Insurer, adjusters sued over Hurricane Rita claim

Kelly Holleran Dec. 3, 2008, 10:25am

A Jefferson County couple has filed suit against Capitol County Mutual Fire Insurance Company, ICA Adjusters and five of its adjusters, alleging they were not paid money to which they were entitled after Hurricane Rita destroyed sections of their home.

When Paul and Trisha Blount's property at 4630 Detroit in Beaumont sustained roof, water, wind and structural damage on Sept. 24, 2005, during the storm, they submitted a claim to Capital, which had insured their property, according to the complaint filed Nov. 26 in Jefferson County District Court.

The Blounts requested Capital cover the cost of repairs and asked for additional living expenses, the suit states.

However, Capital denied the Blounts' claim, even though their policy promised coverage for such losses, the couple claims.

It denied the claim after assigning ICA and five of its adjusters – Aaron Bernard, Randall Chatagnier, Matejka Cherry, Roberto Enriquez and Paul Lampi – to adjust the claim, according to the complaint.

Capitol told the Blounts the damage to their property was not covered under the claim, which constitutes a violation of the Texas Insurance Code, unfair settlement practices, the suit states.

"Defendants failed to make an attempt to settle Plaintiffs' claim in a fair manner, although they were aware of their liability to Plaintiffs under the Policy," the suit states.

Capital also failed to affirm or deny coverage of the Blounts' claim within a reasonable time, another violation of the Texas Insurance Code, unfair settlement practices, the Blounts claim.

Capital's behavior constitutes a breach of contract because it did not live up to promises made in its insurance policy with the Blounts, according to the complaint.

ICA and its adjusters violated the Texas Insurance Code because hey misrepresented material facts relating to the coverage, according to the complaint.

The adjusters and ICA are also liable for common law fraud, the suit states.

"Each and every one of the representations, as described above, concerned material facts for the reason Plaintiffs would not have acted and which ICA, Bernard, Chatagnier, Cherry, Enriquez and Lampi knew were false or made recklessly without any knowledge of their truth as a positive assertion," the suit states.

The Blounts are seeking actual, treble, punitive and exemplary damages, plus attorney's fees, costs, pre- and post-judgment interest and other relief to which they may be entitled.

Michael R. Ramsey and Gregory F. Cox of Beaumont and J. Steve Mostyn of The Mostyn Law Firm in Houston will be representing them.

The case has been assigned to Judge Donald Floyd, 172nd District Court.

Case No. E182-775

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