Author: Jeff Raizner

undisputed payment

Insurance Companies Using Undisputed Payment As Leverage In Puerto Rico

There are many laws that dictate what insurance companies can and cannot do when investigating, adjusting, and paying out on claims. Specifically, policyholders everywhere are protected from insurance companies leveraging undisputed payments to convince policyholders to accept lower payments on disputed damages. Unfortunately, the insurance industry is not complying with this legal and ethical requirement in Puerto Rico, and as a result many Hurricane Maria victims were forced into accepting low-ball settlements.

Undisputed Payments

In most states, insurance companies have an obligation to investigate a claim and issue payment for undisputed damages, allowing for quicker payment of accepted damages. However, in the aftermath of Hurricane Maria, policyholders were not aware of this protection and insurance companies used it to their advantage.

After Hurricane Maria, insurance companies were in no hurry to pay out on claims and they wanted to mitigate the amount they owed. One way they did this was by withholding payment for undisputed damages until policyholders accepted an amount of damages for the disputed portion. It has become unfortunately common for policyholders to accept low-ball settlements for disputed damages just to receive any payment at all. The law in Puerto Rico has since been clarified, but far too late for many policyholders. The insurance companies in Puerto Rico took advantage of the situation, to the detriment of thousands of policyholders. This checkbook power was used to deny thousands of proper and fair payments due to Puerto Ricans.

Hurricane Maria Recovery

It’s been over a year since Hurricane Maria devastated Puerto Rico, but the island is far from a full recovery. Insurance companies in Puerto Rico have been slowing down recovery with their reluctance to pay out on valid claims. In Puerto Rico, insurance companies are required to respond to claims within a certain period of time, but many have simply ignored the requirement. Puerto Rico’s Commissioner of Insurance has levied millions of dollars in fines against insurance companies for acting so slowly, but even this has not spurred them to action.

Get Help With Recovery

At Raizner Law, we believe policyholders shouldn’t be denied their rightful payments from insurance companies. We are helping Hurricane Maria victims with bad faith insurance claims protect their rights and get the compensation they need to rebuild. If your insurance company has delayed, underpaid, or denied your Hurricane Maria claim, contact us today for a free consultation.

Hurricane Harvey bad faith insurance lawsuit

Harris County, Texas Hospital Files Hurricane Harvey Bad Faith Insurance Lawsuit

Raizner Law has filed a Hurricane Harvey bad faith insurance lawsuit on behalf of a Harris, County hospital against Valley Forge Insurance Company, CAN Insurance, and Engle Martin & Associates. Our client alleges numerous violations of the Texas Insurance Code.

The property consisted of 51,114 square feet of finished space, at three stories high, and had a porte-cochere at the main entrance. On August 25, 2017, Hurricane Harvey came ashore along the Texas coast and caused devastating damage throughout the state. Hurricane Harvey’s wind and rainfall caused billions of dollars of damage in Fort Bend and Harris Counties alone.

As a result of Hurricane Harvey’s wind, the Harris, County hospital property suffered significant damage. Sizable portions of the roofs and exterior were compromised by wind. As a result, Hurricane Harvey’s rainfall was able to enter the building and cause damage to the interior.

Immediately upon discovering the damage, the plaintiff filed an insurance claim with the insurance carriers and asked that the cost of repairs be covered pursuant to its policy. In response to the claim, Valley Forge assigned internal adjusters with CNA to the claim. CAN then, in turn, engaged representatives to handle the claim who were improperly trained as to their responsibilities, and who were directed to and did minimize claim payments, delaying the reconstruction project. Sixteen months after Hurricane Harvey severely damaged the property, based on inadequate investigations, wrongful delays, and refusals to fully pay for reasonably clear damages, Valley Forge has not issued payment.

Valley Forge has unreasonably blamed the loss on “pre-existing opening/deficiencies” and has denied Hurricane Harvey played any role in the property damage. Valley Forge did this in an effort to avoid its contractual responsibilities and to save significant sums of money.

Valley Forge Acted 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 adopt and implement reasonable standards for the prompt investigation of claims, and the misrepresentation of the insurance policy under which it provides property coverage to the plaintiff.

Hurricane Harvey Bad Faith Insurance Lawsuits

Insurance lawsuits involving hospitals are always extremely complex. These claims involve structures that have specialized building systems and complexes and expensive medical equipment. Only an experienced insurance lawyer can help hospitals recover the true cost of repairs. Raizner Law is representing Hurricane Harvey victims in lawsuits against dishonest insurance companies including area hospitals. We have extensive experience handling hospital claims against some of the largest insurers in the country. If your insurance company is delaying, underpaying, or outright denying your claim, contact us today for a free consultation to learn your legal options.

