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.

North Dallas Sees Softball-sized Hail

Softball-sized Hail Hits North Dallas

Nestled on the south side of the western edge of Lewisville Lake rests the City of Highland Village. This suburb of north Dallas is known for its annual hot air balloon festival and its summertime firework shows. The region is also known for its history of wind damage and hailstorms.

Softball-sized Hail Thrashes Denton County Costing Millions

On Sunday night, March 26, 2017, a powerful hailstorm (fueled by an abnormal amount of moisture from the Gulf of Mexico) blew through wreaking havoc as it passed through. Softball-sized Hail measured up to four and a half inches across was witnessed by residents. For comparison, a softball is four and a quarter inches across. Thousands of property owners reported severe roof damage, along with busted-out skylights and windows. The majority of the property damage occurred in fifteen minutes after 8 p.m. that night. The hailstorm was reported to be so bad, one Fire Chief’s windshield was destroyed and he had to leave his vehicle and take shelter in an abandoned building for protection.

Our client’s newly constructed, multi-use commercial complex (or town center), which consisted of shops, stores, a leasing office, and apartments experienced the full force of the hailstorm. A total of eleven roofs (4 TPO, 3 modified bitumen, 2 three-tab shingle, and 2 laminated composition shingle), and all the roof-mounted HVAC equipment and accessories were damaged beyond repair or destroyed. The fact that these new roofs had to be replaced is a testament to the property damage that occurred.

Quadrupling The Award Is The Reward

AmGuard Insurance responded to our client’s insurance claim by sending out their adjustors who substantially undervalued the damage. Knowing AmGuard’s inspection results did not represent reality, our client hired us to represent them against their insurance carrier.  After our representation concluded, our client had ample funds to replace all eleven damaged roofs and acquire new HVAC equipment for the complex as well as reimburse litigation expenses and pay the firm’s fee.

Texas Property Insurance Lawyers

Has your homeowner’s or commercial business insurance claim been denied? We can help. Representing thousands of client’s against big insurance companies, our insurance claims attorneys aggressively protect the rights of the policyholder. Our consultations are free, and you owe us nothing until we win your case. Contact us today.

Wind and Hailstorm Damage in Houston

Our client’s office building was severely damaged in the wind and hailstorm that occurred in Houston on January 8th, 2016. The lawsuit against the Hanover Insurance Group was unavoidable due to their practices and the handling of our client’s insurance claim. Without anywhere else to turn, our client chose to hire us to make sure Hanover Insurance honored their commitment and paid for roof and damaged air conditioning units.

Huge Hail Causes Havoc in Houston

The wind and hailstorm dropped golfball-sized hail in Houston and the surrounding areas. The local news stations were inundated with images of people holding huge balls of hail. Our client’s property was a large commercial office building built in 1974, which featured five individual modified bitumen-style roofs. All of the facility’s air conditioning units were destroyed by the hailstorm. The roof-mounted units did not stand a chance against the sheer destructive force of the storm. Some exterior damage to the roof itself also occurred.

The Wind and Hailstorm Claim

Hanover Insurance outright denied our client’s insurance claim, stating after sending four of their adjusters, that no damage had occurred. Seeing that negotiating with their insurance company was a dead end, our client chose to sue Hanover Insurance. Our third-party adjusters evaluated the damage to the office building and determined the real property damage was far greater than nothing.

After mediation, our client was able to secure the finances to repair the roof damage and have all of the damaged air conditioning units replaced. Our client’s business would resume operations and their lives could get back to normal.

Houston Property Insurance Lawyers

We can help with your commercial property insurance claim denial. Our experienced property insurance attorneys have represented more than 1,000 clients in cases against insurance companies and aggressively protect the rights of insurance policyholders. Consultations are free. Contact us today.