Raizner Slania LLP has filed an insurance lawsuit on behalf of Nueces County, Texas hotel owners against Underwriters at Lloyd’s, London, York Risk Services Group, and Charles Allen Bertschi (collectively “defendants”). The lawsuit was necessary due to the unreasonable denial of the plaintiffs’ named windstorm damage claim.
Hurricane Harvey Damages the Hotel
The allegations in the petition are as follows:
On or about August 25, 2017, Hurricane Harvey, recognized as one of the most devastating natural disasters in United States history, made landfall on the Texas coast in San Patricio County and Aransas County as a Category 4 hurricane. Wind gusts of up to 132 miles per hour were reported within the same area of the plaintiffs’ property. 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 in August, the subject property was substantially damaged. Sizeable portions of the roofs were compromised by wind. As a result, there was also major damage to the interior, as the roof, sliding glass doors, and elevator were substantially damaged by the storm. Immediately after the storm, the plaintiffs filed an insurance claim with Lloyd’s, alerting them to the substantial damages.
Lloyd’s subsequently assigned Charles Bertschi of York, as lead adjuster to handle the claim. Mr. Bertschi assigned Michael Wilson with Madsen, Kneppers & Associates (MKA) to inspect the property. Mr. Bertschi and Mr. Wilson were unqualified and incapable of adequately assessing the damages to this type of commercial property and were the source of many delays throughout the claim process. Additionally, the defendants continued to delay the claim resolution and did not provide the insured with answers following the inspection. York subsequently engaged JS Held, LLC. Months after Hurricane Harvey winds severely damaged these properties, based on inadequate investigation, wrongful delays, and refusals to fully pay for reasonably clear damages, the carrier had only issued partial payment.
Despite clear evidence of covered replacement cost damages, Lloyd’s unreasonably blamed the loss on causes other than wind in an effort to avoid contractual responsibilities and to save money. Lloyd’s failed to issue the full payment owed under its insurance policy and instead authorized continued delays and underpayments. To this day, due to Lloyd’s outcome-oriented, inadequate, and haphazard investigation, they have refused to pay for covered damages under the policy.
Bad Faith Violations of the Texas Insurance Code
Plaintiffs allege defendants acted in bad faith by:
Failing to attempt to effectuate a prompt, fair, and equitable settlement of a claim with respect to which liability has become reasonably clear
Failing to adopt and implement reasonable standards for prompt investigation of claims arising under its policy
Failing to provide promptly a reasonable explanation, in relation to the facts or applicable law, for the denial of a claim
Refusing to pay the claims without conducting a reasonable investigation with respect to the claims
Misrepresenting the insurance policy under which it affords property coverage to plaintiffs, by making an untrue statement of material facts
Misrepresenting the insurance policy under which it affords property coverage to plaintiffs by failing to state a material fact that is necessary to make other statements made not misleading
Misrepresenting the insurance policy under which it affords property coverage to plaintiffs 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
Knowingly committing the foregoing acts, with actual knowledge of the falsity, unfairness, or deception of the foregoing acts and practices
Failing to acknowledge receipt of the claim
Failing commence a timely investigation of the claim or to request from plaintiffs any additional items, statements or forms that the defendants reasonably believe to be required from plaintiffs
Failing to notify plaintiffs in writing of the acceptance or rejection of the claim not later than the 15th business day after receipt of all items, statements and forms required by the defendants
Delaying payment of plaintiffs’ claim
The plaintiffs additionally alleged Lloyd’s 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 commercial property owner and your insurance claim has been wrongfully denied, delayed, or grossly underpaid, the Texas insurance coverage lawyers at Raizner Law can help. Contact us today to see how we can best assist you with your claim.