Insurance Dispute Lawyer Blog

Understanding insurance terms: “All Risk” Policy

Published on: January 16, 2009 | By Berniard Law Firm

There are a multitude of different insurance policies available for homeowners to protect their home or property from all the damages that can occur in life. Along with windstorm and flood policies, there are also insurance provisions that home owners hope will protect them no matter what happens. One such example is the “all risk” policy.

An “all risk” policy is oftentimes purchased by homeowners in the hopes that it will work, as it seems to describe, to protect the owner from anything that might happen. On the surface, an all risk policy sells itself as a wide umbrella of protection that secures its validity by appearing to be all that could be assumed from its name. However, such policies also showcase just how intricate and complex the specific coverage can be and just how vague insurance companies can make coverage in order to charge high premiums and prevent payouts.

An all risk policy covers all risks unless a risk is specifically included so as not to be covered. These exclusions serve to insulate the insurance company from various different calamities that they refuse to protect claim-holders from and often relate to elements of the environment that home or property owners assume the risk of damage incurring from.

For example, damage from “surface water” may very well be one of those items an all risk policy excludes. The courts in the state of Louisiana have held that surface water may be defined by policies as bodies of water that collect and build on the surface of the ground. It does not include rainwater, overflowing a rooftop and seeping into a home.

If you feel your all risk policy covers a damage and you are not receiving the adequate policy coverage you deserve, it is essential to go back over your policy and closely examine all inclusive and exclusive language. In the event you feel that your policy covers the damages that should fall under your all risk insurance plan, call the Berniard Law Firm.

Understanding terms: “Direct Loss” and “Proximate Cause”

Published on: January 14, 2009 | By Berniard Law Firm

When dealing with insurance plans and the intricate clauses involved, it is important to fully understand the language used. In utilizing terms like these, insurance companies embed vague, variable levels of damage responsibility so as to skirt responsibility in the event damage comes to your home under what is supposed to be a covered incident. What exactly is a direct loss? What is the proximate cause of a damage? The following will hopefully help you better understand your policy and how to go about receiving the compensation you deserve when damage comes onto you:

Direct loss or proximate cause relates to the dominate and efficient cause of your property loss. In proving the proximate cause of a harm, the courts have held that, through eye witness and/or expert testimony, the insured must prove that the related incident the plan covers was the “dominate and efficient” cause of the loss. As such, it relates to a factual, not subjective, determination by the court or jury.

For example, should your claim relate to wind damage, it would be necessary to prove in court that the proximate cause of your damage to be the wind involved in the related storm. To proceed, you would then bring in an expert on wind damage to tell the court that, were it not for the extreme winds involved in the event that caused damage, your property would not be harmed.

Understanding proximate cause is extremely important because it can cause an extreme hardship to individuals who are unable to prove it when making their claim. For instance, if it can be proven that flood damage would have occurred even without the strong wins, the court or jury may deny the claim in court, alleging the damage would instead only be covered by flood insurance.

Because proximate cause is not a concrete idea and has vagueness that can lead to compelling arguments affecting the outcome of a case, it is essential to have legal representation that is able to effectively litigate in your favor. Proving proximate cause requires careful, well-developed arguments from your attorney and, perhaps most importantly, a compelling testimony from an expert on your side.

Recent Litigation Shows Need for Monitoring Insurance Companies

Published on: January 13, 2009 | By Berniard Law Firm

On Wednesday, December 17, a federal judge dismissed a very important antitrust case dealing with Louisiana insurers for lack of evidence. Former Attorney General Charles Foti, on the behalf of New Orleans citizens and various attorneys throughout New Orleans, filed a lawsuit in November of 2007 alleging that antitrust laws were being broken by insurance companies in the Gulf Coast area. The case, heavily reliant on the events that took place after Hurricane Katrina, alleged that insurance agencies were working together to underpay claims to those who had suffered damage and made hurricane insurance claims. (Read more about the case here)

Central to the suit was an allegation that a particular claims-adjustment software was being used by companies named in the suit and that this software, with minor adjustments, worked to increase the company profits while, at the same time, limiting the financial compensation to be awarded to claimants. Though the case’s dismissal likely ends the issue, it is important to understand the principles involved in why it was brought against the various insurance agencies and what may be gleaned from the ruling.

