Category: Insurance Claim Lawsuits

Insurance companies exist to provide an individual or entity financial protection or reimbursement from loses. These types of contracts can be full of confusing and sometimes conflicting information as well as fine print the average person may not be aware of. Although the companies are supposed to protect their clients, often they will deny, delay, or dispute claims to prevent having to provide compensation. The attorneys of Raizner Slania file lawsuits against these insurance companies acting in bad faith and fight for their client’s right to reimbursement.

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.

Laredo Hail Damage Claims

Laredo Property Owners Still Recovering From Hail Storm

It’s been nearly a year since golf ball sized hail pelted areas of Laredo, Texas, but business owners are still struggling with the storm’s aftermath. Hail causes significant damage to anything in its path, and with many surplus lines insurers operating in a grey area of the Texas insurance market, policyholders are caught between insurance companies wrongfully denying claims and hail damage they can’t afford to fix themselves.

May 2017 Hail Storm

While hail is not an uncommon occurrence in Texas, the hail storm that swept through Laredo on May 21, 2017, was unique in its duration. The storm produced hail for nearly two hours. A maximum hail size was reported at 2.75 inches, but on average the hail was 1.83 inches in diameter. The storm covered a wide area, affecting approximately 38,562 buildings in Laredo and Zapata, Texas. Weather stations measured the storm’s wind gusts up to 56 miles per hour, meaning buildings were being showered with golf ball sized hail.

Laredo’s Mayor quickly declared the city a disaster area after the storm. In order to declare a city a disaster area, damages must exceed $900,000; but in this case, the damage to the World Trade Bridge in Laredo alone is estimated to be approximately $1 million.

How Hail Damage Claims Are Wrongfully Denied

Hail damage claims are particularly painful for insurance companies, often causing billions of dollars in payouts each year. However, insurance companies are first and foremost a business, which means anytime an area is damaged by a hail storm, insurance companies are quick to minimize claims.

Although hail damage might seem obvious, there are several ways insurance companies might try to release themselves from liability. An insurance company might claim the alleged hail damage isn’t actually hail damage but damage caused by the regular wear and tear caused over time. Insurance companies might also try to blame the damage on inadequate maintenance to the property, faulty construction, and/or manufacturing defects of the damaged components.

What This Means For Policyholders

The bad faith tactics used by many insurance companies to wrongfully deny or underpay claims put an extreme burden on policyholders. Many will be forced to pay out of pocket for repairs their insurance company should have covered. Policyholders need to understand that they have rights. If you have regularly paid your premium, you are entitled to full compensation under your policy.

Laredo Hail Damage Claims

If your business was damaged in the Laredo hail storm last May and you are still struggling with your insurance company, you need to immediately call Raizner Slania LLP. Don’t let your insurance company delay, deny, or underpay your claim. We can help with your Laredo hail damage claims and get you the compensation you are entitled to.

Hurricane Harvey Wind Claim

Medical Office Owner Files Bad Faith Insurance Lawsuit After Hurricane Harvey

Raizner Slania LLP has filed a bad faith insurance lawsuit on behalf of a Houston medical office owner against Acceptance Indemnity Insurance Company after its insurance claim was wrongfully denied.

Acceptance has a history in Texas of conducting arbitrary, outcome-oriented investigations intended to deny legitimate claims. Despite Acceptance (and its parent company, IAT Insurance Group) collecting substantial amounts each year from Texas in premiums, Acceptance has intentionally shielded itself from regulation by the Texas Department of Insurance by remaining a non-admitted foreign surplus lines carrier.

Instead, the company rewards claim representatives and consultants who identify grounds to exclude property damage claims under their policies, in violation of Texas law and the provisions within the insurance contract. It is for these reasons that Acceptance/IAT Insurance Group has been sued many times in the last few years in Texas with continual allegations of bad faith, fraud, and misrepresentations being levied against it. Acceptance often settles cases and requires stringent “confidentiality agreements,” so the wronged policyholders are not permitted to tell their stories.

Hurricane Harvey Devastates Texas

Hurricane Harvey came ashore on August 25, 2017 as category 4 hurricane. Our client’s property suffered substantial wind damage from Hurricane Harvey. Immediately upon discovering the damage, our client filed an insurance claim with Acceptance.

