Retained by insurance agency counsel defending alleged Agent Errors and Omissions for failure to procure Business Income coverage for Covid-19 losses under a Commercial Auto (Mobile Operations) endorsement to a Businessowners policy. Case required response to a laundry list of alleged duties owed by the agent far outside the accepted standards of care for a reasonably prudent Texas insurance agent. Case assessment included the lack of physical damage, the standard virus exclusion found in most ISO property forms, and the likelihood of the insured’s failure to read the policy. Attorneys John Nevins and Robert Bragalone, Gordon Rees Scully Mansukhani, LLP, (214) 231-4660. Sanbuco v. Governor Insurance Agency, et al; Civil Action No. SA-20-CV-01045-XR In United States District Court, Western District of Texas San Antonio Division.
Business Income Insurance Expert Witness
All businesses face exposure to Business Income (f/k/a Business Interruption) (“BI”) losses caused by physical damage to its facilities (e.g., fire, windstorm, collapse). BI coverage provides money to replace Net Income, and Continuing normal operating expenses, including payroll (e.g., profits, loan payments, payroll) during the period of restoration. For property owners/lessors coverage is typically referred to as Rents insurance. Optional Extra Expense (“EE”) coverage is intended to pay for extra expenses incurred during the period of restoration to minimize the suspension of operations (e.g., relocation, overtime, expedited freight).
Business Income is also known as Time Element and/or consequential loss coverage in the sense that it covers the time period when operations are interrupted as a consequence of physical damage (e.g., fire, windstorm, collapse) to a business’ facilities. Because BI/EE coverage is based on “forward looking” financial projections/estimates, claim settlement can be complicated. Absent the physical damage, what would the Profit and Loss statement have shown? What is a reasonable period of restoration? How did extra expenses incurred minimize the suspension of operations?
Business Income and Extra Expense insurance policy forms and endorsements are available to insure losses resulting from:
- Physical Damage to buildings/contents
- Loss of Rents
- Off-premises utilities
- Dependent properties
- Extended Period of Indemnity
- Equipment breakdown / Food Contamination
- Builders Risk soft costs
Customized BI/EE policy forms are usually required to cover losses from Electronic media (Computers), International operations, Food Borne Illness, Dependent properties, and Seasonal variation.
We can help with your insurance expert witness search. Call (817) 980-4897 to discuss your case.
BI/EE Coverage Issues
Business Income and Extra Expense coverage can be added by endorsement or written separately because it is typically excluded in Commercial Property Insurance policies. Coverage issues include:
- Calculating accurate/adequate BI/EE limits of insurance.
- Completing a Business Income Worksheet?
- Where does money come from for continuing expenses when business is suspended due to a fire or tornado?
- How long will the business survive if income is reduced by 25%-50%-100%?
- How long can we survive a loss of Business Income before closing the doors?
- How do we establish the length of time for Extended Period of Indemnity coverage?
- What ‘Extra Expenses’ could we incur? How will we pay for those?
- Do we have Selling Price coverage for any of our inventory?
Call (817) 980-4897 to discuss your case.
BI/EE Claims
A $25,000 fire loss can result in a disastrous $500,000 BI/EE claim. Without adequate “BI/EE” insurance limits most businesses cannot survive any extended loss of Business Income.
Resolving BI/EE claims efficiently depends on:
- Properly structured BI/EE coverage forms and adequate limits of insurance.
- Carriers are obligated to investigate and attempt settlement of the claim in reasonable fashion.
- Policyholders are obligated to make efforts to resume operations as soon as soon as practical.
Numerous insurance industry and customer documents are used to substantiate the claim, establish the amount of loss, and/or facilitate settlement:
- Historic pre-loss rent rolls
- Pre-loss accounting data as a template for post-loss expenses.
- BI/EE accountant experts familiar with technical BI/EE issues (retained by policyholder and/or carrier).
- Good faith carrier-policyholder negotiations for variable cost items.
Mr. Daniel offers wide experience with BI/EE insurance from advising clients on initial coverage design through final claim settlement. As a Business Income Insurance expert witness he has been retained on dozens of cases, as well as serving as policyholder’s BI/EE claims representative.
