Month: November 2018

Hurricane Harvey insurance lawsuit

Padre Island, Texas Hotel Owner Files Hurricane Harvey Insurance Lawsuit

Raizner Law has filed a Hurricane Harvey insurance lawsuit on behalf of a Padre Island, Texas hotel owner against Greenhill Group LLC, First Specialty Insurance Corporation, Evanston Insurance Company, and Scottsdale Insurance Company. Our client alleges its Hurricane Harvey insurance claim was wrongfully denied under Texas law.

Our client owns a six-story hotel situated on 126,354 square feet of land with 79,810 square feet of interior space. The building is a well-known hotel and conference facility in the Corpus Christi area, and it contains guest rooms, meeting/reception areas, office space, a fitness area, laundry facilities, a restaurant and bar, and kitchen facilities.

On August 25, 2017, Hurricane Harvey, recognized as one of the most devastating natural disasters in United States history, made landfall on the Texas coast in San Patricio County and Aransas County as a Category 4 hurricane. Wind gusts of up to 132 miles per hour were reported in the same area as the property. As a result of Harvey’s extreme winds and rain when it hit Nueces County and specifically the property, the hotel suffered substantial damage. Sizeable portions of the property’s roof were compromised by wind, which in turn caused damage to the interior of the property, electrical components, ceilings, flooring, and HVAC.

Immediately upon discovering the damage, the plaintiff filed insurance claims with the carriers. As the primary insurer on the property, First Specialty took the lead during the claims handling process; however, its claims-handling process resulted in wrongful denials and gross underpayments that omitted a wealth of facts, physical evidence, obvious wind damages, and meteorological data from Hurricane Harvey supporting the plaintiff’s claim. First Specialty unreasonably pinned the loss on anything but the wind, an action designed to save the insurance company and the other carriers millions of dollars in damages to the property and the business.

Specifically, First Specialty assigned unqualified consultants and adjusters to handle the claim and ignored damages the adjusters initially accepted. First Specialty retained a preferred vendor to handle the initial adjustment. After an inspection on September 13, 2017, First Specialty’s adjuster verbally confirmed coverage and damages of millions of dollars to the building structure alone; however, those amounts were never paid. Rather, First Specialty sent additional consultants out in order to minimize the claim payout to the plaintiff. On September 20, 2017, additional adjusters were sent to the property and admitted they personally observed substantial Hurricane Harvey wind damage.

Acting with authority on behalf of the carriers, the adjusters conceded that millions of dollars were owed on the claim and verbally offered an undisputed amount to pay the insured’s claim. Despite this legally binding agreement, the carriers reneged on their promise, and continued to delay the claim until its partial denial in May 2018. To this day, the plaintiff has not been properly paid for property damage, and has suffered significant economic hardship not only in the cost of repairs but also in lost business income.

Violations of the Texas Insurance Code

Our client cites numerous violations of the Texas Insurance Code, including failure to promptly provide a reasonable explanation for the denial of a claim and misrepresenting the terms of the policy under which it affords property coverage to the plaintiff. Our client also claims the carriers violated the Texas Deceptive Trade Practice Act.

Fighting For Hurricane Harvey Victims

It’s a shame that Hurricane Harvey victims have to fight so hard for the compensation they are rightly entitled to under their insurance policies. Raizner Law is helping Hurricane Harvey victims with bad faith insurance claims. If your Hurricane Harvey insurance claim has been denied or underpaid, contact us today for a free consultation to discuss your case.

Bad Faith Insurance Denials

Raizner Law Files Bad Faith Insurance Lawsuit On Behalf of Harris County Commercial Property Owner

Raizner Law has filed a bad faith insurance lawsuit on behalf of a Harris County, Texas commercial property owner against Underwriters at Lloyd’s, London after its Hurricane Harvey damage insurance claim was wrongfully denied.

Our client owns a one-story building situated on 21,875 square feet of land with 13,261 square feet of interior space. The building houses several separate businesses. On August 25, 2017, Hurricane Harvey came ashore along the Texas coastline as a Category 4 hurricane. As a result of Hurricane Harvey’s extreme winds and rain, large portions of the property’s roof were damaged. Because the roof was compromised, there was also damage to the interiors, ceilings, walls, and flooring of the property.

