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.


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.

Ordinance and Law coverage

What Is Included In Ordinance and Law Coverage?

Rebuilding after a natural disaster is a long and complicated process. For Hurricane Harvey victims, numerous issues are slowing down the rebuilding process and forcing them to pay out of pocket for certain expenses. For example, many Texas property owners are suddenly facing nuances in their insurance policies regarding Ordinance and Law coverage.

What Is Ordinance and Law Coverage? 

Ordinance and Law coverage is a type of insurance that reimburses property owners for the loss incurred by the enforcement of local building codes that regulate the reconstruction of damaged buildings. There are several types of ordinance and law coverage and each protects against certain types of damages.

Ordinance and Law Coverage A

Your insurance policy covers the damaged portions of your property, but you actually need protection for the undamaged portions too because insurance companies will only pay the replacement costs for the portion of the property that was damaged. For example, many properties sustained significant damage during and after Hurricane Harvey. If a covered peril such as wind damaged 50% of building, the insurance companies will cover the cost of replacing that 50%. But property owners can’t just replace part of a building. Even though half of the building was not damaged, the entire building must be rebuilt, and only the damaged half is covered by insurance. With Ordinance and Law Coverage A, policyholders are also insuring the undamaged parts of their property. This prevents policyholders from paying out of pocket for repair and replacement costs.

Ordinance and Law Coverage B

Under some local buildings codes and ordinances, demolition of the undamaged portions of a property may be required. If 75% of your property was damaged, the City of Houston may require you to demolish the remaining 25%. While demolition may not seem like much, older buildings that contain pollutants or building materials that require special clean up. Ordinance and Law Coverage B will cover the cost of demolition of undamaged parts of a building if required by local building ordinances.

Ordinance and Law Coverage C

The city of Houston and most other municipalities have strict building codes to which all new buildings must adhere. These building codes are regularly updated to reflect changes in materials, engineering, and manufacturing. The codes serve to ensure all buildings are built safely for property owners; however, they are not retroactively applied to buildings already built.

In the aftermath of Hurricane Harvey, property owners of older buildings not only have to rebuild, they have to rebuild in adherence to updated building codes. While this might not seem like a big deal, the reality is that for buildings ten years old or older, a lot has changed. Property owners will be required to use more expensive materials and supplies and might need to update components like the HVAC, insulation, electrical wiring, ventilation, heating, or plumbing systems. For nearly all property owners, rebuilding under updated building codes will be more expensive. Property owners will end up paying out of pocket unless they have Ordinance and Law coverage.

Sublimits In Your Policy

Always remember that insurance companies are foremost a business trying to make as much profit as possible. To help avoid large payouts, many insurance companies make sublimits, or a maximum amount they will pay for certain coverage. Therefore, while you may have Ordinance and Law coverage, you may also have a sublimit that would only compensate you for a portion of what you would really need to rebuild. Typically, an insurance policy that provides for ordinance and law coverage also contains a submlimit that may be substantially less than the overall policy limits. It is therefore critical that policyholders and their consultants are aware of what repairs should be covered under the standard building limits, and which repairs relate strictly to ordinance and law requirements.

Don’t Wait To Get Help

Commercial insurance is incredibly complicated and sadly many insurance companies use this to their advantage. Insurance companies will use a variety of bad faith tactics to avoid making large payouts. If you are struggling with your insurance company regarding rebuilding after Hurricane Harvey, immediately contact Raizner Slania LLP. Our experienced insurance lawyers have helped victims of bad faith practices across the country. Call us today for a free consultation to review your case. We can answer all of your questions and help you get what you are rightfully owed under your policy.

natural disaster claims

What Commercial Insurance Holders Need To Know About Natural Disaster Claims

One of the many lessons property owners learned after Hurricane Harvey is that natural disasters can cause catastrophic damage and total losses. While many property owners have insurance coverage for things like fires and leaky pipes, natural disaster claims are a little different than other types of commercial property damage insurance claims. Commercial property owners need to fully understand natural disaster claims to best protect their properties and financial interests.

Know Your Coverage

Many commercial property owners aren’t completely sure what is and isn’t covered under their policy. Does your policy cover total loss replacement? What is the deductible? Are there any policy limits? Do you have business interruption insurance? Understanding exactly how your property and your business are protected can mean the difference between getting an insurance payout to cover damages and paying completely out of pocket.

Immediately Report Damage

After a large-scale natural disaster like Harvey, tens of thousands of property owners will be filing natural disaster claims; therefore, it is important to report your claim immediately. Insurance carriers usually handle claims on a first come, first served basis, so you want to be at the front of line.

Claims Can Take Time

Commercial insurance claims can be complex, and natural disaster claims can make the processes take even more time. However, policyholders have a legal right to have their claim handled in a timely manner. If your insurance company is taking too long to process your claim, you need to contact an experienced commercial insurance lawyer to make sure your insurance company is operating in good faith.

Know What Your Property Is Worth

Commercial buildings can have specialty equipment or tools that many adjusters are unfamiliar with. This can lead to underestimates of replacement costs. Rebuilding after a natural disaster can be expensive, so if your insurance company has given you a lowball offer, do not accept the offer and contact an attorney.

Be Wary Of Surplus Lines Insurers

Surplus lines insurers largely dominate the commercial insurance market in Texas. These companies aren’t traditional insurance companies, and often operate more like file cabinets or foreign investment syndicates. When policyholders file claims with surplus lines insurers, there is no one to process the claim, so surplus lines insurers contract out with external adjusters to handle the claim. The surplus lines insurers incentivize these adjusters to deny or undervalue claims, so many policyholders end up paying out of pocket for most, if not all, of the repairs. To avoid making insurance payments, many surplus lines insurers routinely characterize storm damage as “wear and tear” or maintenance problems.

