Insurance Dispute Lawyer Blog

Couple underpaid by insurer after Katrina receive additional $500,000

Published on: February 5, 2009 | By Berniard Law Firm

When James and Gladys Kemp Lisanby felt they did not receive the proper amount they deserved from their insurance company after Hurricane Katrina severely damaged their home, they did what many Gulf Coast residents are unfortunately too scared or unsure to do: they got a lawyer. And they won.

After receiving over $900,000 in 2008 for their suit of policy limits for their losses and punitive damages as a result of deliberate underpayment, the Lisanbys received an additional $500,000 in January of 2009, bringing their total awardance to over $1.4 million. The additional $500,000 was awarded to compensate legal costs and case fees. The Mississippi couple successfully sued their insurance company, United States Automobile Association, after USAA paid the Lisanbys approximately $45,000 for damage done to the structure and property located on the second floor.

The important message sent by the Mississippi courts is simple: the law will help defend Gulf Coast residents when they are hit by underpaying insurance companies. Various cases similar to the Lisanbys’ have gone through Louisiana and Texas courts.

Understanding Terms: Glossary

Published on: February 4, 2009 | By Berniard Law Firm

When going about shopping for the right policy or making sure your policy protects you in the ways you need, it is important to understand insurance terms used. In educating yourself about the legal jargon employed by the insurance companies, you can be better prepared to combat an unfair claim payment or prevent your policy from being hijacked by vague language.

Below, courtesy of the University of Illinois, is a glossary of insurance terms from the letter C:

Case management. An approach designed to provide effective treatment to meet the specific needs of people with serious medical problems. Benefits not traditionally covered (for example, medical equipment) may be provided to promote cost-effectiveness.

Understanding Terms: Glossary

Published on: February 3, 2009 | By Berniard Law Firm

Understanding Terms Used in Insurance Claims

When going about shopping for the right policy or making sure your policy protects you in the ways you need, it is important to understand insurance terms used. In educating yourself about the legal jargon employed by the insurance companies, you can be better prepared to combat an unfair claim payment or prevent your policy from being hijacked by vague language.

Below, courtesy of the University of Illinois, is a glossary of insurance terms, ranging from the letter A to B:

State Farm withdraws from Florida’s Property Insurance market

Published on: February 2, 2009 | By Berniard Law Firm

Per the Wall Street Journal, State Farm is dropping all of its homeowner policies in the state of Florida. Citing the difficulty of remaining stable in an area that has seen serious hurricane damage in the past decade, State Farm had as many as 700,000 homeowners policies as of September 30th.

One of the most important things to note is State Farm’s choice to withdraw came after Florida regulators refused to accept State Farm’s request to rase rated by 47%. This rate rise would have significantly helped the company’s profits in the wake of a series of hurricane seasons that have driven more people for coverage.

In the wake of this withdrawal, it is important for policy holders in the Gulf Coast to remain vigilant on their payments and not accept rate increases blindly. State Farm’s actions in Florida could easily occur in states like Texas and Louisiana where hurricanes Gustav and Ike caused millions of dollars of damage to policy holder’s homes and property. Care must be taken to use an insurance provider that is proven and tested by previous disasters or widespread damage in order to guarantee that your policy will be handled properly.

Recent Article About Road Home Plan and Insurance Providers

Published on: January 31, 2009 | By Berniard Law Firm

Insurers seek dismissal of state’s Road Home suit

NEW ORLEANS — Lawyers for some of the nation’s largest insurance companies asked a federal judge on Friday to dismiss a lawsuit filed by a former Louisiana attorney general, calling it “a bald attempt” to force insurers to increase payouts for hurricanes Katrina and Rita.

U.S. District Judge Stanwood Duval Jr. heard arguments from lawyers on both sides of the case, but didn’t immediately rule on the companies’ request for him to dismiss the class action suit filed in 2007 by former Attorney General Charles Foti.

Lawyers for Allstate Insurance Co., State Farm Fire and Casualty Co. and other insurers claim the attorney general’s office is trying to take over the rights to more than 155,000 policyholder claims, to recover money the state paid out through the federally funded Road Home homeowner grant program after the 2005 hurricanes.

But the companies say the state already had deducted insurance payments in calculating grant awards.

More can be read at the KATC website, the article being available here

The insurance companies will fight tooth and claw to keep from paying out on claims and often make the process unbearable for policy holders looking to make a claim, going so far as to fight the state when it tries to step in for citizens. It is important to remain on top of your claim at every step and retain adequate legal council if necessary.

Mississippi Mayor pleads not guilty to Insurance scam

Published on: January 30, 2009 | By Berniard Law Firm

Gulfport’s mayor, Brent Warr, along with his wife, pled not guilty to a 16-count indictment charging the city head with seeking financial assistance in the form of a grant for a beachfront home they did not live in but merely owned. With the charges, the government is seeking $222,798 and accuses the pair of lying to their insurance company. The storm damages were linked to Hurricane Katrina, a storm in 2005 that devastated the Gulf Coast region and left thousands homeless.

