Hail Claims

Hail Damage Claims And The Texas Insurance Code

September 21, 2024 | Mark S. Humphreys

Here is a 2024 opinion from the Northern District of Texas, Amarillo Division, that deals with an important procedural in hail damage claims. The opinion is styled, Lotus Sky, LLC v. Lexington Insurance Company and Constitution Insurance Company.

This case arises from a hail damage insurance claim. Lotus Sky sued Lexington for breach of contract and various violations of the Texas Insurance Code. In response Lexington filed a Verified Plea as a Motion to Abate.

Accordingly, because this lawsuit is based on an insurance claim arising from alleged wind and hail damage, this lawsuit triggers compliance with Section 542A.003 of the Texas Insurance Code. Relevant to the Motion before the Court, Lotus Sky was required to provide presuit notice to Lexington at least 60

Roof Damage Claims And Attorney Fees

July 27, 2024 | Mark S. Humphreys

For Insurance Lawyers handling claims caused by “Mother Nature” it is important to understand Texas Insurance Code, Section 542A. This is a specific section for claims related to hail damage, tornados, hurricane’s, etc. As it relates to attorney fees on this type of claim the Southern District of Texas, Houston Division, issued an opinion in June 2024, that needs to be read and understood. The opinion is styled, Carole Baker v. American Economy Insurance Company.

In January 2023, Carole Baker’s home and contents suffered storm damage. She filed an insurance claim with American, which had issued her homeowner’s policy, to recover her covered losses. American sent two independent companies to inspect the residence and analyze mitigation and buildback costs. Following these inspections and the reports on the estimated costs, American paid Baker in accordance with these estimates.

In a series of emails from May to July 2023, Baker contacted American with her own estimates of mitigation and buildback costs based on quotes from a different inspector. Baker asked American to supplement its preceding payment based on the estimates from her own inspector. Baker also asked American to reopen her claim for damage to her roof, which had previously been denied. American sent Baker a revised repair estimate and made an additional payment based on the estimate she submitted.

Insurance Claims And Expert Testimony

December 30, 2023 | Mark S. Humphreys

Fortunately, most insurance claims do not require expert testimony. If expert testimony is needed, here is a 2023 opinion from the United States Fifth Circuit Court of Appeals which needs to be known. The opinion is styled, Cody Horton v. Allstate Vehicle And Property Insurance Company.

Horton reported a claim to Allstate for hail and wind damage to Horton’s metal roof arising from a storm in 2019. However, Horton’s homeowner insurance policy excludes “cosmetic damage caused by hail to the surface of a metal roof…” After investigating and concluding that the damage was only cosmetic, Allstate denied coverage. Horton then sued Allstate for breach of contract.

Allstate filed two motions relevant to this appeal: (1) a motion to exclude the expert testimony of Horton’s expert witness, David Wilson, a licensed and independent insurance adjuster; and (2) a motion for summary judgment based, inter alia, on the cosmetic damage exclusion.

Homeowners Insurance Claims – Got To Give Notice

December 23, 2023 | Mark S. Humphreys

Attorneys handling homeowner claims must be aware of the most recent case law regarding the notice provisions of Texas Insurance Code, section 542A. Here is a 2023 opinion from the Northern District of Texas, Amarillo Division, dealing with this issue. The opinion is styled, Toby Brohlin, et al. v. Meridian Security Insurance Company.

Before the Court is Meridian’s Motion to Deny Plaintiff’s Claim for Attorney Fees under Section 542A.007 of the Texas Insurance Code. The Court granted Meridian’s motion. A reading of the opinion gives brief facts and states the law statutes and law on this matter. This writing is the analysis of the law by the Court.

The Brohlins lawsuit implicated the pre-suit notice requirement contained in section 542A.002(a). The Brohlin’s did not provide the pre-suit notice. Thus, the Brohlins are precluded from recovering their attorney fees.

Claim Denied (Attorney Fees)

November 4, 2023 | Mark S. Humphreys

Insurance lawyers who handle claims being denied are usually asked whether not their attorney fees can be recovered. The answer is usually a “Yes” but their are requirements to be met in order to recover those attorney fees. One of those requirements include giving a pre-suit notice letter in proper form.

In cases where the loss has resulted from an act of nature such as hail storms, tornadoes, hurricanes, freezes, etc. there is a further loop that must be followed involving the timing of the pre-suit notice letter.