Our Experience with BI/EE Coverage
Mr. Daniel’s experience with Business Income and Extra Expense spans 48 years, including nearly 2 decades as an insurance expert witness. Representative client industries:
- Manufacturers
- Retailers / Wholesalers
- Contractors
- Property owners
- Importers / Exporters.
He is frequently engaged as a Business Income/Extra Expense insurance expert witness (see “Cases”) to provide analysis and opinions on various BI/EE coverage and claims issues:
- Manufacturer’s Selling Price valuation
- Loss of Rents
- Agreed Value
- Off-Premises Utilities
- Extended Period of Indemnity
- Dependent Properties
- Ordinance or Law
- Computers / Electronic Equipment / Media
- Builder's Risk “soft costs”
- Inland Marine / Ocean Marine
- Boiler & Machinery / Equipment Breakdown
- Coinsurance / Agreed Value
- Business Owners policies
- Business Income Worksheets
Business Income Cases
Retained by policyholder counsel seeking claim payment for October 2019 tornado losses in Garland, TX. Case required evaluation of Inland Marine, Commercial Property and Business Income clauses and coverage under a Stock Throughput Policy. Litigation ensued following claim denial based principally on nonexistent policy language relative to unscheduled locations and carrier delay/refusal to attempt good faith settlement. Attorneys Darrell Adkerson, Adkerson, Hauder & Bezney, P.C. (214) 740-2500 and Troy Morris, Perez Morris LLC (855) 580-7530. Transform v. Starr Indemnity & Liability Co., Cause No. DC-20-03860 In The 116th District Court, Dallas County, Texas.
Retained by counsel for carrier seeking recovery from the insurance agency based on material misrepresentations regarding the fire protection system required by the carrier to insure a hotel. Engagement required analysis of communications between insured/agency and managing general agent relative to carrier underwriting guidelines and non-compliance with inspection requirements. Litigation ensued following initial claim denial and later payment for a total fire loss to the hotel. Attorney Jennifer Martin, Wilson, Elser, Moskowitz, Edelman & Dicker (214) 698-8000. Liberty Mutual Insurance Europe v. Cottom/RCI Insurance Group, Case No: CJ-2016-03004 In The District Court Of Tulsa County State of Oklahoma.
Engaged by policyholder counsel alleging Agent Errors and Omissions as its basis to recover coinsurance penalties. Despite assuming duties to set replacement cost limits for a hotel, the insurance agency made material errors resulting in deficient property limits and the property being severely underinsured for a hailstorm claim. Engagement required analysis of agency’s flawed valuation methodology using tax rolls and appraised ‘market value’, coinsurance calculations, and issues involving Ordinance & Law and extended Business Income loss. Attorney Todd Hurd (817) 426-4529. Cornerstone, et al v. Rodda Yates, et al; Cases No. 2015-514,308 In The District Court Of Lubbock County, Texas, 99th Judicial District.
Engaged by policyholder counsel to analyze Property and Business Income/Extra Expense coverage issues under Property, Docks & Piers and Excess Ocean Marine policies for two fire losses originating from a tenant’s dockside storage of wood pellets. Case included review of coinsurance issues, tenant’s status as a Dependent Property for Business Income loss plus carrier subrogation against tenant’s Commercial General Liability policy. Travelers (as subrogee of Port of Port Arthur) v. Texas Pellets, et al, Cause No. B-203,222 In 60th Judicial District Court, Jefferson County, Texas. Attorney Clint Brasher, Brasher Law Firm, PLLC. (409) 832-3737
Retained by counsel defending against a third-party landlord’s allegations of Agents Errors & Omissions and Insurance Bad Faith for ‘failure to procure’ additional insured status. Policyholder’s landlord alleged reliance on being a Certificate Holder on ACORD Certificates of Liability Insurance as grounds for being an additional insured under policyholder’s Commercial General Liability and Environmental Liability policies. Engagement required analysis of insurance requirements in the lease, scope of coverage for additional insureds and/or whether landlord ever requested being added as an additional insured. Landlord’s allegations also included Business Income Loss of Rents during site cleanup. HLT v. AssuredPartners, Case No. 1:18-cv-00045-RP, In The United States District Court For The Western District of Texas, Austin Division. Attorney Lisa Yerger, Macdonald Devin P.C. (214) 499-5116
Engaged by policyholder counsel to analyze NFIP, non-NFIP and/or Excess Flood Insurance issues. Case required analysis of NFIP Flood Zones remapping and Flood Insurance Rate Map revisions for a Hurricane Harvey loss at an uninsured location. Agency was retained under terms and conditions of a fee-based insurance and risk management services contract. Attorney Will King, Feldman and Feldman, PC (713) 986-9471. The Harris Center v. Higginbotham, Case No. Case No. 201812120 In 80th District Court, Harris County, Texas.