Immediately after the storm, the plaintiff filed an insurance claim with Lloyd’s, asking that the cost of repairs be covered pursuant to the policy. Although Texas law provides an insurer has a “non-delegable duty” to responsibly handle claims, Lloyd’s does not have a single employee in Texas so they delegated the claim to a third party administrator.

The third party administrator’s adjustment was disorganized, rife with delays, and left many of the insured’s questions unanswered. The plaintiff hired its own representative to assist with the claims process, but adjusters continuously ignored the plaintiff’s representative in an effort to intentionally mislead the insured about the claims process and ultimately deny the claim.

The third party administrator, its adjusters, and Lloyd’s refused to provide any scopes of damage or answer any questions about the status of the claim, despite the plaintiff’s multiple requests. Additionally, they failed to complete an adequate inspection and refused to acknowledge all the damages to the property. In the denial letter, the third party administrator and Lloyd’s stated the “only portion” of the property damaged by Harvey was a small section of the porch, which fell below the policy’s deductible. While they did acknowledge “extensive water damage” at the property, the companies stated the water damage was a result of “improper roof drainage, age-related deterioration to the roof covering and metal decking and deferred maintenance,” which while boilerplate exclusions under the policy, were not supported by any relevant facts or data.

Lloyd’s Violated The Texas Insurance Code

Lloyd’s violated numerous sections of the Texas Insurance Code, including failure to effectuate a prompt, fair, and equitable settlement of a claim, refusal to pay a claim without conducting a reasonable investigation, and misrepresenting the policy under which it affords property coverage to the plaintiff.

Get Help With Bad Faith Insurance Denials

If you regularly pay your premium, you deserve complete protection under your insurance policy. Insurance companies have no right to issue bad faith insurance denials solely in an effort to help them save money. If your insurance company is acting in bad faith, contact Raizner Law today for a free consultation to discuss your case.

Concussion Injury Lawyer

Ohio Supreme Court Ruling Makes it Clear that Concussions are Latent Injuries

Many former collegiate football players no longer think of their time playing football as the “Glory Days.” Instead of looking back at this time joyfully, they are saddened and angered by the National Collegiate Athletic Association’s (NCAA) failure to protect them from the long-term consequences of concussions. While it may have been decades since they stepped on the field, many former football players are suffering from debilitating neurological conditions and side effects. Although nothing can undo the damage, players can at least seek justice. And, a recent Ohio Supreme Court ruling is ensuring that former players may continue to hold the NCAA accountable despite the passage of time.

The widow of a former University of Notre Dame football player filed a lawsuit against the school and the NCAA on behalf of her deceased husband who played football for the university in the 1970s. The lawsuit was filed in 2014, but unfortunately the former football player died in February 2015. Prior to his death, the football player suffered from early onset Alzheimer’s disease and dementia. He was diagnosed postmortem by the Cleveland Clinic with Chronic Traumatic Encephalopathy or CTE. CTE is a degenerative neurological disease that can not only lead to Alzheimer’s and dementia, but also other diseases, such as ALS and Parkinson’s.

Notre Dame and the NCAA argued that the statute of limitations had expired and asked the court to drop the case immediately. An Ohio Supreme Court judge disagreed, stating that the injuries suffered by the football player were latent, and therefore not subject to the statute of limitations. The Ohio Supreme Court then ruled the case can proceed to trial.

Why Is This Ruling Important?

While some side effects of concussions are immediate, much of the damage doesn’t cause side effects until years afterwards. When the brain sustains a concussion, brain cells die, and when brain cells die, they release a protein called Tau proteins or T-proteins. T-proteins cause additional brain cell death over time and can build up in individuals – like football players – that suffer repeated concussions.

Because of the nature of the injury, many football players don’t experience serious symptoms until years later. The NCAA previously used this to their advantage in trying to dismiss cases based on the expiration of the statute of limitations; however, the Ohio Supreme Court ruling ensures former NCAA football players can have their day in court with the organization and the universities that failed to protect them.

