims conduct and ultimately approved a gross underpayment of the contractual damages. Texas Windstorm instead unreasonably blamed the loss on causes other than wind to avoid contractual responsibilities and to save in excess of $1,000,000. The plaintiff cooperated throughout the claim process and even had consultants meticulously point out the extent of the damages covered by the subject policy.

Texas Windstorm chose to ignore obvious damages to the property. The plaintiff was forced to hire its own representative and demand re-inspections and re-evaluations of the obvious damages to the property that Texas Windstorm ignored.

Texas Windstorm Violated The Texas Insurance Code

Our client alleges Texas Windstorm violated the Texas Insurance Code by failing to adequately pay the claim as it is obligated to do under the terms of the policy in question and under the laws in the State of Texas. Our client also claims Texas Windstorm mishandled the plaintiff’s claim to their detriment by intentionally failing to meet the deadlines or timelines established under subchapter L-1 of Chapter 2210 of the Texas Insurance Code.

Hurricane Harvey Wind Damage Lawyer

Insurance companies have no right to wrongfully deny or underpay valid claims. If you did not receive fair compensation from your Hurricane Harvey wind damage insurance claim, contact Raizner Slania LLP today. Our experienced insurance lawyers can help you get what you deserve under your policy. Call us today to schedule a free consultation to discuss your case.

Reinsurance Issues In Puerto Rico After Hurricane Maria

Practically every insurance company utilizes reinsurance to pass on the risk of claims to other insurance companies, or reinsurers. Reinsurance is basically insurance for insurance companies. In principle, the practice of reinsuring risk should help policyholders get their rightful payments without fear that the insurance company will become insolvent. However, in practice, reinsurers are typically foreign based companies that have no incentive to expediently investigate or pay claims. Most primary insurance companies in Puerto Rico cede the vast majority of the liability from their insurance policies to reinsurers. Since Hurricane Maria, insurers have been so slow to act that Puerto Rico’s Commissioner of Insurance has levied over $2 million in fines to insurers who are delaying the processing and closing of claims.

The Power of Maria

Hurricane Maria was the most powerful storm to hit Puerto Rico in almost 100 years, and it came right on the tail of Hurricane Irma, which had already knocked out power on parts of the island. The island faces billions of dollars of damage and is still, eight months later, not fully recovered. Sadly, with the trend over the last 35 years of increased natural disasters more storms like Maria are to be expected. The problem of reinsurer recalcitrance after natural disasters is not going away.

The Reinsurance Traffic Jam After Hurricane Maria

Many business and commercial buildings were damaged by Maria, and thousands of business policyholders filed claims with the insurer they received their policy from, only to find their insurer had ceded the vast majority of their coverage to a reinsurer. While there is nothing unique about that process, the way the insurance market is structured in Puerto Rico has created a traffic jam preventing insurance capital from flowing back into the economy. Here’s why: the insurance market in Puerto Rico is dominated by thinly capitalized domestic insurers who ceded almost all of their risk to European reinsurance companies. But the primary obligation to inspect properties and handle claims falls to these marginally capitalized primary insurers, some of which are nothing more than fronting entities. Given the vast numbers of claims filed after Maria, these domestic insurers lack the resources and expertise to handle the volume of claims they are being presented with, and many continue to do absolutely nothing with those claims.

Meanwhile, in the United Kingdom, German, Switzerland and elsewhere, the reinsurers who bear the vast majority of the risk on Maria claims are simply watching, waiting, and investing money they should be paying out to rebuild Puerto Rico. The reinsurer generally doesn’t have an obligation to pay until the primary insurer completes its investigation and requests payment; and the primary insurers don’t have the resources to accomplish these basic tasks.

The policy holder now has two companies either unmotivated or incapable of paying out on claims. Recalcitrant, slow paying insurance companies are causing policyholders additional economic hardship in a time when it matters the most. Without prompt payouts some businesses are unable to make the repairs necessary to rebuild and reopen.

Know Your Rights

Recalcitrant reinsurers have been a huge issue in Puerto Rico in the aftermath of Hurricane Maria. There are many ways recalcitrant insurers can slow down the claims process. They have every motivation to do so: most profits for an insurance or a reinsurance company come from the “float,” meaning the cash difference between premiums and claim payouts. Insurers invest the float, and make money on their investments. Even though the insurers are being fined for their wrongful conduct, it is still cheaper for them to pay the fines than to pay the claims. This is a gross violation of the legal rights of the insured. Under Puerto Rico’s insurance laws, policyholders have the right to have their claims handled in a timely manner. Policyholders in Puerto Rico can report abuses by their insurance company to the Commissioner of Insurance. Once reported, the Commissioner of Insurance will investigate these claims and levy fines if the insurance company is found to be acting in bad faith.

Restaurant Insurance Lawyers

Harris County Restaurant Files Fire Damage Insurance Claim Lawsuit

Raizner Slania LLP has filed a bad faith insurance lawsuit for fire damage against Blackboard Insurance Company (formerly known as Hamilton Insurance Company) and Texas General Insurance on behalf of a local restaurant owner.