Retained by policyholder’s counsel to opine regarding material misrepresentations made by the wholesale agent/intermediary in placing a large apartments/condominiums enrollment policy. Misrepresentations included the structure of self-insured retentions, towers of policy layers with multiple carriers, stop-loss limits and failure to add/delete properties when requested. Case required analysis of issues including Agents Errors & Omissions, Insurance Bad Faith, Commercial Property and Business Income Insurance. Property Risk Services Management v. Jonathan Hilsher, Risk Placement Services, et al, Cause No. DC-18-04287 In The 193rd Judicial District Court, Dallas County, Texas. Attorney Tim Soefje, Seltzer Chadwick Soefje & Ladik, PLLC (469) 626-5180.
Engaged by defense counsel to address allegations of Insurance Agent E&O / Bad Faith involving Business Income – Rents insurance. Dispute resulted following a restaurant fire loss and subsequent carrier denial of landlord’s claim for Rents coverage under tenant’s Property insurance policy. Case required analysis of insurance requirements in a building lease, numerous years of tenant and landlord carrier/coverage histories and associated Certificates of Insurance. Attorneys Bill Threlkeld and James Wilcoxen, Fenton, Fenton, Smith, Reneau & Moon, PC, (405) 235-4671. PWB v. Frates Insurance, Case No. CIV-17-387-R, In The United States District Court For The Western District of Oklahoma.
Engaged by policyholder counsel to analyze and opine on issues relative to Agents Errors & Omissions relative to Business Income coverage. Dispute resulted from Insurance agency’s failure to follow up with policyholder on carrier request for Business Income underwriting information at a new location. This failure resulted in partial denial of a Business Income claim when a building collapsed. Attorneys Mike Abrams and Kim Winter, Lathrop Gage, LLC (816) 460-5530. Axiom v. Marrs & Davolt, Case No. 16CY-CV00586 Division No. 5, In the Circuit Court of Clay County Missouri.
Engaged by counsel defending insurance agent against Agent Errors & Omissions failure to procure allegations. Case involved carrier notice to the insured that the flood peril would be removed at renewal of its property policy. Agent received no response to NFIP flood quotes provided to the policyholder. Policyholder now asserts that it instructed agent to procure NFIP replacement policies for two locations which subsequently sustained uncovered flood losses. Attorney Anthony Green, Winget, Spadafora & Schwartzberg, LLP (212) 221-6900. Pinnacle Property v. Haylor Freyer & Coon, et al, Index No.: 2016EF2833, Supreme Court of The State of New York County of Onondaga.
Engaged by policyholder counsel as their designated Property and Business Income expert to opine regarding claims handling for two Business Interruptions resulting from one water loss. Case involved partial claim denial for a furniture store’s second temporary business closure. Attorney Michael Collins, Hill Farrer & Burrill LLP, (213) 620-0460. Leather Expo, Inc. v. California Capital Insurance Co., Case No. BC611176 Superior Court Of The State of California County of Los Angeles Central District.
Engaged by policyholder counsel as their designated expert for Agents Errors & Omissions and Insurance Bad Faith to evaluate issues regarding failure to procure proper insurance coverage. Case involved claim denial of a large wood kiln fire loss due to improperly structured Property. Boiler & Machinery and Business Income Insurance. Attorney Brady Rife, McNeeley Stephenson Attorneys (317) 825-5110. Kustom Kilns v. Nuthak, In Shelby County Superior Court I, State of Indiana, Cause No. 73D01-1502-CT-5.
