Articles Posted in Hail Claims

It is important to understand the time frame under which lawsuits must be filed.  As part of that, reading the insurance policy is vital.  A 2024 opinion from the Western District of Texas, Del Rio Division, discusses limitation periods written into insurance policies.  The opinion is styled, Antonio Caballero v. Allstate Vehicle And Property Insurance Company.

This case was decided on the summary judgment motion filed by Allstate.

This matter arises from an insurance claim.  The Plaintiff alleges hail storm property damage in excess of $20o,000.  The Plaintiff filed a claim with the Defendant on December 13, 2018.  The Defendant denied the Plaintiff’s claim on October 11, 2019.  The Plaintiff filed suit in Texas state court on August 21, 2023, asserting:  violations of the Texas Insurance Code and breach of contract among other causes of action.

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

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.

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.

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.

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.

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

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.

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 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.
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