Hurricane Maria Insurance Claims

What Is Xactimate and How Could It Help Hurricane Maria Victims?

It’s been nearly a year and a half since Hurricane Maria, and victims are still struggling with insurance companies over property damage claims. Commonly used insurance software could help policyholders get their rightful compensation, but some insurance companies in Puerto Rico are refusing to use it. It’s called Xactimate, and while you likely have never heard of it, it’s crucial to the insurance claims industry.

What is Xactimate?

Xactimate is software used by insurance adjusters, insurance companies, and contractors, among others, to estimate the cost of building and repairing properties. Many insurance companies use Xactimate or a similar software platform to value insurance claims. Xactimate contains pricing databases for all sorts of materials, labor, products, and consumer goods so an estimate of damages can easily and quickly be put together. Xactimate also adjusts prices for specific to locations to ensure estimates include objective pricing. Xactimate’s calculations are considered an objective industry standard for valuing insurance claims.

Insurers Refuse To Use Xactimate On Hurricane Maria Insurance Claims

Insurance companies in Puerto Rico are frequently refusing to use Xactimate, instead, relying on subjective, non-standard methods to value insurance claims. Insurance companies are doing this in an effort to devalue claims and reduce the amount of money they have to pay out to policyholders. For an island already devastated by a natural disaster, this unfair insurance practice comes as yet another blow.

Puerto Rico has had an incredibly slow recovery in part because the island’s infrastructure was damaged in the storm, but mainly because of the dilatory tactics of many insurance companies. To compound the problem, foreign reinsurers dominate most of the insurance market in Puerto Rico, and they are reluctant to process and pay out on claims. This has led to policyholders waiting for months to hear the outcome of their claims, extreme undervaluation of damages, and outright denials. The only choice for many policyholders is to pursue a legal claim in order to obtain their rightful compensation.

Helping With Hurricane Maria Insurance Claims

Raizner Law is helping policyholders with Hurricane Maria insurance claims. We believe insurance companies have no right to withhold the funds property owners need to rebuild. Contact us today for a free consultation to see how we can help.

Rockport Insurance Claim Denial Lawyers

Raizner Law Files Hurricane Harvey Lawsuit On Behalf of Rockport Movie Theater

Raizner Law has filed a Hurricane Harvey bad faith insurance lawsuit on behalf of a Rockport, Texas movie theater owner against State Farm Lloyds after its insurance claim was wrongfully denied under the Texas Insurance Code.

Hurricane Harvey Makes Landfall Near Rockport, Texas

The plaintiff owns a movie theater in Rockport, Texas, that is a one-story building with over 90,000 square feet of interior space. On August 25, 2017, Hurricane Harvey came ashore in Aransas County and San Patricio County as a Category 4 Hurricane. Wind gusts in Rockport, Texas were reported up to 150 miles per hour; and, the First American Weather Service has stated these wind gusts could be underestimated in coastal areas because measuring equipment was damaged by the storm. Hurricane Harvey continued to travel through southeast Texas, inflicting billions of dollars in damages to private and public property.

As a result of Harvey’s extreme winds and rain when it hit the Texas coast, the property was substantially damaged. The catastrophic wind and rain caused substantial damage, including damage to the signage, furniture, fixtures, cameras, movie theatres, screens, and more. Immediately upon discovering the damage, the plaintiff filed an insurance claim with State Farm and asked that the cost of repairs be covered pursuant to the policy.

State Farm’s claim-handling process omitted important facts, physical evidence, and meteorological data supporting the plaintiffs’ claim and extensive losses and resulted in a wrongful underpayment. State Farm underpaid the plaintiff’s claim for the covered damage to the property and the plaintiff’s loss of business/business interruption claim.

The plaintiff was forced to hire its own consultants, who identified dramatic damage that ruined the building’s interior and business personal property. Despite clear evidence of covered damages, State Farm failed to issue the full payment owed under the insurance policy covering the plaintiff’s property and instead authorized continued delays and underpayments.

State Farm Violated The Texas Insurance Code

Our client alleges State Farm violated numerous aspects of the Texas Insurance Code, including failing to attempt to effectuate the prompt, fair, and equitable settlement of a claim and failuring to adopt and implement reasonable standards for prompt investigation of a claim.

Rockport Insurance Claim Denial Lawyers

Raizner Law is helping Rockport business owners with dishonest insurance companies who are wrongfully underpaying and denying Hurricane Harvey claims. If your Hurricane Harvey claim was denied, call us today to schedule a free consultation to see how we can help.