Here is a 2023, opinion from the Eastern District of Texas, Tyler Division, that is worth reading. It is styled, Curt Adkisson v. Safeco Insurance Company Of Indiana.

Hail Damage Claim Attorney

August 12, 2023 | Mark S. Humphreys

Here is a hail damage claim that has a frequently heard assertion by the insurance company. That assertion being that whatever hail damage exists occurred outside the policy period.

This is a 2023, summary judgment opinion from the Western District of Texas, San Antonio Division. The opinion is styled, PMJ Bleu Terre Management, LLC v. AmTrust Insurance Company of Kansas, Inc.

The facts presented in the motion are lengthy and should be read. Here is the analysis of the case by the Magistrate Judge.

Hail Damage Claims

July 17, 2023 | Mark S. Humphreys

From a statistical point of view, less than 2% of all lawsuits result in an actual trial. They either get thrown out of court on a motion for summary judgment or they they get settled. Most get settled. For the cases that go to trial, the public hears about the “million dollar” wins. What is not reported are the day in and day out loses that occur. It is important to understand why they lost.

Here is a 2023 opinion from the San Antonio Court of Appeals wherein the case appealed had been lost at trial and the insured filed the appeal. The opinion is styled, Brian Jones v. Allstate Vehicle And Property Insurance Company.

Brian sued Allstate on a claim resulting from a 2016 hail storm. He sued for breach of the insurance contract and unfair settlement practices.

Bad Faith Insurance And Claims Expert

June 3, 2023 | Mark S. Humphreys

Here is a case discussing bad faith insurance and a claims expert. This is an 2023 opinion from the Western District of Texas, San Antonio Division. The opinion is styled, PMJ Bleu Terre Management, LLC v. AmTrust Insurance Company of Kansas, Inc.

AmTrust filed a Motion to Strike Expert, PMJ’s claims handling expert, Mark Earle. The Court has authority in this matter pursuant to 28 U.S.C., Section 636(b)(1)(A).

This is a claim arising out of alleged property damage that resulted from a storm causing wind and hailstorm damage.

Hail Damage And Experts

May 29, 2023 | Mark S. Humphreys

Hail damage claims sometimes require experts to assist in the claim. This is the case in a 2023 opinion from the Western District of Texas, San Antonio Division. The opinion is styled, PMJ Bleu Terre Management, LLC, v. AmTrust Insurance Company Of Kansas, Inc.

AmTrust filed a motion to exclude the expert testimony of a roofing expert hired by PMJ to testify about wind and hailstorm damage to PMJ’s property. AmTrust denied the claim stating that the hail damage found on the property predated the policy period by a couple of months and therefore fell outside the scope of coverage. This lawsuit followed.

AmTust’s motion arises under the standards set forth in Rule 702 of the Federal Rules of Evidence. Rule 702 of the Federal Rules of Evidence was amended to provide that a witness “qualified as an expert . . . may testify . . . in the form of an opinion . . . if (1) the testimony is based upon sufficient facts or data, (2) the testimony is the product of reliable principles and methods, and (3) the witness has applied the principles and methods reliably to the facts of the case. When expert testimony is challenged, the burden of proof rests with the party seeking to present the expert testimony.

Hail Damage – Cosmetic Exclusion

May 27, 2023 | Mark S. Humphreys

Hail damage claims are common and the wording of “Cosmetic Damage” exclusions that apply to these types of claims are important for an insurance attorney to understand. This issue is discussed in a 2023 opinion from the Western District of Texas, San Antonio Division. The opinion is styled, Charles Wall and Franze Wall v. Safeco Insurance Company Of Indiana.

This case is writing its opinion in response to Safeco’s motion for Summary Judgement.

Both sides agree that this case arises out of a May 2020 hailstorm. The primary dispute is whether the damage from the storm is excluded from coverage by an exclusion for cosmetic damage. As the summary judgment movant, Safeco bears the initial responsibility of informing the district court of the basis for its motion. Safeco argues that “there is no competent summary judgment evidence that Safeco was unreason- able in handling the insureds’ claim.” It contends that “this case concerns a bona fide dispute as to coverage.” It later argues that “there is no evidence it breached the policy.” As for Plaintiff’s bad faith and related claims, Safeco argues that Plaintiffs cannot show it acted unreasonably. And Safeco further argues that there is no evidence that it engaged in any conduct entitling Plaintiffs to treble or exemplary damages, mental anguish, emotional distress, or fraud.