Orange resident says adjuster committed fraud

An Orange homeowner filed a claim with his insurance company after Hurricane Rita and now blames the adjuster for the company's failure to pay in full.

Jefferie Cartwright filed a suit against Balboa Insurance on May 10 in Orange County district court.

The plaintiff says after he filed a claim for roof, water, foundation and wind damage to his home on Clairmont Drive after the hurricane, but the claim was denied by the insurer.

Cartwright seeks $211,000 in economic damages, $30,000 for mental anguish and $71,000 for additional expenses including attorney fees.

"Balboa wrongfully denied plaintiff's claim for repairs of the property, even though the policy provided coverage for such losses as those suffered by plaintiff," the original plaintiff's petition states.

The insurance company failed to perform its contractual duties, misrepresented that the damages were not covered and failed to explain the reason for the inadequate settlement, plaintiff argues. Those actions make Balboa in violation of the Texas Insurance Code, Unfair Settlement Practices, the suit says.

There was "no basis whatsoever on which a reasonable insurance company would have relied on to deny full payment," the petition states.

"Plaintiff's experience is not an isolated case," plaintiff's attorney Steve Mostyn writes, and occur "with such frequency that they constitute a general business practice of the defendant with regard to handling these types of claims. Defendant's entire processes are unfairly designed to reach favorable outcomes for the company at the expense of the policy holder."

The suit also names insurance adjuster Marie Chaddick as a defendant, claiming she "knowing made false representations."

"Defendant Chaddick is liable for common law fraud," plaintiff states.

Plaintiff requests a trial by jury and the petition also requests disclosure of information that includes adjuster training manuals and records of all claims adjusted by Chaddick.

The case has been assigned to Judge Dennis Powell of the 163rd Orange County District Court.

Case No. B070-239-C