Engaged by carrier’s defense counsel to evaluate homeowners coverage issues and address allegations of insurance bad faith claims handling. Dispute resulted after a carrier’s denial of a total fire loss to a dwelling (including rental income) insured under a homeowners policy but occupied by a tenant. Attorney Zane Wilson, CSG, Inc. (907) 452-1855. Baumgartner v. UMIALIK Insurance Company, Case No. 4FA-22-01509 CI In the Superior Court for the State of Alaska Fourth Judicial District at Fairbanks.
Category: Business Interruption/Business Income
30
Jul2023
Engaged by carrier’s defense counsel to assess coverage and claims handling issues for a sprinkler system leak claim at a high value vacant dwelling and whether a surplus lines intermediary has any duty to advise a policyholder. The policyholder had declined water damage coverage during a surplus lines placement, resulting in carrier later denying the sprinkler claim. Attorneys Doug Fogle and Joel Wertman, Winget, Spadafora & Schwartzberg, LLP (215) 433-1500. Newtown Square v. Worldwide Facilities, et al, Civil Action No. 21-5397 In the United States District Court for the Eastern District of Pennsylvania.
July 30, 2023burld
30
Mar2023
Retained by policyholder counsel as an insurance expert witness to review insurance industry renewal procedures when an agent failed to adequately disclose Business Income insurance being deleted on a renewal policy. Dispute arose following a major fire loss, when the agent finally informed the policyholder clearly that its Commercial Property policy provided only Extra Expense coverage leaving a multi-million dollars claim uncovered. Attorneys Halsey Knapp and Barclay Valloton, Krevolin & Horst, LLC (404) 888-9700. Buckhead v. McGriff Insurance Services, Civil Action File No. 22-GSBC-0004 In The Georgia State-Wide Business Court.
March 30, 2023burld
30
Dec2022
Retained by policyholder counsel as an insurance expert witness to review insurance industry claims handling standards of care for Commercial Property and Business Income losses. Policyholder’s business was highly seasonal with most of the Business Income concentrated in the several months before the Christmas holidays. Dispute arose following a large theft claim at the start of policyholder’s high season, with carrier refusing to consider the policyholder’s seasonal concentration of earnings when calculating the amount of Business Income loss. Attorneys Greg Goodheart and Ed Schreiber (818) 992-4463. Shimony v. State Farm, Case No.: 21CHCV00085 In Superior Court Of The State Of California For The County of Los Angeles.
December 30, 2022burld
30
Jun2022
Engaged by policyholder’s General Counsel to analyze and assist with claims-handling issues to settle a multi-million-dollar hail claim which the carrier refused to acknowledge exceeded the deductible. Engagement involved hiring additional roofing consultants and addressing carrier’s badly flawed analysis of the hail damage; claim eventually settled. Attorney Craig Crockett (817) 628-9998. TCRG v. Starr Surplus Lines Insurance Company.
June 30, 2022burld
01
Jul2021
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.
July 1, 2021burld
30
Apr2021
Engaged by defense counsel to respond to allegations of Insurance Agency Errors & Omissions stemming from placement of Ocean Marine Insurance coverage for the lessee under a short-term barge rental and subsequent denial of a hull damage claim. Case required analysis of issues including limited carriers willing to quote short-term coverage, the barge owner’s allegations of Business Income loss, and whether any barge damage occurred during the rental. Attorney Ken Gutsch, Richmond & Quinn, (907) 276-5727. Swalling v. Alaska USA Insurance Brokers, Case No. 3AN-19-10857CI, In Superior Court For The State Of Alaska Third Judicial District At Anchorage.
April 30, 2021burld
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, 2021burld
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, 2021burld
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, 2019burld