File an NCAA Concussion Lawsuit Today

If you played collegiate football for an NCAA regulated team, you might have many questions. Raizner Law is currently representing former NCAA football players in lawsuits against the organization. Get in touch today, so we can help explain your legal options and pursue compensation on your behalf.

Aetna

Insurance Giant Aetna Slammed With $25.5 Million Bad Faith Jury Verdict

Insurance is a critically important financial safety net for most Americans. People pay into a system that will protect them financially in the event of a disaster or catastrophic medical treatment. However, this system only works if insurance companies honor their agreements. When insurers face large claim payouts, they sometimes resort to inappropriate tactics to minimize claims and wrongfully deny payouts. But policyholders were handed a powerful win recently when insurance giant Aetna was slammed with a $25.5 million jury verdict for wrongfully denying coverage for cancer treatment.

In 2014, Orrana Cunningham was denied coverage for treatment of her Stage 4 nasopharyngeal cancer located near her brainstem. Because of the cancer’s location, ordinary radiation therapy would cause blindness, memory loss, and other debilitating side effects. Her doctors instead recommended a targeted form of radiation called proton beam therapy.

Mrs. Cunningham was denied coverage for proton beam therapy because Aetna deemed the treatment “experimental” and therefore not covered under her policy. However, as expert witnesses explained during the recent jury trial, proton beam therapy has been used successfully for decades, hardly making the treatment experimental.

Radiation oncologist Dr. Andrew L. Chang explained it best when he told the jury, “Proton therapy is a well-established treatment for cancer and has been for decades. … Nobody in the oncology community considers proton therapy experimental for the treatment of cancer.” Dr. Chang also pointed out that Medicare covers proton beam therapy, as do most pediatric plans for patients up to 21 years old. If insurance companies covered the cost of this treatment for patients under 21 and over 65, what exactly makes it experimental for those between the ages of 22 and 64?

Nothing does, according to an Oklahoma jury. Mrs. Cunningham died in 2015, and an Oklahoma jury believed it was important to send Aetna a message, awarding $25.5 million in damages to Mrs. Cunningham’s spouse. One might think the verdict would give Aetna a sense of responsibility or remorse. But unfortunately, lesson about bad faith insurance denials, but this is unlikely. Mr. Cunningham reported that after the verdict was read aloud in the courtroom, Aetna’s lead congratulated him on the verdict before telling him he would lose on appeal.

Insurance Companies Prey On Policyholders

Insurance companies rely on uninformed policyholders. Most policyholders are completely unaware of their rights and the actions they can take against insurance companies operating in bad faith. Insurance companies are aware of this, so they often utilize bad faith tactics hoping they don’t get caught – because most of the time they don’t. This is wrong, and every policyholder has a right to stand up to insurance companies that wrongfully deny claims. Whether you own a commercial property insurance policy or health insurance policy, you deserve full coverage.

Fight Back With Raizner Law

At Raizner Law, our experienced insurance lawyers pursue claims against insurance companies that deny cancer treatment. If your insurance company is delaying, undervaluing, or outright denying your claim for medically necessary cancer treatment, contact us today to see how we can help. All of our consultations are free and we work on a contingency fee basis, meaning there is no upfront cost for working with us, and you won’t owe us anything unless we help you recover compensation.

Building reduced to a pile of wood as a result of damage caused by Hurricane Harvey.

Portland, Texas Hotel Owner Files Lawsuit After Wrongful Denial Of Hurricane Harvey Claim

Raizner Law has filed a lawsuit on behalf of a Portland, Texas hotel owner against Palomar Specialty Insurance Company after its Hurricane Harvey insurance claim was wrongfully denied under Texas law.

Our client owns and operates a four-story hotel situated on 147,668 square feet of land with 17,324 square feet of interior space and a 1,440 square foot canopy. The building houses guest rooms, meeting/reception areas, office space, and kitchen facilities. On August 25, 2017, Hurricane Harvey made landfall on the Texas coast as a Category 4 hurricane. Within the same area as the subject property, wind gusts were recorded as high as 132 miles per hour; and, the National Weather Service has stated these wind speeds are likely underestimated in coastal areas, such as San Patricio County, due to disabled equipment at the time of Hurricane Harvey’s landfall.

