Texas Underpaid Homeowners Insurance Claim Victory

Do you have an underpaid homeowners insurance claim?

Many insurance companies regard plumbing to be part of routine homeowner maintenance. Maintenance is entirely the property owner’s responsibility. Damage to pipes that develops over time because of lack of maintenance is typically not covered. Pipes in this state could potentially flood an entire house, causing catastrophic damage! Many Insurance agencies will deny or send you away with an underpaid homeowners insurance claim. For an insurance company to cover a broken pipe, the burst must have occurred suddenly and by accident, and should not have been easily preventable. If an ignored leaking pipe suddenly burst, the insurance company’s agents will look for evidence of a long-term leak and will likely deny your claim. Some insurance policies look at the differences in what is referred to as “resulting damage” versus “initial damage”. If water damage resulting from a broken pipe or appliance is addressed in your insurance policy, then you could be compensated for all or some of the damages…even if those damages did not occur instantly. 

When a pipe does burst, homeowners insurance typically covers carpets or rugs, flooring, drywall, and paint in most cases. Any clean-up service may also be included in your coverage. Sadly, the cost of the problem, repairing the busted pipe or replacing the broken appliance is generally not covered.

What Came First? The Foundation Damage Or The Pipe Burst?

In the case of a client of ours out of Montgomery, Texas, the family of three experienced a pipe burst the wall of their garage. The pipe burst leaked sewage onto the garage floor and the resulting odors penetrated the house for a year before the case was resolved. Because the insurance claim was underpaid, the homeowner had little choice but to clean up the mess himself which ultimately lead to him getting E.coli and requiring urgent medical attention. 

Along with the damage to the garage and living with the sewage smell inside their home for a year, our client lost all personal possessions in the garage when it flooded. Their insurance company sent out an adjuster and an engineer to handle the carrier’s side of the insurance claim and both remarked the damage could be from the foundation moving, citing cosmetic repairs which had been made to the foundation’s corners. Our adjuster determined that the damage was indeed sudden and accidental and covered under the homeowner’s insurance policy. This slight on the insurance company’s end made it possible for us to pursue 8 times the initial payout to our client from the insurance company, allowing our client to make the appropriate repairs and get on with life without the smell of sewage in their home.

What Can You Do To Prevent Your Water Damage Claim From Being Denied?

Make sure you have any repairs to your home well documented. Keep any receipts from any professional services that may have worked on your pipes or home. These records can make or break a denied, delayed, or underpaid homeowners insurance claim. Replace pipes that have outlived their structural integrity. Inspectors can find tell-tale evidence of a slow leak and can deny your insurance claim accordingly. Know where the shutoff valve for your home is at in case you need to turn off the water quickly. Make your best effort to prevent your pipes from freezing. Wrap pipes, leave them to drip when appropriate, heat the home, and so on.

Filing A Claim Tips

• Keep proof that you paid the deductible for your claim. State law allows insurance companies to ask for verification, like a receipt or check stub, that you paid for repairs in the amount of your deductible.
• Keep your receipts for temporary repairs, but don’t make any permanent repairs until the insurance adjuster authorizes you to do so. Failure to do so may complicate the payment of your claim.
• Look over your policy. Determine what is covered and what is not and any deductibles there may be. Contact your insurance agent if you are uncertain about your coverage.
• Document your communication with the insurance company. Record the date, name, and role of each person you speak with and the content of the conversation.
• Get a second opinion. Get repair bids from other contractors and compare them with the insurance adjuster’s report before resolving your claim.
• Assert your right to the protection you paid for and be prepared to negotiate for a fair settlement of your claim.
• Be present during the claim adjusters’ visit so you can point out all of the damage.
• Document the damage. Photos and videos can strengthen your claim.
• Be patient. Every insurance company handles claims differently.

Should I Hire An Attorney?

If you have an underpaid homeowners insurance claim and you think your insurance policy covers your loss and your insurer doesn’t, or if you feel the damage you sustained is far more than what your insurance company compensates you for, or if your carrier neglected your claim altogether, then the Texas Insurance Code allows recovery of “actual damages, plus court costs and reasonable attorney’s fees” and if the insurer acted in bad faith you may pursue an award of up to “three times the number of actual damages.”

If you’re unsure of whether or not your situation warrants filing a claim against your homeowner’s insurance company, contact us. Free consultation. No recovery equals no fee.

