Engaged by policyholder counsel to serve as their Property Insurance and Equipment Breakdown / Boiler & Machinery Expert. Case required analysis of claims handling proof of loss issues after a low-pressure underground pipeline was damaged by an over-pressurization event. Case also involved Business Income and Insurance Bad Faith. Dispute resulted following carrier’s claim denial citing an “observable” damage requirement in lieu of technical pressure analysis as proof of loss. NiSource v. FM Global, Case No. 2:20-cv-00572-GCS-CMV in United States District Court for the Southern District of Ohio Eastern Division. Attorneys Brad Nes and Teri Josie-Diaz, Morgan, Lewis & Bockius LLP, (202) 739-3000.
Category: Business Interruption/Business Income
26
Mar2021
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.
March 26, 2021Don Hirsch
22
Jan2021
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.
January 22, 2021Don Hirsch
16
Jun2020
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
08
Dec2019
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
03
Sep2019
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
September 3, 2019Don Hirsch
12
Jan2019
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
21
Nov2018
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
11
Oct2018
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
26
Nov2017
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.
November 26, 2017Don Hirsch