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Insurance Coverage - What To Do Following a Catastrophe

Recently, I did a podcast where I was asked questions regarding what to do following a catastrophe with your insurance claim. The podcast was conducted in a question-and-answer format and ended up running about twenty minutes long. That podcast can be reached by navigating my firm's website (www.abrahamwatkins.com). I wanted to discuss what you should do following a catastrophe, such as a hurricane or a fire.

First, you should know what type of coverage you have beforehand. While it is tedious, and the language of the insurance policy can be difficult to understand, you must take steps to determine what type of protection you have. You should discuss your coverage with your insurance agent, the person who sold you the policy. Additionally, you should communicate in writing with your agent and keep all correspondence relating to coverage in a file with your policy. Policies will differ depending on whether the coverage you seek is residential or commercial in nature. Further, within those categories, there is a myriad of different coverage combinations. The first step will be you having a general understanding of what types of coverage you have and what types of risks are being insured.

Once you have a general understanding of your policy, you should then familiarize yourself with how you are supposed to make a claim following an occurrence. Nearly every policy will require that you notify the insurance company (insurer), in writing, when reporting a claim. However, in order to protect your rights, I recommend notifying both the insurer and the insurance agent of the claim. Send notice of your claim, in writing, to both of them. Remember, your agent is just the person that brokered the insurance contract between you and the insurer. In order to avoid any arguments that you did not timely provide notice to the insurer, you should report your claim to both the insurer and the insurance agent. This is a belt-and-suspenders approach.

I have handled cases where the policy holder reported his claim through the insurance company's telephonic center and did not report the claim in writing. This became an issue in the case. The argument from the insurance company was that my client did not comply with the notice provisions in the policy, which required notice of all claims to be in writing. In that particular case, we were able to prove through discovery that the insurance company did, in fact, receive notice of the claim. I have also handled cases where the policy holder reported his claim to the insurance agent and not to the insurance company. Again, the insurance company will make a strict compliance argument that the policy holder did not comply with the letter of the insurance contract. While these issues may not be fatal, depending on some other circumstances, you can avoid these issues entirely by promptly providing written notice of your claim to both your insurance company and the insurance agent. Be sure and send the letter by certified mail with return receipt requested; or, if you send your notice by facsimile, keep the confirmation sheet so you can prove that you complied with the insurance contract. Keep copies of all correspondence sent to or received from the insurance company and the insurance agent. In the event that your claim is denied, delayed, or mishandled, you will have the burden of proving it.

Additionally, every policy will require you to promptly notify the insurer of an occurrence and every policy will require you to cooperate with the insurance company during its investigation into the claim. Most policies state that the insurer has an absolute right, even without justification, to make the claimant (policy holder) submit to an examination under oath (EUO) following a claim. This means that you will have to answer questions under oath from the insurance company or its lawyer(s). If you refuse to do so, you will likely be facing an argument later from the insurer that you failed to cooperate and that you cannot recover under the policy. Again, to make sure that you protect your rights, you should cooperate with the insurer during the investigation and you should keep records establishing that you did so.

Under Texas law, the insurance companies owe the policy holder a whole host of duties. If you find yourself in a situation where your claim is being delayed, denied, or whether you feel that you are being treated unfairly, you likely have a claim against the insurance company for bad faith. The Texas Insurance Code has hefty penalties for the insurance company that engages in bad faith practices. In order to successfully assert a bad faith claim against the insurance company, you need to make sure that you have clean hands and that you have complied with your duties. If you do find yourself in that situation, do not hesitate to contact me. My firm, Abraham, Watkins, Nichols, Sorrels, Agosto & Friend, handles these types of case and I will meet with you for a free consultation. Indeed, we work these cases on a contingency fee and do not charge the client for the services. If there is a recovery for the client, our fees are paid as a percentage of the recovery out of the money received from the defendant. Moreover, if you can prove that the insurance company violated the Texas Insurance Code, the insurance company will have to pay for the attorney's fees, on top of the other damages.

Remember, the job of the insurance company is to collect premiums and try to avoid paying claims. The insurance companies will vigorously seek to deny your claim for even the slightest breach on your part. They have the money and the lawyers to do this. As such, you must familiarize yourself with your policy and you must comply with its provisions completely.

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