Here’s How to Get Compensation

If your business was harmed by the COVID-19 shutdown, you may be wondering how to get compensated. Unfortunately, there is no one-size-fits-all answer to this question. Every business will have a different experience and will need to approach things differently. In this blog post, we will discuss some of the options that are available to business owners who have been impacted by the pandemic.

Check your Insurance Policy

First and foremost, it is important to check your insurance policy. Many business owners have paid their premiums for years, thinking that they are protected in the case of a pandemic or other disaster. However, insurers are now stalling or denying coverage to many businesses that need it. If you think you may be covered by your insurance policy, it is important to contact your insurer as soon as possible and find out what your options are.

Another option that may be available to you is government assistance. The Small Business Administration (SBA) has created a number of programs to help businesses that have been impacted by the pandemic. If you think you may be eligible for any of these programs, you can find out more information on the SBA website.

Finally, you may also be able to get compensation from your state or local government. Many states and municipalities have set up programs to help businesses that have been impacted by the shutdown. You can find out more information about these programs by contacting your state or local government.

Business Interruption Insurance

If you have business interruption or business income insurance, you may be covered for the COVID-19 shutdown. Even if your policy has an exclusion, coverage may still be possible. The insurance company must demonstrate that an exception is real and applies.

A qualified insurance claims attorney can help you determine if coverage is possible. They will review your policy and help you understand the coverage debate.

If you have business interruption insurance, don’t wait to file a claim. The sooner you file, the sooner you can get the compensation you deserve. Contact a qualified insurance claims attorney today. They will help you navigate the process and get the best possible outcome for your claim.

Consult with one of our experienced insurance claims attorneys

The first step is to take a look at your policy and see if you have business interruption insurance. This type of insurance is designed to protect businesses from lost income in the event that they are forced to close due to an unforeseen event. If you do have this type of coverage, there will likely be some restrictions and exclusions that apply. However, it is still worth looking into to see if you can make a claim.

The next step is to consult with an experienced insurance claims attorney. They will be able to review your policy and help you determine if you have a valid claim. If you do have a case, they can also assist you in filing the necessary paperwork and representing you in court, if necessary.

There is no guarantee that you will be successful in making a claim for business interruption compensation. However, it is worth exploring all of your options and seeking professional help to give yourself the best chance at getting the money you deserve.

Government COVID-19 Shutdown

Most business insurance policies have a civil authority exclusion that limits or excludes coverage for business income losses caused by an order from civil authority, like a state or local government. So if your policy has this exclusion and you’re forced to shut down due to a government-mandated stay-at-home order, you likely won’t be covered for any resulting business income losses.

However, some policies may have a civil authority coverage endorsement that can provide limited coverage for business income losses in these situations. Whether or not you’re covered will depend on the specifics of your policy, so it’s important to check with your insurance company or broker to see if you have this coverage.

If you don’t have a civil authority exclusion or coverage endorsement in your policy, you may still be covered for business income losses caused by the shutdown. That’s because most policies have a virus exclusion, which excludes coverage for any loss that is directly or indirectly caused by a virus. So if your policy has a virus exclusion and you’re forced to shut down due to a government-mandated stay-at-home order, you likely won’t be covered for any resulting business income losses.

However, some courts have ruled that the virus exclusion does not apply in these circumstances because the shutdown was ordered by the government, not by the presence of the virus itself. So if your policy has a virus exclusion and you’re forced to shut down due to a government-mandated stay-at-home order, you may be able to get coverage for your business income losses.

If your business has been impacted by the COVID-19 shutdown, you may be wondering if you can get compensation from your insurance company. The answer to that question depends on the specific details of your policy.

The bottom line is that whether or not you’re covered for business income losses caused by the COVID-19 shutdown will depend on the specifics of your policy. So if you’re forced to shut down your business, the first thing you should do is check with your insurance company or broker to see if you have coverage.

If you have any questions about your policy or coverage, please contact us and we’ll be happy to help.

Should I make a claim for compensation?

If you are wondering if it is a good idea to make a claim on your insurance policy for business losses due to the COVID-19 shutdown, the answer is yes. Your insurance company should not drop you for making a business loss claim. Your insurer’s risks do not increase because you filed a claim, as this was not caused by you the business owner.

Making a claim is the only way to get compensated for your losses, and it is important to remember that you are not alone in this situation. Many businesses are facing hardship due to the shutdown, and insurance companies are expecting a high volume of claims. The key is to be prepared and have all of the necessary documentation ready when you file your claim.