First, the fact that any dominant software format is being used by various companies to figure out compensation should be a red flag for anyone who may be making a claim in the Gulf Coast area. As each claim is different, it is important for claimants to make sure that they receive the individualized and full attention from their insurance company on their damage report. Second, vigilance on the part of professionals and everyday property owners is essential to keep insurance agencies honest in their business practices. Finally, should a claim payout under compensate a property owner, supplemental payouts from the insurance company are possible should the amount be insufficient to make the necessary repairs.

If you feel that your claim has been denied unfairly or that your payout was insufficient for the repairs necessary to return your home to its pre-storm condition, proper legal representation is essential.

Happy New Year!

Published on: January 12, 2009 | By Berniard Law Firm

We hope that everyone had a restful and happy holiday season!

The Insurance Dispute Lawyer Blog will now resume regular posting to help you handle your insurance claims for natural disasters, everyday damages, claims resolution, provider disputes and all the various problems that happen to everyday people. Whether you live in Dallas, San Antonio, Lafayette or New Orleans, hopefully this blog will help you navigate the often confusing and difficult process of insurance claims and help you get the resolution you need and deserve.

Holiday Pause

Published on: November 26, 2008 | By Berniard Law Firm

During the holiday season, the blog will be taking a brief break so as to allow staff to focus hard on insurance cases coming in before the calendar year ends. The blog will resume in early 2009 with new and helpful information on hurricane and other damage-related insurance claims for Louisiana and Texas residents, as well as those living elsewhere on the Gulf Coast.

Have a Great Holiday season and see you in ’09!

What You Need to Know About Homeowner’s Exceptions (Deterioration)

Published on: November 24, 2008 | By Berniard Law Firm

Home deterioration can happen anywhere as a result of the natural climate and conditions that exist in the Gulf Coast. Whether it is the ceiling caving in or holes emerging in the floor, various different calamities can develop in your home that require action and repair. Under Texas law it is very important to understand exactly what the law says about what your Homeowners Insurance will and will not cover in the event things in your home begin to fall apart.

Under Homeowners Insurance Form A and B in Texas, deterioration that comes from within the home’s condition itself is not covered. Specifically, Exclusion 1(f)(1) excludes losses caused by “wear and tear, deterioration or loss caused by any quality in property that causes it to damage or destroy itself.” This type of loss specifically relates to a loss brought about entirely by internal decomposition or some quality of the property that brings about damage independently.

What this means to you is simple: allowing any condition in your home to go unrepaired and untreated may lead to even more significant damage to your home than what existed before. Getting a jump on a water leak or damaged foundation may be the difference between having a claim and having the insurance claim denied under this Exclusion.

Understanding Texas Home Insurance Plans (Form B)

Published on: November 23, 2008 | By Berniard Law Firm

Homeowner’s Insurance is a necessity for many Texas residents worried about the heavy winds that can come through the area and damage homes. Wind damage is a very specific claim under Homeowner’s Insurance that can be easily recorded and claimed in many cases. However, with Homeowner’s Form B insurance in Texas, not every claim is covered outside of a very specific list.

While Homeowners Insurance Form B is the most frequently sold Homeowners policy in Texas, the fact it provides coverage on an “all-risk” basis does not mean it covers everything. In fact, Form B Homeowners Insurance in Texas only covers the following:
fire and lightning, sudden and accidental damage from smoke, windstorm, hurricane and hail, explosion, aircrafts and vehicles, vandalism and malicious mischief, riot and civil commotion, collapse of building or any part of the building, accidental discharge, leakage or overflow of water or steam from within a plumbing, heating or air-conditioning system or household appliance, falling objects, freezing of household appliances and theft.
Very absent from this list is, of course, flood protection.

