Proper Claims Against The Adjuster

Too many times, the claims against an adjuster fail when those claims are removed to Federal Court.  There was a successful claim recently in the Southern District, Houston Division.  It is styled, Lillie Jean Hooper v. Allstate Texas Lloyd’s, et al.

Hooper suffered storm damage and submitted a claim to Allstate for severe damage to her roof and home, and water damage.

The adjusters assigned to the claim were Katherine Hernandez and Joe Bobbitt.  They conducted a assessment and later a second assessment of the claims submitted by Hooper.  Hooper alleges the adjusters intended to deny her claim and fabricated explanations of the visible damage that attributed them to causes not covered by the policy.  Hooper own evaluator estimated the damage at $26,459.86.

Hooper sued Allstate and the adjusters in State Court for breach of contract and Insurance Code violations among other things.

The defendants removed the case to Federal Court arguing diversity jurisdiction by arguing the adjusters (Texas residents) were improperly joined in the lawsuit.

The doctrine of improper joinder stems from the text of 28 U.S.C., Section 1441(b)(2).  The Court can analyze an allegation of improper by conducting a Rule 12(b)(6) analysis.  Under this analysis, any doubt about the propriety of removal must be resolved in favor of remand.

The defendants allege the adjusters cannot be liable under Insurance Code, Section 541.060.  This is an issue that is litigated in Texas courts.  The weight of authority is that adjusters can be liable under 541.060.  Adjusters are expressly included in Section 541.002, where it is stated who can be liable.  The courts have noted thta individuals were included in the definition of those who could be held liable.

The Fifth Circuit has expressly that Texas law clearly authorizes these actions against adjusters in their individual capacity.  Those decisions reaching the opposite conclusion on adjuster liability are less well supported.

The determining question here is whether Hooper has supported her claims against the adjusters with sufficient factual allegations.  Hooper alleges the adjusters evaluated her home on two occasions; that they misrepresented the amount of damage and the costs of repair; that they fabricated alternative explanations for visible damage to her home to place the damage outside of her policy’s scope; that they did so intentionally; and that their evaluation deviated markedly from the conclusions of Hooper’s own third-party adjuster.

The Court held these allegations have adequate detail to reach the threshold of facial plausibility and thus state a claim on which relief can be granted under the Texas Insurance Code.

Hooper’s Motion to Remand the case back to the State Court was granted.

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