Insurance Adjuster Found To Have Wrongfully Denied ClaimsJuly 12, 2016
Insurance companies are for-profit businesses and they are constantly under pressure to increase revenue, decrease expenses, and maximize profits for the benefit of shareholders. To reach that objective, they employ several tactics and tools such as having insurance adjusters serve as the eyes and ears of the company. Unfortunately, adjusters face the pressure to limit expenses and also are incentivized to underpay, delay, or deny valid claims in order to maximize profits. In the grand scheme of things, insurance companies can save hundreds of millions or more by underpaying or denying valid claims.
To illustrate this point, we can cite a case where a former client had her claim handled in bad faith. The client’s home was severely damaged as a result of a severe hail storm in North Texas which led to major roof and siding damage. Immediately, she called her insurance company and filed a claim. The insurance company sent out their adjuster who spent less than five minutes examining the roof and quickly making notes of the siding of the house. The adjuster did not take any pictures, any measurements, or anything besides jot down a few quick notes. About a month later, after repeated attempts to contact her claim handler, our client was finally able to speak to a different adjuster who was not present at the initial inspection. The adjuster informed our client that the claim was denied because, based on the information she had, the damage to the house was due to routine wear and tear and lack of adequate maintenance by the homeowner. Her house was brand new – only five years old.
The client hired us and we coordinated with a trustworthy contractor to thoroughly inspect the house. The contractor determined that severe damage was not due to lack of maintenance or wear and tear, but caused by a hail storm. In addition, we obtained a copy of the denial letter the insurance company sent to our client. The letter was ambiguous and not even based on the terms of our client’s insurance policy. We caught both insurance adjusters wrongfully denying the claim. With all of these facts in hand, we had enough leverage to force the insurance company to overturn its denial and were able to get our client’s repairs covered free of charge.
This type of conduct by insurance companies and their adjusters constitutes bad faith and there are remedies available under Texas law. Therefore, it is highly recommended for you to seek legal advice from an experienced attorney who can help you determine if your insurance claim has been properly handled, if the insurance company’s determination was in bad faith, or whether there have been any other conducts that may violate in any way Texas law.
The attorneys at the Amaro Law Firm have vast experience dealing with insurance companies. In fact, some of their attorneys worked as insurance company defense lawyers before joining the firm. Now, they help property owners fight for fair and just treatment. Our consultations are free. If we cannot add value to your claim, we will not take your case. When an insurance company is found to have acted in bad faith, they are required to pay reasonable attorney’s fees. Therefore, we are only paid if we win. Contact us for a free claim evaluation.