Homeowner claims insurer failed to pay full Rita claim

Kelly Holleran Jan. 14, 2009, 4:47am

Steve Mostyn

A Jefferson County woman has filed suit against Capitol County Mutual Fire Insurance Company, ICA Adjusters and one of its employees, alleging she was not paid money to which she was entitled after Hurricane Rita destroyed sections of her home.

When Anemy Domingue's property at 6065 Trahan Road in Beaumont sustained roof, water, wind and structural damage on Sept. 24, 2005, from the storm, they submitted a claim to Capitol, which had insured their property, according to the complaint filed Jan. 9 in Jefferson County District Court.

Domingue requested Capitol cover the cost of repairs and asked for additional living expenses, the suit states.

However, Capitol denied Domingue's claim, even though their policy promised coverage for such losses, the couple claims.

It denied the claim after assigning an adjuster – Jade Saucier of ICA Adjusters, Inc. -- to adjust the claim, according to the complaint.

Capitol told Domingue the damage to her 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 Plaintiff's claim in a fair manner, although they were aware of their liability to Plaintiff under the Policy," the suit states.

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

The company failed to explain the reason for their offer of an inadequate settlement, another violation of the Texas Insurance Code, according to the complaint.

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

Saucier and ICA violated the Texas Insurance Code because they misrepresented material facts relating to the coverage, according to the complaint.

Capitol, Saucier 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 Defendants knew were false or made recklessly without any knowledge of their truth as a positive assertion," the suit states.

Domingue is 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 The Mostyn Law Firm in Beaumont and J. Steve Mostyn of The Mostyn Law Firm in Houston will be representing them.

The case has been assigned to Judge Bob Wortham, 58th District Court.

Case No. A182-996

More News