Because Acceptance does not have a single employee in Texas, they assigned The Artisan Works Group to handle the claim. Although Texas law provides that an insurer has a “non-delegable duty” to responsibly handle claims, delegate is precisely what foreign insurance entities like Acceptance do on a regular basis. Artisan Works commenced its investigation by assigning the claim to a local adjuster.

The local adjuster observed that hurricane force winds ripped up the roof seams, causing “severe” saturation to the roofing system and leaking into the interior of the building. The adjuster strongly recommended a full roof replacement due to the wind damage, replacement of ceiling tiles (in affected rooms), and significant repair to the drywall and insulation (above the flood line). Subsequently, Acceptance asked the adjuster to revise his estimate on two separate occasions. Ignoring the obvious damages already conceded in writing, the adjuster and Artisan Works Group did what they were ordered to do by Acceptance and lowballed the claim.

Acceptance derailed the claim process, contending the water entry was not due to a storm created opening and that only a roof repair was warranted despite blatant evidence of the roof caving in. Without consulting any experts, Acceptance refused to pay the claim. Acceptance’s refusal to pay for necessary repairs has crippled our client’s ability to operate its business.

Acceptance Engaged In Deceptive And Unfair Trade Practices

Our client cites numerous violations of the Texas Insurance Code, alleging Acceptance failed to effectuate a prompt, fair, and equitable settlement of a claim and that Acceptance misrepresented the insurance policy under which it affords coverage to the policyholder.

Get Help With Your Hurricane Harvey Wind Claim

Hurricane Harvey caused billions of dollars of property damage. Insurance companies are desperate to limit Hurricane Harvey claims payouts. If your insurance company isn’t being straight with you, call the experienced insurance lawyers at Raizner Slania LLP today. We can help with your Hurricane Harvey wind claim and make sure you get rightful compensation under your policy. Call us today to see how we can help.

Harris County Insurance Lawyers

Harris County Apartment Complex Owner Files Insurance Lawsuit

Raizner Slania has filed an insurance lawsuit on behalf of a Harris County apartment complex owner against AmRisc LLC, Certain Underwriters at Lloyd’s London, Indian Harbor Insurance Company, QBE Specialty Insurance Company, Steadfast Insurance Company, General Security Indemnity Company of Arizona, United Specialty Insurance Company, Lexington Insurance Company, Princeton Excess and Surplus Lines Insurance Company, and International Insurance Company of Hannover.

January 2017 Windstorm

On January 20, 2017, a windstorm ripped through Harris County. The windstorm caused significant damage to our client’s apartment complex, including damage to building components like light fixtures, windows, drywall, flooring, and the roofing system. Immediately upon discovering the damage, the plaintiff filed an insurance claim and asked that the cost of repairs be covered pursuant to the policy.

The insurance carriers, through AmRisc, assigned adjusters, consultants, and agents to the plaintiff’s file that were inadequate and improperly trained. Specifically, the claim was delegated to AmRisc to assign the claims to Vericlaim as the third party adjusting firm to handle the claims. Vericlaim, in turn, assigned the claim to an internal adjuster. The internal adjuster was assigned as the adjuster with decision-making authority over the plaintiff’s claim under the policy. Vericlaim and the internal adjuster conducted an unreasonable and inadequate investigation of the property and wrongfully denied any windstorm damage.

Despite clear evidence to the contrary, Vericlaim and its internal adjuster claimed the damages were not storm related, and instead were a result of normal wear and tear, deferred maintenance, construction deficiencies, and other excuses. Additionally, they confirmed damages to thousands of shingles and other areas of the property, but instead of providing full indemnity, they understated the damages and admitted only spotty repairs.

The carriers engaged in and ratified this improper claims conduct and ultimately approved a gross underpayment of the contractual damages. This underpayment omitted important facts, physical evidence, and meteorological data supporting the plaintiff’s claim. The Carriers instead unreasonably blamed the loss on causes other than wind to avoid contractual responsibilities and to save themselves in excess of $1,000,000.

The Carriers Acted In Bad Faith

Our client cites numerous violations of the Texas Insurance Code, including failure to adopt and implement reasonable standards for prompt investigation of claims, refusal to pay a claim without conducting a reasonable investigation, and misrepresentation of the insurance policy under which it affords property coverage to the plaintiff.

Harris County Insurance Lawyers

If you are an apartment complex owner and your insurance claim was wrongfully denied or grossly underpaid, the Harris County insurance lawyers at Raizner Slania LLP can help. Call us today for a free consultation to review your case.