A Jefferson County couple has filed suit against Capitol County Mutual Fire Insurance Company and an adjuster, alleging they were not paid money to which they were entitled after Hurricane Rita destroyed sections of their home.
When Rafael and Myriam Duran's property at 4498 Woodlawn in Beaumont sustained roof, water, wind and structural damage on Sept. 24, 2005, during the storm, they submitted a claim to Capitol, which had insured their property, according to the complaint filed Dec. 22 in Jefferson County District Court.
The Durans requested Capitol cover the cost of repairs and asked for additional living expenses, the suit states.
However, Capitol denied the Durans' claim, even though their policy promised coverage for such losses, the couple claims.
It denied the claim after assigning an adjuster – Hahn Le -- to adjust the claim, according to the complaint.
Capitol told the Durans 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.
Capitol also failed to affirm or deny coverage of the Durans' claim within a reasonable time, another violation of the Texas Insurance Code, unfair settlement practices, the Durans claim.
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 the Durans, according to the complaint.
Le violated the Texas Insurance Code because he misrepresented material facts relating to the coverage, according to the complaint.
Le and Capitol 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 Capitol and Le knew were false or made recklessly without any knowledge of their truth as a positive assertion," the suit states.
The Durans 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 Bob Wortham, 58th District Court.
Case No. A182-898