One way to find out if you have coverage is to contact one of our expert attorneys. We offer free consultations so that you can get the information you need to make a decision about your next steps.

Don’t try to navigate this process on your own. Let us help you get the compensation you deserve. Contact us today to learn more.

Our team of expert attorneys has extensive experience in handling insurance claims and can help you get the compensation you deserve.

Homeowners Insurance Claim Victory Exceeds Policy Limits

Weather Service Report Links Roof Damage to Hailstorm That Insurance Company Claims Never Happened

Paying a high premium on an insurance policy can be a burden most people are familiar with. At some point in everyone’s life, you will need insurance. Whether that’s to pilot a boat, drive a car, or own a home, insurance is meant to financially compensate the policyholder if their property is lost, damaged, or stolen. Insurance companies make their bread and butter off their policyholders and in turn, those policyholders expect a reasonable investigation and fair compensation when they are required to file a claim because their property is damaged or made unusable.

On the night of April 18th, 2020, Montgomery County experienced a powerful wind and hail storm that blanketed the area in 1.2-inch size hail and wind gusts powerful enough to knock down several trees and powerlines throughout the county. Our client’s home endured the storm that evening. The hail damaged portions of our client’s roof and a storage building. The damage to the roof was severe enough that water had penetrated the roof and made its way inside through the ceiling of a utility room near the rear of the home. The hail also damaged gutters and drainage downspouts on the home.

Due to some unforeseen circumstances, some time passed before the claim was reported in March 2021. The insurance company received the claim—as it would any other—and began investigating the incident. As it would turn out, our client had canceled his policy with the insurance company in December 2020, prior to reporting the claim. The policy was canceled because our client ended up going with a different insurance company.

After its investigation, the insurance company denied our client’s claim. The alleged late reporting of the claim and the fact that the client had canceled his policy prior to reporting the claim likely factored into the insurance company’s decision.

Once the case came into our hands, we filed a lawsuit and pressed the insurance company immediately during discovery. During that process, we learned that the insurance company was using a third-party weather data source to pull aggregated data, which showed that the most recent date for sizable hail at our client’s home was 1-inch or larger hail which fell on September 19th, 2019. It seemed clear that the adjuster for the insurance company did not look at any other weather data. As a result of the tunnel vision that this report created, the insurance company then used this date as the actual date of loss.

Conveniently for the insurance company, there was a provision in the insurance policy stating that if the property damage is reported one year or 365 days after the date of loss, the insurance company can deny the claim.

In other words, with this claim the insurance company used favorable weather data from its preferred third-party vendor—apparently without checking other sources—as an excuse to move the date of loss to an earlier date. It then retroactively relied on the late reporting provision in the policy to deny the claim.

Our own investigation into the claim using other weather data sources—including the Severe Weather Data Inventory database provided by the National Oceanic and Atmospheric Association, or NOAA—uncovered severe hail in the immediate area of our client’s home on April 18, 2020. This date was within the policy period prior to cancellation and within one year of when the claim was reported, meaning that the late reporting provision did not apply.

When confronted with conflicting data, the insurance company initially stood its ground, believing its weather data as gospel. But our negotiating position had been improved and we were able to steer the case into mediation quickly. In mediation, we were able to get the insurance company to agree to a settlement that was favorable for our client and would allow him to complete the repairs to his home.

We are proud to say this case ended in a good recovery for our client and righted a wrong by the insurance company.

Many disputed wind and hail claims depend heavily on documenting and proving that severe weather impacted an insured’s property on a particular date. Insurance companies will use their own preferred third-party vendors to obtain data as part of their investigation, sometimes even consulting multiple services but only providing the insured with the data that supports the insurance company’s position. Our firm is very familiar with this tactic and frequently resolves cases where these issues are involved.

FREE CASE REVIEW

If your home or business was damaged by a wind or hailstorm and your insurance claim has been denied, delayed, or underpaid, call the expert property litigation attorneys at the Chad T. Wilson Law Firm today. Maximize your settlement and make the insurance company pay.

Federal Courts Adopt the Western District of Louisiana’s Case Management Order

The U.S. District Court for the Western District of Louisiana and the 14th Judicial District Court for the Parish of Calcasieu have adopted a Case Management Order (CMO) that allowed for a streamlined litigation process for insurance claims that arise due to property damage resulting from Hurricanes Laura and/or Delta. The CMO helps produce a just and equitable resolution, enabling the local community to repair or rebuild their homes and businesses after the devastation of the 2020 Hurricane Season. Most Hurricane Laura or Delta property loss claims that give rise to a lawsuit would be subject to this CMO, which provides for an expedited procedural schedule.

