Raizner Slania LLP has filed an insurance lawsuit on behalf of a commercial property owner in Caddo Parish, Louisiana (“Plaintiff”) against EMC Property & Casualty Company (“EMC” or “Defendant”). The lawsuit was necessary due to the wrongful denial of Plaintiff’s property damage claim.
Severe Wind and Hailstorm Causes Property Damage
On or about May 8, 2019, there was severe wind and hailstorm at Plaintiff’s shopping center, causing significant damage to the property, including the roof systems. After several leaks were found in February 2020, the property manager, on Plaintiff’s behalf, submitted a claim to EMC for payment for the covered damages under the policy.
On February 7, 2020, the Defendant sent a reservation of rights letter indicating it would not be making a coverage determination at that time. After several months with no contact from the Defendant, Plaintiff was forced to hire a licensed public adjuster to represent its interests.
With still no communication from the Defendant on the status of the claim, on or around April 24, 2020, another significant wind and hailstorm struck the Shreveport area, exacerbating the property damage.
Finally, on September 18, 2020, the Defendant sent a consultant to inspect the property. During the inspection, Plaintiff’s personal consultants were also present and specifically identified significant physical damage to the roof systems, HVAC units, and exterior. Plaintiff’s consultants also pointed out the interior damage and leaks caused by the hail damage in support of the claim.
On November 20, 2020 – over 10 months after Plaintiff filed its insurance claim – Defendant sent a denial letter. This letter included the report Defendant’s consultant had prepared, which recognized significant hail dents and impacts, but was carefully drafted to diminish the impact of this obvious damage. The Defendant conveniently and selectively ignored significant evidence of covered hail damage.
Despite the Defendant’s own consultant’s acknowledgment of the hail damage, the Defendant continued to ignore all evidence of the covered damages presented by both the Plaintiff’s and Defendant’s own retained consultants.
On December 7, 2020, Plaintiff sent the Defendant a sworn statement in partial proof of loss, which outlined in detail the extent and nature of its loss. However, the Defendant rejected the proof of loss by email on December 8, 2020; and, to date the carrier has paid nothing to the Plaintiff.
The Insurance Carrier Breached its Contract and Acted in Bad Faith
Under LSA-R.S. 22:1892, an arbitrary, capricious, and without-probable-cause failure to pay benefits owed subjects an insurer to a penalty of 50% of amounts due plus reasonable and necessary attorneys’ fees and costs incurred.
Plaintiff additionally alleges the carrier breached its contract, breached its duty of good faith and fair dealing, and acted in bad faith by:
- Unreasonably and in bad faith denying benefits due under the property and casualty insurance policy.
- Unreasonably and in bad faith denying payment or settlement of claims.
- Unreasonably and in bad faith ignoring and refusing to consider information favorable to Plaintiff’s claim for benefits due pursuant to the property and casualty insurance policy.
- Unreasonably and in bad faith refusing to pay the benefits Plaintiff is due pursuant to the property and casualty insurance policy.
- Unreasonably and in bad faith placing its own welfare and financial interests ahead of the welfare and financial interests of the Plaintiff.
- Unreasonably and in bad faith compelling Plaintiff to institute this litigation to obtain benefits due under the property and casualty insurance policy.
- Misrepresenting pertinent facts or insurance policy provisions relating to any coverage at issue.
- Failing to pay the amount of any claim due to any person insured by the contract within 60 days after receipt of satisfactory proof of loss from the claimant.
- Failing to pay claims pursuant to R.S. 22:1893 when such failure is arbitrary, capricious, or without probable cause.
Insurance Coverage Attorneys
If you are a commercial property owner whose wind and hailstorm insurance claim has been wrongfully delayed, denied, or underpaid, the insurance coverage attorneys at Raizner Slania can help. Contact us today to see how we can best assist you.
