Insurer, agency and adjusters sued by local couple over Ike claim

Kelly Holleran Mar. 4, 2009, 2:45am

A Jefferson County couple has filed suit against Empire Indemnity Insurance Co., ZC Sterling Insurance Agency Inc., Audit Services Inc. and an adjuster, alleging they were not paid money to which they were entitled after Hurricane Ike destroyed sections of their home.

When Robert and Gloria Holton's property at 3090 Willowood Drive in Beaumont sustained roof, water, wind and structural damages on Sept. 13 during Hurricane Ike, they submitted a claim to Empire, which had insured their property, according to the complaint filed Feb. 24 in Jefferson County District Court.

The Holtons requested Empire cover the cost of repairs, the suit states.

However, Empire denied the Holtons' claim for the repairs of their property, even though the policy provided coverage for losses, they claim.

It denied the repairs after assigning an adjuster from ZC Sterling -- Angie Vidal -- to adjust the claim.

Empire told the Holtons it would not pay the full proceeds of the policy, although demand was made for it, which constitutes a breach of the insurance contract, the suit states.

"Defendants Empire, ZC Sterling, Audit and Vidal misrepresented to Plaintiffs that the damage to the property was not covered under the policy, even though the damage was caused by a covered occurrence," the suit states.

Empire, ZC Sterling, Audit and Vidal also failed to make an attempt to settle the Holtons' claim in a fair manner, a violation of the Texas Insurance Code, unfair settlement practices, they claim.

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

Empire, ZC Sterling, Audit and Vidal failed to affirm or deny coverage of the claim within a reasonable time frame, the suit states.

They refused to fully compensate the Holtons, even though they did not conduct a reasonable investigation, which constitutes another violation of the Texas Unfair Competition and Unfair Practices Act, the Holtons allege.

Empire, ZC Sterling, Audit and Vidal are liable for common law fraud because each of their representations contained facts they knew were false, according to the complaint.

They also committed numerous violations of the Texas Unfair Settlement Practices.

Empire breached its contract with the Holtons by refusing to pay the policy, according to the suit.

The Holtons are seeking unspecified actual, treble, punitive and exemplary damages, plus attorney's fees, costs, pre- and post-judgment interest and other relief the court deems just.

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. A183-376

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