The CMO was adopted by the Western District after the Court reviewed the Disaster Litigation Initial Discovery Disaster Protocols recommended by a study committee and adopted by the United States District Court for the Southern District of Texas following Hurricane Harvey.

The CMO allows for resolution and settlement of lawsuits outside the courthouse walls. Once the answer to your claim is received, the court sets deadlines for initial disclosures, settlement negotiations, and formal mediation, in a matter of weeks or a few months, not years.

After receiving Answer or other responsive pleading:

• 45 days from the date the defendant files responsive pleadings or 20 days from an order denying a timely motion to remand.

Upon the exchange of Initial Disclosures:

• Within 15 days. Counsel for both parties shall meet to confer and discuss a mutually convenient time, date, and manner for conference.
• Within 30 days, the informal settlement conference must be conducted.
• Counsel for both parties must have full authority to resolve the from their clients.

If the initial settlement conference fails to reach a resolution:

• Case is set for formal mediation.
• Both parties complete a Mediation Stipulation form.

If formal mediation fails, the case is set for trial.

Recently, the first Hurricane Laura claim went to trial, and the jury found in favor of a Lake Charles businessman after the jury found that the insurance company acted in bad faith and did not pay timely or fulfill its contractual obligations. Consequently, the insurer must now pay additional penalties, attorney fees, and court costs.

If your home or business is dealing with the fallout of a denied, delayed, or underpaid property insurance claim or your insurer has acted in bad faith, call the Chad T. Wilson Law Firm today. We have obtained millions of dollars in settlements for our Louisiana clients that have had difficulty recovering from their insurance companies for claims related to Hurricanes Laura and Delta. Our expert insurance litigation attorneys know how insurance companies operate and the best way to maximize your settlement.

Cosmetic Damage Exclusions & Property Litigation

Recently proposed property exclusions have created intense debates among agents, adjusters, insurers and insureds. As chaotic weather conditions across the country continue to rise, these exclusions claim to focus on the type of roof damage in an effort to circumvent coverage.  Essentially, what the insurer deems as “cosmetic damage” is excluded from coverage when/if the insurers choose to use this type of endorsement.

That’s where our client, BCD (a family partnership) needed our help. On June 6th, 2018 an intense hailstorm produced wind gusts over 59 miles per hour with massive hail, ultimately destroying windshields, skylights, roofs and other exterior structures on numerous homes and businesses throughout the Dallas area.

The following day, roof leaks began to appear causing water to visibly enter 3 of the 6 commercial properties BCD owns. The businesses impacted by the leaks reached out to their landlord, who promptly filed an insurance claim with Covington Insurance.

After filing the insurance claim with their provider, the insurer sent out an adjuster who reviewed the claim for roof leaks and cited “no damage” to any of the properties. When our clients rebuked the adjuster’s findings, the insurer sent a second adjuster who this time claimed the damage was minimal and fell under the deductible but for only one of the properties. Now befuddled and irritated with their insurance company’s confusing findings, BCD hired their own public adjuster. The insurer responded by sending out an engineer who did recognize the roof damage however he now claimed the damage was merely “cosmetic” in nature.

BCD and their public adjuster recognized what Covington was up to and promptly filed suit. Covington Insurance moved the case to Federal court where both parties were ordered to participate in an early mediation. At mediation, the case settled for more than 200 times the original under-deductible estimate written by Covington. Not only was our client delighted, but the public adjuster who they hired attended mediation and was also relieved to see the insured be fully indemnified. Now our client’s tenants could go back to running their businesses without the constant threat of interior leaks and roof damage disrupting their business operations.

A cosmetic damage exclusion means damage to external surfaces, including walls, roofs, doors, and windows that allegedly only impact the appearance (but not the functional purpose) may not be covered under the policy. These are things insurers consider ornamental or cosmetic and are usually very vaguely defined so that the insurer can tailor the damage as one being “merely cosmetic” to deny the claim.

Just because you have a cosmetic damage exclusion does not mean you are out of luck with your insurance claim. Our expert insurance litigation attorneys know how insurance companies operate and the tactics they employ to delay, deny, or underpay your property insurance claim. Our consultations are free, and you owe us nothing until we win your case. Contact us today.

Why It’s Important To Take Your Time When Purchasing Property Insurance