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.
Category: Agent Errors and Omissions
March 26, 2021Don Hirsch
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.
June 16, 2020Don Hirsch
Engaged by Surplus Lines intermediary’s defense counsel to evaluate allegations of Agent Errors & Omissions and Insurance Bad Faith involving placement and renewal of a contractor’s Commercial General Liability policies. Analysis involved guardrail operations being excluded, multiple policies and additional insured issues. Litigation followed carrier’s claim denial for a vehicle accident involving guardrail repairs performed by the contractor. Attorney Tom Alleman, Dykema Gossett PLLC (214) 698-7830. Guerra v. US Risk, et al, Cause No. C-3634-18-B In The District Court of Hidalgo County, Texas 93rd Judicial District.
April 4, 2020Don Hirsch
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.
December 8, 2019Don Hirsch
Retained by counsel defending a landlord policyholder against tenant allegations of injury due to negligence following an apartment complex fire loss. Policyholder provided suit papers to the agent, who in turn failed to forward same to carrier resulting in a default judgment being entered in favor of the tenant. Carrier denied coverage based on extreme prejudice for late claim reporting. Case required analysis of issues regarding Agents Errors & Omissions, Insurance Bad Faith and Commercial General Liability. Geier v. Stonewood Apartments v. The Sloan Agency, Case No. 1716-CV25412 In the Circuit Court of Jackson County, Missouri at Kansas City. Attorney Wes Carillo, Ensz & Jester, PC, (816) 474-8010.
July 11, 2019Don Hirsch
Engaged by counsel defending allegations of Agent Errors and Omissions relative to Commercial Auto underlying limits required for Umbrella coverage. Case involved policyholder allowing Commercial Auto policy to cancel for nonpayment and later placing coverage with deficient limits through a different agent. Case required analysis of policyholder’s pattern of conduct and failures to communicate relative to realistic expectations of the agency, plus Umbrella policy language relative to requirements in a construction agreement. Litigation resulted after carrier denied Umbrella coverage following a fatality auto accident. Attorney Shelley Rogers, Sheehy Ware Pappas, (713) 951-1033. ATCI v. Holmes Murphy, et al; Cause No. CC-18-02926-E, In The County Court at Law No. 5, Dallas County, Texas.
June 19, 2019Don Hirsch
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
January 12, 2019Don Hirsch
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.
November 21, 2018Don Hirsch
Engaged by defense counsel for Surplus Lines agency to address allegations of Insurance Agent E&O and Bad Faith including failure to procure proper insurance coverage. Case required analysis of the placement process to provide Property and Builders Risk insurance for an existing hotel plus renovations and additions. Dispute resulted from carrier’s partial denial of a windstorm claim while the hotel was still under construction. Attorneys Sarah Wariner and Scott Shanes, Clark Hill | Strasburger (469) 287-3900. Robertson v. Chubb, CRC, et al, Cause No. A160450C In The 51st Judicial District Court, Tom Green County, Texas.
October 26, 2018Don Hirsch
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.
October 11, 2018Don Hirsch