Raizner Slania LLP has filed an insurance lawsuit on behalf of Harris County homeowners against Pure Insurance Company (the “defendant”). The lawsuit was necessary due to the unreasonable denial of the plaintiff’s residential property wind and hailstorm damage claim.
May 2019 Wind and Hailstorm
On May 9, 2019, a wind and hailstorm struck the plaintiff’s property, resulting in significant damage to the structure, including damage to sizeable portions of the property’s roof. As a result, the roof damage caused interior damage as well. Following the storm, the plaintiffs promptly filed an insurance claim.
The insurance carrier—Pure—assigned Mark Maddox as the lead adjuster to handle the claim. Maddox then engaged HAAG Engineering to perform an inspection of the property. Maddox chose HAAG Engineering – an engineering consulting company consistently retained by insurance carriers – to generate a report that would lean toward claims denial or severe underpayment. Benjamin Taylor of HAAG inspected the property and ignored clear evidence of significant property damage, citing installation wear and tear as the cause. Maddox prepared a lowball estimate far below the plaintiffs’ deductible. Despite clear evidence of covered damages, the carrier has failed to issue the full payment owed under the policy covering the plaintiffs’ property, instead authorizing continued delays and underpayments. To this day, Pure has refused to pay for the covered damages under the policy.
Following Governor Greg Abbott signing House Bill 1774 into law as Section 542A of the Texas Insurance Code, the plaintiffs gave pre-suit notice to Pure. The notice provided a comprehensive outline of the claim, damages, and quantified the loss, even offering to waive a former claim of attorneys’ fees if the amounts were paid properly. Pure responded to the demand letter but refused to acknowledge its own wrongdoing.
The Carrier Acted in Bad Faith
Our client cites numerous violations of the Texas Insurance Code, including:
Failure to attempt to effectuate a prompt, fair, and equitable settlement of a claim with respect to which liability has become reasonably clear.
Failure to adopt and implement reasonable standards for prompt investigation of claims arising under its policy .
Failure to provide promptly a reasonable explanation, in relation to the facts or applicable law, for the denial of a claim.
Refusal to pay the claims without conducting a reasonable investigation with respect to the claims.
Misrepresentation of the insurance policy under which it affords property coverage by making an untrue statement of material facts.
Misrepresentation of the insurance policy under which it affords property coverage by failing to state a material fact that is necessary to make other statements made not misleading .
Misrepresentation of the insurance policy under which it affords property coverage by making a statement in such manner as to mislead a reasonably prudent person to a false conclusion of material facts and failing to disclose a matter required by law to be disclosed.
Failure to acknowledge receipt of the claim.
Failure to timely commence an investigation of the claim or to request from plaintiffs any additional items, statements or forms the defendant reasonably believed to be required.
Failure to notify plaintiffs in writing of the acceptance or rejection of the claim.
Delayed payment of plaintiffs’ claim.
The plaintiffs additionally alleged Pure breached its contract, breached its duty of good faith and fair dealing, acted fraudulently and with malice, and violated the Texas Deceptive Trade Practices Act (DTPA).
Texas Insurance Coverage Lawyers
If you are a residential or commercial property owner and your insurance claim has been wrongfully denied or grossly underpaid, the Texas insurance coverage lawyers at Raizner Law can help. Contact us today for a free consultation to review your case.