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: Insurance Bad Faith
July 1, 2021Don Hirsch
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
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
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 to analyze Ocean Marine coverage issues under a yacht policy following extensive propeller repair delays. Insurance Bad Faith Claims Handling issues arose based on whether a boat remaining outside navigation warranty specified waters was beyond insured’s control and when carrier was informed. Suzam v. ACE, Civil Action No. 19-CV-01832-PAB-NRN In The United States District Court For The District of Colorado. Attorneys Scott O’Sullivan and Cara New, The O’Sullivan Law Firm (303) 388-5304.
January 29, 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
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
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