Engaged by agent’s defense counsel as their designated expert for Agents Errors & Omissions and Insurance Bad Faith. Case involved Property and Business Income Insurance written on a Surplus Lines basis. Dispute resulted from hailstorm claims adjusted on a Per Location/Per Occurrence Wind and Hail deductibles basis. Hipoint v. Pathfinder, et al, Case No. Case No.5: 13-cv-687-D In The United States District Court For The Western District of Oklahoma. Attorney Jim Secrest, Secrest Hill Butler & Secrest, PC (918) 494-5905
Engaged by defense counsel for Surplus Lines broker as their Agent Errors & Omissions and Insurance Bad Faith expert. Case required analysis of Property, Flood Insurance and Business Income claims issues relative to Statements of Value, Margin Clauses and Scheduled vs. Blanket policies. Litigation resulted from disputed values during flood claim settlement. Attorneys David Clark and Jack Urquhart, Beirne, Maynard, & Parsons, LLP (713) 623-0887. Menard v. Wells Fargo and Swett & Crawford; Civil Action No. 10-cv-7592, State of Wisconsin Circuit Court Milwaukee County.
Engaged by defense counsel as their Flood Insurance and Agent’s Errors & Omissions expert. Case required analysis of Insurance Bad Faith allegations resulting from claim denial for Flood Zone A locations. Claim included loss of Property and Business Income under an Inland Marine policy form. Attorney Tom Cooper, Pignato, Cooper, Kolker, & Roberson, P.C. (405) 606-3333. Coast to Coast Power Sports v. Robert Bates Agency, et al; Case No. CJ-2012-03555 In The District Court In And For Tulsa County, Oklahoma.
Engaged by agent’s defense counsel as their Agents Errors & Omissions, Insurance Bad Faith, Business Income and Property Insurance Expert for multiple Hurricane Ike apartment complexes claims. Case involved Surplus Lines, standard of care, and disclosure of material facts relative to coastal windstorm deductibles. Landco v. Consolidated American Services; Cause No. 2010-23329 In The District Court Harris County, Texas, 281st Judicial District. Attorney Kevin Madden, Kane Russell Coleman & Logan PC, (713) 425-7452.
Consulting expert engaged by counsel for carrier and surplus lines agent pursuing recovery from retail agent. Case involved placement issues for a Food Borne Illness policy covering Trade Name Restoration, Loss of Business Income and Incident Response. Following claim denial for an E-coli outbreak, litigation resulted from retail agent’s “failure to disclose material terms” to restaurant franchisees enrolled under a Master policy. Lloyds and Professional Liability Insurance Services v. IMA of Kansas; Cause no. D-1-GN-10-004172 In District Court of Travis County, Texas, 353rd Judicial District. Attorney Christopher White, Lewis Brisbois Bisgaard & Smith LLP (214) 722-7100.
Engaged by carrier’s defense counsel as their Insurance Bad Faith, Business Income and Property Insurance Expert. Case required evaluation of claims handling practices relative to partial denial of water damage and mold claims based on a wear and tear exclusion. Eagles Nest Church v. State Auto Insurance, et al; Cause No. 096254334-11 in The 96th Judicial District Court, Tarrant County, Texas. Attorneys Charles Mitchell and Ray Palmer, Naman Howell Smith & Lee, PLLC , (817) 509-2025.
Engaged by policyholder counsel as their Boiler & Machinery and Property Insurance Expert. Case required analysis of Difference-in-Conditions coverage, Business Income and Insurance Bad Faith regarding carrier’s claims handling practices. Case involved Boiler & Machinery cause and origin review of pressure vessel implosion at a Chlor alkali plant near Las Vegas, NV. Olin Chlor Alkali Products v. Continental Casualty, et al, Case No. 2:10-cv-00625-GMN-RJJ in United States District Court for the District of Nevada. Attorney Lorie Masters, Jenner & Block LLP, (202) 639-6076.
Engaged as a Property Insurance Expert by policyholder seeking coverage for Hurricane Ike Builders Risk claims. Case included allegations of Insurance Agent Error & Omission and carrier Insurance Bad Faith. Case required expertise with construction agreements relative to ordinance and law coverage, large Wind and Hail deductibles, and Business Income soft costs under Inland Marine builders risk policies. Attorney Windell Snow (316) 263-5959; Construction Services Bryant v. Cincinnati Insurance Company, Case No. 09 CV 3137 in the Eighteenth Judicial District Court, Sedgwick County, Kansas, Civil Department.