Don’t Wait To Contact An Attorney

Natural disasters can cost insurance companies billions of dollars in payouts. Some insurance companies will do everything in their power to avoid paying out on expensive claims. Policyholders shouldn’t have to deal with unfair insurance companies, but the reality is that many do. Getting an attorney involved in your claim can make sure claims are handled efficiently and help you get full coverage.

Church Insurance Claim Attorney

Raizner Slania Files Bad Faith Insurance Lawsuit On Behalf of Houston Church

Raizner Slania LLP has filed a lawsuit on behalf of a Houston Church against Scottsdale Insurance Company after its windstorm insurance claim was wrongfully denied under the Texas Insurance Code.

August 2015 Windstorm

On August 11, 2015, a windstorm swept through Houston, causing significant damage to the roof, HVAC, exterior, and interior of the church. Immediately upon discovering the damage caused by the storm, the plaintiff filed an insurance claim with Scottsdale and asked that the cost of the repairs be covered pursuant to the policy.

In response to the windstorm claim, Scottsdale assigned adjusters, consultants, and agents to the plaintiff’s file that were inadequately and improperly trained. Specifically, Scottsdale assigned the claim to an adjuster who would violate standard insurance practices when directed to do so by Scottsdale.

The adjuster failed to perform a thorough investigation of the claim and instead delayed the claim payment. The adjuster did not engage the necessary consultants or qualified experts to appropriately assess the damage to the property.

Scottsdale relied solely on the adjuster and its preferred vendors to determine what amounts, if any, to pay on the claim and did not perform its own investigation. Scottsdale and its adjuster misrepresented the policy, stating certain damages were not covered, when in fact they were. As a result of the incomplete and unreasonable investigation, Scottsdale grossly underpaid the plaintiff’s claim.

Unfortunately, Scottsdale delayed payments for necessary and covered property repairs under the insurance policy. Given the repeated delays of payments, the plaintiff has been subjected to significant economic impact, and continuing economic and physical damages. Because of Scottsdale’s delays, denials, and underpayment, the plaintiff has been unable to make necessary repairs to the church, which resulted in further damages.

Scottsdale Utilized Bad Faith Tactics To Underpay The Claim

Scottsdale violated numerous provisions 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 investigation of a claim, and failure to affirm or deny coverage of a claim to policyholders within a reasonable timeframe. The plaintiff also alleges Scottsdale violated the Texas Deceptive Trade Practices-Consumer Protection Act.

Church Insurance Claim Attorney

Just like other businesses and nonprofits, churches are not immune to the bad faith tactics used by insurance companies to avoid paying out on claims. If your church suffered wind or hail damage and your insurance company delayed, denied, or underpaid your claim, a Houston church insurance claim attorney at Raizner Slania LLP can help. Call us today to schedule a free consultation to discuss your case.

Hail Damage Insurance Lawsuits

Dallas County Apartment Owner Files Hail Damage Insurance Lawsuit

Raizner Slania has filed a hail damage insurance lawsuit on behalf of a Dallas County apartment owner against Peleus Insurance Company, Strata Claims Management, LLC, and Engle Martin & Associates, Inc. after its insurance claim was wrongfully denied.

March 2016 Hailstorm

On March 17, 2016, a wind and hailstorm swept through north Texas, causing substantial damage to the roofs, HVAC, exteriors, and interiors of the apartment complex property. Upon discovering the damage, the plaintiff filed an insurance claim with Peleus. In response to the claim, Peleus assigned adjusters, consultants, and agents to the plaintiff’s file that were inadequately and improperly trained.

Specifically, Peleus assigned the claim to both Strata and Engle Martin. In turn, both Strata and Engle Martin assigned the claim to claims representatives. Peleus, Strata, Engle Martin, and their representatives failed to perform a thorough investigation of the claim.

The representatives performed a haphazard inspection of the property and its damages and grossly undervalued what damages they did accept. Additionally, Peleus, Strata, Engle Martin, and their representatives made false representations to the plaintiff, including illegitimately claiming the damage occurred prior to the policy period and improperly ignoring facts confirming the wind and hail storm.

Strata and its representative also misrepresented the extent of damages confirmed at the property, falsely used excuses such as roof deficiencies and improper installation, and made misrepresentations about available weather data, including blatant misuse of predictive modeling supposedly being relied on to deny and delay the claim.

Strata and its representative then wrongfully claimed the roofs did not need to be replaced and instead blamed the clear damages on installation failures and the age of the roof systems. These are deceptive, unfair, and unreasonable claim actions, as Peleus and Strata’s own underwriting data confirms the good and insurable condition of the buildings.

As a result of the haphazard inspections and investigation, Peleus wrongfully denied the plaintiff’s hail damage insurance claim. Peleus failed to perform a thorough investigation of the claim and the plaintiff has been unable to make the necessary repairs, causing additional property damage.

Peleus Wrongfully Denied The Claim

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.

Hail Damage Insurance Lawsuits

If you regularly pay your insurance premiums, you deserve full policy protection. Oftentimes when apartment owners try to receive compensation from a claim, they discover their insurance company is less than honest. If your apartment complex suffered wind or hail damage and the insurance company isn’t being straight with you, contact the hail damage insurance lawyers at Raizner Slania LLP. We’ve helped hundreds of property owners get full compensation under their policies.