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

Attorney Patrick McGinnis Talks Winning Claims On ‘The Legal Fix’ Radio Show

Chad T. Wilson Law Firm Attorney, Patrick McGinnis, was a special guest on The Legal Fix radio show last month where he talked about winning denied insurance claims. Has your insurance company unfairly denied your property damage claim? If so, contact us today for a free case review. You may be entitled to compensation.

Courtroom Victories Against State Farm

Chad T. Wilson recently sat down with Roofing Insights to discuss his firm’s recent legal victories against State Farm. Watch the full interview below. You can also read about the State Farm cases here and here.

Chad T. Wilson Courtroom Victories Against State Farm:

Victory: Texas Jury Awards Damages To State Farm Policyholder Over Unfair And Deceptive Practices

In March this year, the Texas Supreme Court published its landmark opinion on another Chad T. Wilson Law Firm case – again, a client insured by State Farm, Luis Hinijos.  This was a huge win for all policyholders in Texas because it stopped all insurance companies from utilizing a carrier-created loophole to circumvent Texas law.  Here’s the typical scenario. An insured has a covered loss and notifies their insurance company.  The company would accept the claim and pay pennies on the dollar of the damages. The insured would complain but the carrier would not budge far from its initial position. The insured would then sue and the carrier, State Farm being the worst culprit, would run up litigation expenses. Appraisal of the damages would be invoked to set the cost to repair; the carrier would send a check for the appraisal award less the depreciation less the deductible less prior payments if any. The carrier would run back to the court and ask for summary judgment claiming “no harm, no foul judge” – and they were getting away with it. This left insureds economically upside down on their cases. The Chad T. Wilson Law Firm took Mr. Hinojos’s case to the Texas Supreme Court to stop this trend in its tracks. The Court agreed stating that an insurer is not absolved of its statutory liability when it pays only part of a claim within the statutory deadline set forth in the statute. An insurer that fails to pay all amounts that “must be paid” under the applicable policy will be liable for interest and attorney’s fees. On the street, this means if an appraisal award comes back higher than the insurance company’s initial estimate of damages, they owe the difference plus interest plus attorney fees and they are still on the hook for damages for violations of the Texas Insurance Code and Texas Deceptive Trade Practices Act. 

Unanimous Jury Verdict in Tarrant County for CTWLF Client: Jury found State Farm knowingly violated the Texas Insurance Code Jury awarded Plaintiff damages equivalent to seven times his property damage 

After the trial concluded, jurors stated they were disappointed with how State Farm handled Aaron’s claim, how State Farm ‘covered up’ the first adjuster’s haphazard inspection, and were deeply troubled that it took three years and a trial for State Farm to admit they made a mistake; it obvious to the jury that State Farm’s admission was only for damage control, there was no remorse.  This jury was made up of Tarrant County citizens, a jurisdiction typically known as a tough venue for Plaintiffs.  Not only did this jury see Defendant State Farm’s actions were wrong, they returned a unanimous verdict that left no doubt how wrong State Farm was in this case.

Has your claim been denied?

The Chad T. Wilson Law Firm handles insurance property disputes and takes on tough, serious cases against some of the largest corporations in America. With a proven track record of getting things done, Chad T. Wilson is fighting for courtroom victories against State Farm and other major insurance carriers. If your homeowner’s insurance claim has been denied, delayed or, underpaid, call us. We have represented thousands of homeowners against insurance companies, big and small. As a contingency-based law firm, our expert insurance claims attorneys aggressively fight for the rights of the policyholder. Free consultation. No recovery equals no fee. Contact us today.

Huge Victory For Policyholders in Texas Supreme Court!

On March 19, 2021 the Texas Supreme Court issued its opinion in Hinojos v. State Farm Lloyds (No. 19-0280), in favor of Louis Hinojos, a client of Chad T. Wilson Law Firm. This was a huge victory for Texas policyholders. The Hinojos opinion will substantially assist policyholders to win Texas Prompt Payment of Claims Act (“TPPCA”) damages including interest and attorney fees after appraisal.

Before the Texas Supreme Court decided the case of Barbara Technologies Corp. v. State Farm Lloyds, 589 S.W.3d 806 (Tex. 2019), insurance companies could avoid all damages, including TPPCA damages, by simply invoking appraisal and paying the resulting appraisal award. This situation was patently unfair to Texas policyholders because the typical fact pattern was that an insurer would make a low initial claim payment, the policyholder would file suit, and during litigation (months or years after the date of loss) the insurance company would invoke appraisal and then pay the resulting award…an award that was always substantially more than the initial claim payment. The insurance company would then file a motion for summary judgment and get the policyholder’s entire case dismissed, including 18% interest under the TPPCA and attorney fees. However, Barbara Technologies held that an insurer may not avoid TPPCA damages by simply paying an appraisal award. Not surprisingly, the insurance industry quickly tried to find ways around Barbara Technologies. Using a portion of a string cite in the 5th Circuit case of Mainali Corp. v. Covington Specialty Insurance Co. 872 F.3d 255, 259 (5th Cir. 2017), insurance companies argued that as long as the initial claim payment was “reasonable” then even if the appraisal award ended up being much higher than the initial claim payment, policyholders were still unable to pursue TPPCA damages against the insurance company. For example, in the case of Shin v. Allstate Texas Lloyds, No. 4:18-CV-01784, 2019 WL 4170259, at *2 (S.D. Tex. September 3, 2019) Allstate argued and the court held that an initial claim payment that was 5.6 times less than the ultimate appraisal award was still “reasonable” and the court granted summary judgment for Allstate, which eliminated the policyholder’s damages under the TPPCA.