The lesson? Don’t lie to your insurance company. Follow the letter of law with the assistance of an attorney to make sure your claim is on the up and up. Individuals who lie on their insurance claims cost policy owners money as premiums go up and insurance companies seek to justify their hard-nosed process of investigation and claim denial. By working with a legal and building expert, you can present the most comprehensive and honest claim to get you the money you’re owed.

For more information on Mr. Warr’s legal troubles, click here

Ike Victims in Texas Possibly Eligible for Extra Coverage

Published on: January 25, 2009 | By Berniard Law Firm

Good news for some of those people who were hit hard by Ike:

Texas Ike victims may be eligible for additional coverage

NAMIC DAILYLEAD | 01/26/2009

The Burden of Proof in an Insurance Claim

Published on: January 21, 2009 | By Berniard Law Firm

Should an insurance claim go to court, there is a strict process and shifting burden of proof when damage comes to your property. Whether dealing with a questionable cause to damage or if an exclusion prevents you from making a claim, the court takes a different approach that is necessary to understand when building your case.

While an insurance company policy often means to people a specific protection that seems simple enough, this is not the case. It is in fact the responsibility of the insured to prove whether or not a policy affords coverage for an incident. This burden of proof is heavily relied upon by insurance companies because, if it is not met, the insured is left out in the cold, regardless of how expensive premiums were or how confident they were in the the policy’s protection.

With this basis of a burden of proof on the insured to demonstrate the damage incurred is covered by their policy, this is not the case for policy exclusions. In regards to exclusions, it is the insurance company’s burden to prove that the exclusion is applicable to the incident in question.

Here is an example of how these burdens can play out:
A homeowner in Lafayette has windstorm protection. A heavy storm rolls through and a tree branch knocks in the roof. As the storm rages, the kitchen begins to fill with water. In the aftermath, the insurance company refuses to pay for the water stains and various other rain-based damages that come from the storm. The burden of law falls upon the homeowner to prove, through expert testimony and a fact pattern, that the tree branch was knocked down by the wind and that the water damage would have never occurred had the wind not damaged the tree and so on. However, if the insurance company maintained an exclusion that they would not insure tree damage from branches that hang within 5 feet of the home, it would be their responsibility to prove that the tree was, in fact, within the prevented distance.

As you can imagine, it is essential to have the best legal team possible to meet the burden of proof or disprove that of the insurance company’s.

Problems With Insurance Companies

Published on: January 20, 2009 | By Berniard Law Firm

In the wake of Hurricane Ike, residents of the Gulf Coast are beginning to piece together their lives and rebuild their property as they attempt to return to a sense of normalcy. While making claims for damages rendered by the storm, various difficulties will arise that Texas, Louisiana, and Mississippi residents must remain vigilant and observant for to prevent abuse and misconduct on the part of insurers.

When disasters like Ike occur, problems with insurance claims consistently pop up that relate to the following issues:

Improper adjusters
Forced/intentionally confusing settlement offers
Refused claims based upon no merit
Harassment
Grievously low estimates
Incorrect rebuilding figures
Bad faith efforts on the part of insurers
Frivolous litigation threats
Such actions can truly hinder and harm insured victims of storms that are merely looking for a way to return to what was once home. While federal protection agencies serve as a watchdog for these forms of fraud and misconduct, they often are incapable of handling every single instance. When this happens, it is essential for claimants to have proper representation to protect themselves from being bullied or mishandled by the insurance agencies.

If Allstate, State Farm or any of the other insurance companies in the Gulf Coast are giving you a hard time in your insurance claim, contact an attorney immediately.

Settlements and Payments of Claims

Published on: January 19, 2009 | By Berniard Law Firm

An insurance agency has a specific duty to settle and pay a claim that meets the required standards for an insured damage. This duty is set into motion when the claimant submits what is considered a “satisfactory proof of loss.” In Louisiana, the courts have held that satisfactory proof of loss is to be considered with reference to the relevant law and the policy itself.

In the case of Louisiana, the relevant general substantive law states that reporting requirements are inherently minimal and do not have a high threshold to satisfy. The Second Court of Louisiana has gone so far as to hold that there is no specific or particular form required for such a claim and, in some cases, may even just be simple verbal notification to the insurance agency itself. The basic purpose of the notification requirement by law is to alert the insurer of the facts of the event upon which the claim is being made.

However, when dealing with the proof of loss itself, insurance agencies often place very strict or rigid requirements for the actual means in which a claim is fully reported or demonstrated. While insurance companies may allege certain requirements such as filling out your claim with only their forms, these requirements are subject to the court’s review. Supporting this idea, courts will more often than not prevent insurers from restricting payouts on the basis of a technicality. The fact judicial discretion can settle this issue and that it is not explicitly clear by the word of law, though, makes this an important issue to always be ahead of.

When dealing with an insurance company, it is important to remain vigilant not only with paying premiums on time and following your end of the agreement to the most minor detail, but also with any claim process that should develop. By filling out a claim exactly as proscribed by the insurance agency as well as notifying them of any impending claim when the damage occurs, you begin setting yourself up for a solid claim defense should it be necessary. If the insurance company denies your claim on the grounds that the proper procedure was not followed, however, contact an attorney immediately to review your case.