When an insurance adjuster makes mistakes in handling a claim, it is usually necessary to sue the adjuster in addition to suing the insurance company. The trick is properly suing the adjuster.
A 2023 opinion from the Northern District of Texas, Dallas Division, dealt with properly suing the insurance company adjuster. The opinion is styled, Samurai Global, Inc., v. Rockford Kyle Brothers And Landmark American Insurance Company.
This case had a few legal issues going on at the same time but what is relevant here is the Court points out the proper way to make allegations against the insurance company adjuster.
To assess whether a Plaintiff can establish a cause of action against a non-diverse party in state court, the Court conducts a Rule 12(b)(6) type analysis. To survive this analysis, Plaintiffs must plead factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged.
In considering a Rule 12(b)(6) motion to dismiss, the court must accept all well pleaded facts in the complaint as true and view them in the light most favorable to plaintiff. The court’s review is limited to the complaint, any documents attached to the complaint, and any documents attached to the motion to dismiss that are central to the claim and referenced by the complaint.
Samurai alleges violations of the Texas Insurance Code in the First Amended Petition – specifically referring to Texas Insurance Code, Section 541.060. The Petition then cites the statutes on this matter. The only alleged violations consist of merely the following language:
Specifically, Brothers failed to conduct a reasonable investigation. Instead of evaluating the damage objectively, Brothers ignored the damage, failed to investigate the damage and misrepresented that Plaintiff was required to take actions that the insurance policy did not require Plaintiff to perform as a condition to coverage. As all times during the course of Brothers’ investigation it was reasonably clear that the damage to Plaintiff’s property was covered. Plaintiff notified Brothers and specifically pointed out the damage, Brothers failed to investigate. scope or estimate the covered damage. The investigation performed by Brothers was unreasonable because he overlooked the damage that would have been obvious to a competent adjuster and/or failed to recommend coverage to Plaintiff’s insurer. Either way, the investigation by Brothers was unreasonable.
Samurai’s allegations are wholly conclusory, unsupported by factual content, and thus insufficient. The Petition fails to allege facts sufficient to allow the Court to draw a reasonable inference that Brothers is liable on such claims.