Catastrophic Restaurant Fire

On September 9, 2017, a catastrophic fire broke out at the restaurant and caused significant damage to the business equipment, which in turn resulted in an extensive loss in income. Soon after the fire, the plaintiff filed an insurance claim and asked that the cost of repairs be covered pursuant to the policy. At the time of the fire, the property was being used in accordance with the plaintiff’s customary operations and business design, the same way the property was being used when the insurance policy was applied for and sold to the plaintiff.

Texas General and one of its agents sold the policy to the plaintiff. However, Texas General and its agent falsely represented to the plaintiff that damages caused by fire, among other things, would be, and indeed are covered by the insurance policy based on the known facts about the business, including the lack of an internal fire alarm system. The plaintiff trusted and relied upon the experience of Texas General and its agent to procure the appropriate coverage for its specialized business needs, and Texas General acted as the agent of Blackboard in connection with the procurement of coverage. Texas General and its agent led the plaintiff to believe the insurance policy secured would cover their business personal property and business income in the event of standard perils, including a fire loss.

Blackboard conducted an unreasonable and inadequate investigation of the damages to the restaurant and looked to find policy exclusions in order to deny the claim. Blackboard wrongfully denied and delayed the plaintiff’s claim for damages to contents and lost business income. Blackboard has chosen to continue to deny and delay timely payment of the damages. Because of Blackboard’s refusal to the pay the claim, the plaintiff has suffered significant economic loss.

Violations Of The Texas Insurance Code

Our client alleges Blackboard violated the Texas Insurance Code by failing to effectuate a prompt, fair, and equitable settlement of the claim and by failing to promptly provide a reasonable explanation for the denial of a claim. Additionally, Texas General and Blackboard misrepresented the policy under which they provided coverage to the plaintiff.

Restaurant Insurance Lawyers

At Raizner Slania LLP, we have extensive experience handling litigation against insurance companies. We provide aggressive, efficient, and effective representation. If you are facing a dispute over a restaurant insurance claim, contact us today for a free consultation to discuss your case.

Hospitality Industry Claims

Hospitality Industry Claims

Rebuilding after a natural disaster can be extremely challenging for any business, but for property owners in the hospitality industry, the challenges are more staggering. Many hotel and motel owners have insurance policies to protect them and their businesses after natural disasters, but when insurance companies use bad faith tactics, the consequences can be fatal for a hospitality industry business.

Hotel And Motel Damage

Like any other property that suffers damage, insurance companies will use a variety of bad faith tactics to minimize or completely deny claims for hotel and/or motel property damage. Oftentimes an insurance company will wrongfully claim that the damage was due to normal wear and tear or inadequate maintenance of the property. While these tactics are incredibly harmful to any business, they are particularly devastating to companies operating within the hospitality industry.

Business Interruption Claims For The Hospitality Industry

Business interruption insurance is a type of insurance designed to compensate business owners for a loss in income after a natural disaster. For example, if a business suffers damage from a fire, the business will be closed while necessary repairs are made. Business interruption insurance covers the loss of income and the costs incurred by the business while it is closed for repairs.

For hotels, business interruption claims often involve a decline in occupancy. Hotels and motels are in high demand after any natural disaster or major storm. Not only are residents displaced, but restoration crews, FEMA workers, insurance adjusters, and contractors flock to the affected area. These individuals need places to stay, so it is incredibly important that damaged hotels and motels can get up and running as fast as possible to benefit from the increased demand.

When insurance companies delay or fail to pay valid property damage claims for hotels and motels, these businesses lose the opportunity to serve the numerous individuals who have been displaced or have come to the area to assist in evaluating and rebuilding. This scenario occurred for many hotel and motel owners after Hurricane Harvey and Hurricane Maria last year. Those hurricanes devastated many buildings in their paths. While some hotels and motels were able to make repairs quickly, others sat boarded up or remained only partially operational, losing significant revenue.

Franchise Owners And Loss of Flag

For hotels and motels that are part of a franchise, delayed or underpaid insurance claims can have additional complications. Hotel franchisors have strict requirements for property condition, so when an insurance company delays or denies a payment, it can put the franchisee at risk of not being able to perform covenants in the franchise agreement.  At the end of the day, if the insurer doesn’t pay and the hotel owner cannot afford to complete the repairs themselves, the owner can lose the right to conduct business under the franchise agreement.  This then results in enormous added costs as the hotel owner seeks a different franchise – or flag – to operate under.

Get Help With Your Hospitality Insurance Claim

If your hotel or motel suffered commercial property damage or an interruption in regular business, don’t wait to contact an experienced lawyer to help with your hospitality insurance claim. Raizner Slania LLP can help you get full compensation under your policy. Call us today for a free consultation to discuss your case.

Commercial Insurance Attorneys

What Is Reinsurance?

