Raizner Slania LLP has filed an insurance lawsuit on behalf New Jersey commercial property owners (“Plaintiffs”), who own property in Caddo Parish, Louisiana (“Plaintiffs”) against Great American Insurance Company of New York (“Great American” or “Defendant”). The lawsuit was necessary due to the wrongful rejection of the Plaintiffs’ property damage claim.

Wind and Hailstorms Cause Property Damage

On or about March 25, 2019, a severe wind and hailstorm caused significant damage to the subject properties, including the roof systems. Significant leaks resulted after another severe wind and hailstorm on May 8, 2019. The property manager hired a licensed public insurance adjuster, on behalf of the property owners, to assess the damage from the storms. 

The public adjuster submitted a claim to Defendant for payment to cover the damages under the policy. The Defendant retained an independent adjuster, Engle Martin & Associates, to investigate the claim. However, Engle Martin only investigated some of the properties on May 13, 2020. During the investigation, the Plaintiffs’ professional consultants were present and specifically identified significant physical damage to the roof systems and exterior of the properties. Further, Plaintiffs’ consultants pointed out interior damage and leaks caused by the hail damage in support of the claim.

On September 9, 2020, Defendant sent a reservation of rights letter indicating it maintained its right to disclaim coverage for loss or a portion of each loss at a later date while the investigation was ongoing. The reservation of rights letter included a summary of the report by its consultant, Roof Technical Services, which recognized wind and hail damage as well as hail dents and impacts. However, Defendant’s consultant was careful in drafting the report to diminish the impact of the obvious damage. Despite Defendant’s own consultants recognizing the presence of wind and hail damage at the properties, the Defendant ignored all evidence of covered damage presented by both the Plaintiffs’ and the Defendant’s retained consultants.

On December 7, 2020, Plaintiffs sent a sworn statement in partial proof of loss that outlined in detail the extent and nature of their loss. On January 14, 2021,Defendant’s retained counsel at Chaffe McCall LLP rejected the proof of loss, and to date the insurer has paid nothing.

The Insurance Carrier Breached its Contract and Acted in Bad Faith 

Under LSA-R.S. 22:1892, an arbitrary, capricious, and without-probable-cause failure to pay benefits owed subjects an insurer to a penalty of 50% of amounts due plus reasonable and necessary attorney’s fees and costs incurred. 

The Plaintiffs additionally allege the carrier breached its contract, breached its duty of good faith and fair dealing, and acted in bad faith by: 

  • Unreasonably and in bad faith denying benefits due under the property and casualty insurance policy.
  • Unreasonably and in bad faith denying payment or settlement of claims.
  • Unreasonably and in bad faith ignoring and refusing to consider information favorable to the plaintiff’s claim for benefits due pursuant to the property and casualty insurance policy.
  • Unreasonably and in bad faith refusing to pay the benefits the Plaintiffs are due pursuant to the property and casualty insurance policy.
  • Unreasonably and in bad faith placing its own welfare and financial interests ahead of the welfare and financial interests of the Plaintiffs.
  • Unreasonably and in bad faith compelling Plaintiffs to institute this litigation to obtain benefits due under the property and casualty insurance policy.
  • Misrepresenting pertinent facts or insurance policy provisions relating to any coverage at issue.
  • Failing to pay the amount of any claim due any person insured by the contract within 60 days after receipt of satisfactory proof of loss from the claimant.
  • Failing to pay claims pursuant to R.S. 22:1893 when such failure is arbitrary, capricious, or without probable cause.

Insurance Coverage Attorneys

If you are a commercial property owner whose insurance claim has been wrongfully delayed, denied, or underpaid, the insurance coverage attorneys at Raizner Slania can help. Contact us today to schedule a free consultation.

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