Homeowners Insurance is essential for the peace of mind Texas residents are looking for in the midst of adverse weather. Flood protection, though, is an additional insurance necessary should water cause damage without being the direct result of a home collapse or wind destruction.

Understanding Texas Home Insurance Plans (Form A)

Published on: November 21, 2008 | By Berniard Law Firm

When getting Homeowners Insurance in the state of Texas, it is important to understand just what is, and is not, covered by these policies. While agents might be eager to assure you that any accident or damage can be quickly claimed under Homeowners Insurance policies, citizens in Texas found themselves out of luck in the wake of Hurricane Gustav. Instead of hoping that your protection is all you need it to, get informed about your policy.

Under Texas Law, there are two very specific types of Homeowners Insurance – Form A and Form B. With these types of policies, the exclusions to coverage are what is important to point out.
Under Form A Homeowners Insurance, the following incidences are covered:
fire and lightning, sudden and accidental damage from smoke, windstorm, hurricane and hail, explosion, aircraft and vehicles, vandalism and malicious mischief, riot and civil commotion, and theft. Form A does not, however, cover losses caused by a “flood,” surface water or the overflow of streams or lakes. This means that while your homeowner’s insurance would cover a plane crashing into your home, it will not cover any damages the Colorado River could cause if it overflowed.

Homeowner’s Form A insurance is a great policy to have for Texas residents hoping to protect their home from a Christmas fire or the torrents of hurricane wind. However, Form A, as noted, is not enough coverage to protect your home in the event of the very types of flooding that Texas saw during Hurricane Gustav.

How to Save Money on your Home Insurance Deductible

Published on: November 20, 2008 | By Berniard Law Firm

Saving money when buying home insurance is often essential for Louisiana residents looking for the best coverage for the most reasonable rate. The Gulf Coast’s recent struggle with hurricanes has made it even more evident just how important sound, proper insurance coverage is for resident’s homes. Hurricane Katrina’s damage was unfathomable to many and Hurricanes Ike and Gustav were even able to catch some Louisiana residents offguard. Coverage for storm damage is essential and there are several things you can do to save on your home’s monthly insurance payment.

Raising your deductible on your home’s insurance coverage is often a surefire way to lower monthly dues. Using one insurance provider for all of the various coverage aspects you are looking to get for your house is also a way to get appreciable savings. An exhaustive search of all of the various resources for insurance is an excellent way to make sure your price quote is the best available. Searching online and making phone calls to agents in your area could save you hundreds of dollars monthly. Protection systems like flood doors and alarms can also raise your property value and lower your premiums.

Protecting Yourself From Inadequate Insurance Coverage

Published on: November 18, 2008 | By Berniard Law Firm

When buying insurance, it is often hard for homeowners to know if they are buying too much or too little. When asking an agent, people expect and appreciate candor and honesty when it comes to know how much insurance is necessary to protect their home. This trust that is placed into an agent’s skill and honesty is one that must be respected by the agent but also inspected and checked by the client.

When getting an insurance plan, requesting a second opinion from another agent or insurance company is a safe way to not only guarantee that you are getting the best rate but also the coverage you need. It will also confirm or deny the claims of another agent regarding what best suits your needs. After Katrina and many other hurricanes and tropical storms, lawsuits come to the public’s attention where an agent assured their client that hurricane damage would be covered under the homeowner’s insurance in place. This, however, is often not the case and leaves the homeowner out to dry.

In the Louisiana case of Schwartz v. Chubb & Sons Inc., the courts dealt with a similar issue of when the time for filing suit against an insurance agent who commits such misdirection expires. The courts in this case held that many current laws may be extended when an agent’s misinformation regarding coverage is damaging to the home owner.

Whether in the process of purchasing insurance or simply checking the plan in place, it is important to not only document what the agent states regarding coverage but also read the language yourself. A homeowner would much rather be properly protected before something happens to their home rather than have to go to court to get the financial compensation they require.