Articles Posted in Hail Claims

The vast majority of  insurance claims that get denied are settled.  Less than 2% of these cases actually result in trial.  When there is a trial, the odds are typically with the insurance company prevailing.  That is what happened in this 2021, verdict in a case from the Southern District of Texas, Houston Division.  The case is styled, Shane and Shannon Richardson v. Liberty Insurance Co.

The Richardson’s claimed damage to their roof and part of the interior of their home from a storm.  Liberty inspected the damage and denied the claim based on their assertion that the covered damages were less than the deductible.

The case was tried to a jury and the jury found in favor of Liberty on the breach of contract damages but found that Liberty engaged in “false, misleading and deceptive acts or practices in the  business of insurance in this case” and “misrepresented to the Richardsons the scope or cause of the damage from wind or hail,” in violation of the Texas Insurance Code, Section 541.001 et seq.  The jury awarded no damages for any claim, but, based on finding that Liberty’s violation of the Insurance Code was “knowing,” the jury awarded the Richardson’s $7,082.54 in “additional” damages.

Here is a 2021, opinion from the Western District of Texas, San Antonio Division, where the insured made a claim for hail damage against its insurer but did virtually nothing to prove the damage was caused by hail.  The style of the case is, 343 West Sunset, LLC v. Seneca Insurance Company, Inc.

In this case, 343 made a claim for hail damages.  The date listed for the hail damage was the last date for which there was coverage and it was undisputed that there was no hail storm on that date.

The Court spells out the problems with this claim and why the court is granted summary judgment in favor of Seneca.

This is a case about hail damage.  But, this is not the significance of the case.

The Northern District of Texas, Dallas Division, issued an opinion on April 28, 2021.  The opinion is styled, Alejandro Martinez Perez and Claudia A. Lopez Orozco v. Allstate Vehicle And Property Insurance Company and Stephen McKinney.

The significance of this case is that the Plaintiff’s filed a motion for summary judgement and Allstate did not respond to the motion.  In 27 years of practicing law, this is the first time I have noticed an insurance company law firm not respond to a summary judgment motion.

Maybe the title of this blog should be a little different but for insurance lawyers dealing with insurance companies all the time the comment by the Judge at the end of the case is worthwhile.

As all insurance lawyers know, the insurance companies prefer to litigate denied claims in Federal Court rather than the State and County Courts.  It’s really simple to understand, the rules and handling of cases in Federal Court tend to favor insurance companies.

The case here is from the Northern District of Texas, Fort Worth Division.  It is styled, Gina Lewis et al. v. Safeco Insurance Company of Indiana et al.

Insurance attorneys are well aware of the changes in the Texas Insurance Code statutes that effect hail damage claims and other damages resulting from Mother-Nature.  What cannot not be overlooked is the responsibility to make clear what caused the claimed damages.  In other words are all the damages from a particular event or are some of the damages being claimed the result of another event or are simply wear and tear.

A 2021, opinion from the Northern District of Texas, Fort Worth Division, explains the necessity of segregating damages in a claim for insurance coverage.  The style of the opinion is, Harold Franklin Overstreet v. Allstate Vehicle and Property Insurance Company.

Pursuant to the 1999, San Antonio Court of Appeals opinion styled, Wallis v. United Servs.  Auto. Ass’n, an insured can only recover for covered events under his policy; therefore, he bears the burden of segregating the damage attributable solely to the covered event.

Hail damage claims, like most claims are unique to themselves.  Questions that have to be answered in favor of the homeowner include, 1) when did the damage occur, 2) is the damage real damage versus cosmetic damage, 3) was there any damage already existing on the roof, 4) is hail the sole cause of the damage or were there other causes of damage, 5) is wear and tear an issue?  These and other factors are sometimes obvious.  But, at other times an expert is needed.

The Southern District of Texas, Houston Division, issued a 2021, opinion which is a summary judgment opinion wherein an expert was needed.  The opinion is styled, Dustin Farris v. State Farm Lloyds.  This is a case where the expert did much more harm than good.  The discussion of his opinion shows how obviously bad the expert report he wrote is bad.

The Court spent much time discussing how summary judgment is decided.

Here is an opinion from the Northern District of Texas, Dallas Division, that concerns hail damage and segregating damages.  The opinion is styled, Frymire Home Services, Inc. and Whitfield Capital, LLC v. Ohio Security Insurance Co.

This is a summary judgement opinion in filed by Ohio and the Court granted the summary judgment in favor of Ohio.

This is a hail damage insurance dispute.  Ohio insured Property owed by Plaintiffs.  The policy was in effect from March 23, 2018, until March 23, 2019.

Lawyers handling hail damage claims have to prove the claim.  This is illustrated in a Southern District of Texas case styled, Faustina Ortiz v. United States Liability Insurance Group, et al.

Ortiz owns a restaurant in Conroe, Texas.  He had a policy of insurance with United that provided coverage for windstorms and hailstorms wherein the policy period was from January 26, 2016, to January 26, 2017.  On August 23, 2016, a claim was filed with United asserting that on May 26, 2016, a hailstorm caused extensive damage to the building and walls.

United’s adjuster inspected the building on September 6.  He photographed and found (1) deterioration, (2) poor maintenance, (3) numerous gaps in the roof, and (4) earlier repairs.

Texas has a new law regarding hail damage claims.

Here are five things to know about the new law.

First, it creates a new chapter in the Texas Insurance Code, Chapter 542A, which applies to property damage claims caused by “forces of nature.”  This includes damage caused by earthquakes, wildfires, floods, tornados, lightning, hurricanes, hail, wind, snowstorms, and rainstorms.  The law applies to any lawsuit the insured may bring against the insurer or its agent even if the insured does not sue the insurer.  Besides, Insurance Code violations, this new law applies to breach of contract claims and common law claims.  Further, “forces of nature” are not specifically limited to weather related events and litigation will probably result over what else is included.

The Amarillo Court of Appeals issued an opinion on October 13, 2017, that is a must read for insurance lawyers who handle homeowner claims.  It is styled, Christopher Hall v. Germania Farm Mutual Insurance Company.

This case involves a homeowners policy and damage to Hall’s insured property and Germania’s attempt to adjust the claim.  A lawsuit was filed over the amount of the loss sustained by Hall and eventually Germania invoked the appraisal clause in the insurance contract.  An appraisal was eventually performed and Germania tendered to Hall the appraised amount.  In the lawsuit, Germania invoked the doctrine of estoppel.

A motion for summary judgment was filed by Germania and granted in their favor.

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