Dallas Fort Worth Insurance Lawyer Blog
Here is a case from the Northern District of Texas, Fort Worth Division, wherein the dates of the alleged damage incurred because of hail, is in dispute. The style of the case is, LTG & Associates, Inc. v. Monroe Indemnity Insurance Company.
This is a summary judgment case granted in favor of Monroe.
LTG owns several properties that are insured by Monroe. LTG alleges that on or about April 1, 2015, and March 23, 2016, the properties suffered damage due to a severe hail and windstorm. The storm is alleged to have caused incredible damage. LTG further claims that Monroe hired adjustors for both storms to provide biased engineering reports so that it could deny coverage. It is also alleged that on both occasions the adjustors wrongfully and intentionally ignored objective evidence of the wind and hail storm.
LTG sued for breach of contract and violations of the Texas DTPA and for Insurance Code violations.
Federal Rule of Civil Procedure 56(a) provides that a court shall grant summary judgment on a claim or defense if there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law.
An insured has to establish coverage under the terms of a policy pursuant to Texas law. Proof that a loss occurred during a policy period is essential to a claim. As a result, LTG must prove that its damages were caused by the claimed storm and not another storm outside the policy period.
The evidence in this case establishes that on October 7, 2015, LTG reported a claim for hail damage that occurred on April 1, 2015. The claim was reported after a roofer soliciting business, inspected LTG’s property. On October 19, 2015, a company working for Monroe, Nelson Forensics, inspected the property and determined the hail damage occurred long before April 1, 2015. The claim was denied based on Monroe’s assertion the damage had occurred prior to the inception of the policy. In May 2017, LTG reported another hail claim with a loss date of March 23, 2016. Nelson Forensics again inspected the property and concluded that the conditions were consistent with prior observations when conducting the first inspection and subsequently denied the claim.
LTG has consistently maintained that the losses occurred on or about April 1, 2015, and on or about March 23, 2016.
The problem for LTG is that it’s own expert says no hail damage occurred at those times. And, LTG agrees that its claims based on the April 1, 2015, loss date should be withdrawn. LTG admits that it has known since receipt of its expert report dated February 14, 2019, that the second loss did not occur on or about March 23, 2016, as alleged, yet LTG has not amended its complaint. As a result LTG has not raised a genuine fact issue as to breach of the insurance contract and summary judgment was granted in favor of Monroe.