As a result of Harvey’s extreme winds and rain when it hit Portland, Texas and specifically the subject property, the hotel was substantially damaged. Sizeable portions of its roof were compromised by wind, which caused additional damage to the interior, including damaged ceilings, walls, and flooring. Immediately upon discovering the damage, the plaintiff filed an insurance claim with Palomar and asked that the cost of repairs be covered pursuant to the policy.

In response, Palomar assigned the claim to an internal adjuster that was unqualified and incapable of adequately assessing the damages to the property. After utilizing a preferred vendor to inspect the property in September, Palomar and the adjuster continued to delay claim resolution and ignored the insured’s requests for updates. The plaintiff continued to press Palomar for updates – or any estimate of damages after their inspection – but they declined and ignored the requests.

Months after the inspections and after the plaintiff continuously pressed Palomar and the internal adjuster for updates, the internal adjuster responded to the plaintiff’s representative’s request for a copy of the revised estimate by simply stating “Not until I receive authority. Sorry.” The internal adjuster then followed up with more requests for repair documentation. To this day, due to Palomar’s outcome-oriented, inadequate, and haphazard investigation, Palomar has refused to fully pay for the damages covered under the policy.

Palomar Violated The Texas Insurance Code

Our client alleges Palomar violated numerous sections of the Texas Insurance Code, including failure to adopt and implement reasonable standards for prompt investigation of the claim, failure to provide promptly a reasonable explanation for the denial of a claim, and refusing to pay the claim without conducting a reasonable investigation.

Get Help Against Insurers Acting in Bad Faith

Insurance companies have no right to regularly accept your premium payments, but not provide the coverage promised. If your insurance company is delaying, undervaluing, or denying your Hurricane Harvey insurance claim, contact Raizner Law today for a free consultation to discuss your legal options.

Hartford Fire Insurance

Raizner Law Files Hurricane Harvey Damage Lawsuit Against Hartford Fire Insurance Company

Raizner Law has filed a Hurricane Harvey insurance lawsuit on behalf of a commercial property owner against Hartford Fire Insurance Company after its insurance claim was wrongfully denied under Texas Law.

The plaintiff owns three one-story commercial properties in Houston, Texas, totaling 66,350 square feet of combined interior space. Unfortunately, on August 25, 2017, Hurricane Harvey came ashore along the Texas coast and caused widespread devastation. When Hurricane Harvey swept through Houston and specifically the plaintiff’s properties, it caused significant damage. Sizeable portions of the properties’ roofs and exterior were compromised, which in turn caused interior damage to ceilings, insulation, and flooring.

Immediately upon discovering the damage, the plaintiff filed an insurance claim with Hartford and asked that the cost of repairs be covered pursuant to the policy. Hartford’s claims-handling process resulted in a wrongful denial that omitted a wealth of facts, physical evidence, obvious wind damages, and meteorological data from Hurricane Harvey supporting the plaintiff’s claim.

Hartford conducted inspections that ignored obvious and extensive damages from Hurricane Harvey at the properties and were conducted with the intent to simply deny the claim. The inspectors were not qualified to assess the commercial property damages, and as a result, the inspections were haphazard, rushed, and incomplete. Hartford unreasonably stated in its reports that “the roofs had not been damaged by Harvey and no other storm-caused opening existed” in an effort to avoid contractual responsibilities and to save Hartford significant sums of money.

Hartford Violated The Texas Insurance Code

Our client alleges Hartford violated numerous sections of the Texas Insurance Code, including failure to effectuate a prompt, fair, and equitable settlement of a claim, refusal to pay the claim without conducting a reasonable investigation, and misrepresentation of the insurance policy under which it affords coverage. Our client also claims Hartford violated the Texas Deceptive Trade Practices Act.

Get Help With Your Hartford Insurance Claim

If you are struggling with a Hartford insurance claim or any other Hurricane Harvey insurance claim, contact Raizner Law today. We help policyholders protect their rights and get the compensation they are rightfully owed under their policies. Contact us today for a free consultation to discuss your case.