Natural disasters have the potential to cause millions of dollars in claims payouts from insurance companies. Most insurance companies would be unable to make such large payouts if it weren’t for reinsurance. Reinsurance is like insurance for insurance companies. It allows insurance companies to pass on the risk of large payouts to other insurers in exchange for part of the premium they receive from policyholders. Commercial insurance attorneys frequently witness firsthand the effect reinsurance has on insurance claims.

Why Do Insurance Companies Need Reinsurance?

By law, insurance companies are required to have enough capital in their reserves to pay all potential claims. This protects policyholders from not receiving payouts if an insurance company becomes insolvent. For example, if an insurance company receives $50 million in premiums from policyholders in a year, but a natural disaster comes and causes $100 million in covered damages, the insurance company may not have enough money to pay out on all the claims. To prevent this, insurance companies will mitigate their risks through reinsurance. When insurance companies utilize reinsurance to mitigate their risks, they are also lowering the amount of capital they are required to have in their reserves.

What Is A Reinsurance Treaty?

A reinsurance treaty is like an insurance policy between insurance companies. The original insurance company contracts under a treaty with the reinsuring company for it to cover a particular type of risk in a group of policies. The original insurance company cedes the risk to a reinsurer and will share the premiums it receives from its own policyholders with them. In turn, the reinsurer will pay out on claims against the original insurer that involve that particular type of risk.

What Is A Reinsurance Bordereau?

An initial reinsurance bordereau is a detailed report to the reinsurer on the premiums ceded from each of the underlying policies. Typically, it includes basic details about each policy including the gross premium and ceded premium. This is how the reinsurer initially finds out the details of the policies they are reinsuring. Bordereaux are usually required periodically under a reinsurance treaty. In this case, they are frequently monthly or quarterly reports of premiums and losses. A loss bordereau will contain details of claims on reinsured policies and any paid-out losses or expenses.

Limitations Placed On Reinsurance

Insurance companies are regulated by the state (or commonwealth in the case of Puerto Rico) governments where they do business. Each state can put limits on how much risk an insurer can cede, but it often is a very high percentage. The Office of the Insurance Commissioner (OIC) of each state can require extra approval for insurance companies to reinsure more than a certain amount of risk. For example, in Puerto Rico an insurer can cede the total or partof their risk, but a domestic insurer needs written authorization from the OIC to cede more than 75%. Various states have similar rules on whether an insurer can cede all or part of its risk to other insurers. Similarly, states and territories may place restrictions on whether an insurer may reflect proceeds due from a reinsurer as an asset on the insurer’s balance sheet, and these limitations are important when insurers calculate their compliance with capitalization rules.

Commercial Insurance Attorneys

The use of reinsurance can complicate the insurance process. Regardless of whether an insurance company has a reinsurance policy, policyholders are entitled to complete protection under their policies. If your insurance company has delayed, underpaid, or denied your insurance claim, contact the commercial insurance attorneys at Raizner Slania LLP today for a free consultation to discuss your case. We have experience dealing with the largest insurance companies in the world and our commercial insurance attorneys can make sure you get what you are rightfully entitled to under your policy.

3M Bair Hugger Claim

Raizner Slania Files 3M Bair Hugger Claim On Behalf Of New York Couple

Raizner Slania LLP has filed a 3M Bair Hugger claim on behalf of a New York couple after the husband obtained a severe infection from the device. The couple alleges that manufacturers 3M Company and Arizant Healthcare failed to adequately warn them of the infection risk associated with the device.

In December 2015, the plaintiff underwent surgery in which the Bair Hugger warming blanket was used throughout the scope of his procedure. The Bair Hugger was used to help regulate the patient’s body temperature during surgery, which can help reduce bleeding risks and shorten hospital stays. However, the design of the Bair Hugger allows for contaminants in the operating room air to be introduced into open surgical wounds.

As a result of the Bair Hugger being used during his surgery, contaminants were introduced into the plaintiff’s open surgical wounds causing him to develop a periprosthetic joint infection (PJI). Plaintiff’s gram stain showed elevated white blood cells, indicating infection, along with elevated sedimentation rate and C-reactive protein. The plaintiff required additional surgeries to treat the infection, and according to the operative report from one of his subsequent procedures, he had pus buildup from his infection.

As a result of the plaintiff’s infection caused by the Bair Hugger, he has undergone extensive medical treatment, including an irrigation and debridement with near complete synovectomy, femoral head and acetabular polyethylene exchange, and PICC line antibiotics, among other treatments.

Not only did the plaintiff suffer physically from the infection caused by the Bair Hugger, but he and his wife also suffered economically, with the cost of additional medical treatment. The couple believes the Bair Hugger device is defective in both its design and manufacture. The couple alleges 3M and Arizant have committed consumer fraud and/or unfair and deceptive trade practices under New York state law.

Get Help With Your 3M Bair Hugger Claim

If you underwent a joint surgery within the last five years and suffered an infection, you may be able to file a claim. The experienced trial attorneys at Raizner Slania LLP can analyze the facts of your situation and help you understand your legal options. We work on a contingency fee basis, meaning you won’t owe us anything unless we help you recover compensation. Call us today to schedule a free consultation to discuss your case.