Designated by counsel for policyholder as their Flood Insurance and Property Insurance Expert. Case required analysis of excess flood Business Income, funding excess flood deductibles with NFIP policies, and the effect of ‘Other Insurance’ policy language. Attorney Wendy O’Connor, Tallman, Hudders & Sorrentino, P.C., (484) 765-2274. Pine Grove Manufactured Homes v. Indiana Lumbermens, et al; Civil Action No. 3:08-CV-1233, US District Court for the Middle District of Pennsylvania.
Engaged as Property Insurance Expert by a property owner following a fire loss. Case required knowledge of coinsurance, Agents Errors & Omissions, Insurance Bad Faith and Business Interruption. Fuller v. Ramey King and Northfield Insurance; Cause No. 352232972, 352nd Judicial District Court of Tarrant County, Texas. Attorney Barry Hasten, Hasten & Hansen Attorneys, (817) 429-0956.
Designated by plaintiff counsel as their Property Insurance Expert regarding a total loss due to Hurricane Wilma. Provided analysis pertaining to Agent Error & Omission. Case issues involved Florida Windstorm insurance, Business Income and Surplus Lines Insurance placement. Scott Katz & Beth Berry, Butler Pappas Attorneys , (813) 281-1900. TCB Farms v. Oswald Trippe, et al; Case No. 07-1389-CA, Twentieth Judicial Circuit Court, Collier County, FL.
Consulted as Property Insurance Expert for claims under Inland Marine, Boiler & Machinery and Business Income coverage. Case involved damage to a printing press during transport and upon arrival at a new location. Northeast Impressions, Inc., et al v. Camden Fire, et al; Superior Court of New Jersey, Passaic County Docket No. PAS-L-390-07. Tom Lloyd (973) 863-7612 Morgan Melhuish Abrutyn, Attorneys.
Retained by policyholder to negotiate a machine shop total fire loss claim with the carrier. Policyholder was General Machined Products; carrier was Sentry Insurance Company. Engagement required Property Insurance ACV and RC calculations of difficult to value inventory, analysis and calculations for Business Income and assessment of potential bad faith claims handling. Settlement was finalized through the Appraisal process. Attorney Craig Crockett, The Crockett Firm PC (817) 810-0400.
Designated as Business Income and Property Insurance Expert by plaintiff counsel regarding coverage denial for Flood and Windstorm, damages resulting from Hurricane Katrina. Delta Land & Title v. State Farm Insurance Company; Civil Action 06-5374; Section L, Mag. 1; United States District Court for the Eastern District of Louisiana. Attorney Peter Koeppel (504) 598-1000.
Engaged by defense counsel as their Agent Errors and Omissions, Property Insurance and Insurance Bad Faith Expert. Case required expertise with Business Income, Flood Insurance, Surplus Lines & Ocean Marine Insurance. Litigation resulted from partial claim denials for losses during Hurricanes Jeanne and Francis. Attorneys Larry Montgomery & Lee Chase, Glankler Brown, PLLC ( 901) 525-1322 . Dyer Investment Company, LLC, et al v. Marsh & McLennan and Certain Underwriters at Lloyd’s; Case No. 05CV2812-D/P in the United States District Court for the Western District of Tennessee Western Division.
Plaintiff engagement as their expert for Property Insurance, Agent Errors & Omissions & Business Income. Litigation involved a total fire loss to underinsured building and Business Personal Property. Attorney Jeff Stewart – Seikaly & Stewart, Attorneys, (248) 723-5120. Trojan Cleaners, et al v. The Regency Insurance Group, et al; Case No. 2006 611590 CK 6 611590 CK, State of Michigan Wayne County Circuit Court.
Engaged by counsel for plaintiff as an expert for Property, Flood, and Business Income Insurance and to assist with carrier Bad Faith claims handling issues. This case involved Flood Zone determinations and prior Flood claim payments. Attorney John Gabroy – Gabroy Rollman & Bosse, PC (520) 320-1300. Eurofresh v. Travelers Indemnity Company; US District Court for The District of Arizona, Tucson Division, No. CIV 04-6 79 TUCRCC.