Hurricane Harvey Insurance Lawsuit

Texas Hospital Files Hurricane Harvey Insurance Lawsuit

Raizner Law has filed a Hurricane Harvey insurance lawsuit on behalf of a Texas hospital against Underwriters at Lloyd’s London, Fair American Select Insurance Company, and Engle Martin & Associates. Our client alleges its Hurricane Harvey insurance claim was wrongfully denied under Texas law.

The plaintiff is a hospital consisting of six different buildings. The main hospital was built on four acres of land and is currently a three-story building with four separate wings. On August 25, 2017, Hurricane Harvey made landfall off the Texas coast as a Category 4 Hurricane. Wind gusts in the vicinity of the property were recorded up to 132 miles per hour. This wind caused sizable portions of the roof to be compromised, which in turn caused interior damage to the buildings during Harvey’s unprecedented rainfall.

Upon discovering the damages, the plaintiff filed an insurance claim with Lloyd’s and Fair American and asked that the cost of repairs be covered pursuant to the policy. In response, Lloyd’s and Fair American assigned the claim to Engle Martin & Associates. The adjusters assigned to the claim by Engle Martin were unqualified and incapable of adequately assessing the damages to this type of commercial property. These adjusters were also the source of many delays throughout the claims process. Fifteen months after the Hurricane Harvey winds severely damaged these properties, based on inadequate investigation, wrongful delays, and refusals to fully pay for reasonably clear damages, the carriers had only issued partial payment. Despite clear evidence of covered replacement costs and mitigation of damages, the carriers failed to issue the full payment owed under the insurance policy covering our client’s property and instead authorized continued delays and underpayments.

Violations of the Texas Insurance Code

Our client alleges Lloyd’s, Fair American, and Engle Martin violated numerous aspects of the Texas Insurance Code, including failing to attempt to effectuate the prompt, fair, and equitable settlement of a claim and failure to adopt and implement reasonable standards for prompt investigation of the claim.

Get Help With Your Hurricane Harvey Insurance Lawsuit

Raizner Law is a national insurance claim litigation firm that handles commercial property insurance claims, residential property insurance claims, and bad faith claims. Our dedicated team of insurance attorneys is committed to resolving your property insurance claims. Many insurance companies prey upon uninformed policyholders unaware of their legal rights. If your insurance company is denying your claim, Raizner Law can help you with a Hurricane Harvey insurance lawsuit. Contact us today for a free consultation.

NCAA Concussion Lawsuit

Researchers Take A Closer Look At Concussions In Youth Football

Both amateur and professional football players are struggling to understand how their time playing football has caused them to suffer long-term neurological damage. While a number of studies have looked into how to help these players, very few studies have looked at concussions in young players. Now, researchers from Boise State University have teamed up with St. Luke’s Hospital to try and understand how younger players are affected.

In a recently released study, researchers looked at the flow of fluid across white matter tracks in the brain in young football players both pre and post season. Researchers wanted to look at white matter because it serves as a communication path, similar to an electrical wire, between the brain and spinal cord. White matter is crucial for motor control, and when it is healthy, fluid flows in a single direction down the communication path. When a person suffers a concussion, however, the swelling caused in the brain can disrupt these paths, which in turn disrupts the flow of fluid. By examining the flow of fluid, researchers were able to better understand head injuries. The study found a concerning pattern among the football players. As the magnitude of hits increased, the player usually had a greater diffusion of fluid in the left cingulate cortex.

While a better understanding of concussions in young player can greatly help improve the safety of the sport and prevent long-term injuries, many former football players are already suffering from their time spent on the field. Hundreds of former NCAA football players are seeking to hold the organization responsible for not doing enough to protect them from the dangers of concussions. Some of these players began experiencing neurological symptoms while still playing football, but for many the first signs did not appear until long after their last game.

NCAA Concealed Concussion Dangers

Studies linking concussions sustained while playing football to long-term conditions such as Parkinson’s, Alzheimer’s, and ALS have existed for decades. Despite this evidence, the NCAA did not adopt concussion protocols that could have lessened the long-term effects until 2010. The NCAA also failed to educated student athletes about the dangers of concussions. As the organization overseeing the health and wellbeing of its student players, the NCAA had a responsibility to them to protect them from harm incurred on the field. Instead, the NCAA chose to put profits first.

Join The NCAA Concussion Lawsuit

Raizner Law is representing former collegiate football players in their fight against the NCAA. If you would like to learn about your legal options, contact us today for a free consultation to learn about filing an NCAA concussion lawsuit.