Thanks to the Chad T. Wilson Law Firm, the Texas Supreme Court closed the door on this ridiculous “reasonable” claim payment argument. Louis Hinojos is a homeowner in El Paso, Texas who purchased an insurance policy from State Farm Lloyds. On June 3, 2013 the Hinojos home was hit by a severe wind and hailstorm. Hinojos filed a claim with State Farm. State Farm timely accepted the claim and investigated it. The outcome of its initial adjustment of the claim was State Farm agreed to $755.02 in property damage, but because Hinojos had a $1,290 deductible, State Farm paid nothing. Hinojos requested a second inspection and State Farm agreed to $3,859.22 in damages then but paid $1,995.11 after the subtracting depreciation and the $1,290 deductible. Not satisfied with this result, Hinojos hired the Chad T. Wilson Law Firm and suit was filed. Some fifteen months after suit was filed State Farm invoked appraisal. The appraisal award came in at $38,269.95 replacement cost value and $26,259.86 actual cash value in property damage. State Farm paid $22,974.75 on the award, which was the replacement cost value minus depreciation, the deductible, and the prior payment. This payment was made some two and one-half years after Hinojos submitted his claim. After payment on the award, State Farm filed a motion for summary judgment arguing that timely payment of the award precluded Hinojos’ TPPCA damages. The Chad T. Wilson Law Firm argued that State Farm was subject to liability because State Farm had not made any payments within the timelines set out in Section 542.057 or that State Farm was liable for interest on the difference between what State Farm had paid on the claim and the amount of the appraisal award. The trial court granted summary judgment against Hinojos and the court of appeals affirmed two and a half years later. The Texas Supreme Court granted review.

Reaffirming its holdings in Barbara Technologies and Alvarez v. State Farm Lloyds, 601 S.W.3d 781 (Tex. 2020) (per curium) the Hinojos Court held that State Farm paying the Hinojos appraisal award did not preclude Hinojos from pursuing TPPCA damages against State Farm. Better still, the Court went further. Recognizing that insurance companies could initially make a nominal payment toward a valid claim and avoid TPPCA damages by later paying an appraisal award, the Hinojos Court held that to be reasonable the initial claim payment must “roughly correspond to the amount owed on the claim.” Therefore, in the future when an appraisal award comes in several times higher than the initial claim payment, the Texas policyholder can sue for TPPCA damages on the difference between the initial claim payment and the amount of the award. Not only will this opinion allow policyholders to secure TPPCA damages for underpaid claims after appraisal, but it should also incentivize insurance companies to make valid claim payments at the inception of the claim.

Since 2005 I have dedicated my practice solely to representing policyholders in first-party cases and contract disputes. Over the years I have attended countless industry events where this person or that person gets on stage and pounds their chest talking about what they can do for policyholders. It is one thing to talk about what you can do for policyholders, but it is another thing altogether to actually do something for policyholders. Chad T. Wilson Law Firm actually did something for policyholders. Because the system was not fair to policyholders, we kept fighting this case, even after losing at the trial court and the court of appeals. We took the case all the way to the Texas Supreme Court and we won! This Hinojos decision marks a great day for all policyholders. Thanks to Andrew Bender for his appellate work in this case and to Sharon McCally who made the argument before the Texas Supreme Court.

Frozen pipe bursts wreak havoc in Texas

Texas has recently experienced winter weather not seen in ages. Temperatures fell to minus 2 degrees in some of the hardest-hit areas. Power suppliers never prepared to withstand these conditions.  Power outages across the state left almost all Texans to struggle with the cold. The combination of freezing weather and power outages caused plumbing and frozen pipes to burst and damage homes, businesses, schools, and churches.

Texans are strong and will recover but it will take time.  The scale of property damage from this winter event has never been seen before and insurers are struggling to meet the volume of insurance claims coming in.  The queue is long and insureds are having to wait weeks for their insurance company’s first inspection.

If you are a property owner, home, or business, your insurance policy specifies your responsibilities when you have a claim, notify the insurance company of your claim and mitigate the damage.  TAKE PICTURES, SHOOT VIDEOS, KEEP RECEIPTS.  Try to capture the entire state of damage, you can never have too many pictures.  With a backlog of claims, many Texans have had to start moving wet carpets and sheetrock out before their insurer’s first visit.  Ask your carrier if there are any specific requests they have to document the damage during remediation.

All insureds’ policies are unique but are derived from the same general forms approved by the Texas Department of Insurance.  Each carrier has its own name for each of the forms and variations of the same.  Most of these are “all-risk” or “named peril.”  If you don’t have an “all-risk” policy, your agent would have discussed other options which may include the accidental discharge of water or the option to add accidental discharge of water to your policy.  Read this section and be familiar with the terms; make sure the adjustment of your claim complies with those terms. Make certain to document everything. Here are some good guidelines to plan for filing your insurance claim:

• Start a journal documenting your insurance claim that includes dates, conversations, names, and contact information related to your insurance claim
• Collect receipts showing payment for damaged property.
• Collect evidence of loss and store it in a safe place.
• Take pictures and videos of the property damage.
• Get your insurance claim submitted on time.

For more tips visit: findlaw.com

SHOULD I HIRE AN INSURANCE ATTORNEY?

If 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.