When a freak weather event damages your home, the insurance adjusters who come out to inspect the property have a great deal of power. It is their judgment that determines if you will be reimbursed for your losses, and how much.
Despite the importance of their jobs, however, claims adjusters aren’t always properly trained to carry out their duties—and that can turn into a major problem for homeowners. Just ask Ana Bonilla and Juan Guzman.
On or around June 13, 2012, a hailstorm damaged the Grand Prairie, Texas, home of Bonilla and Guzman. The hail was significant enough to create a hole in the roof that allowed water to seep in, damaging the ceilings, walls, insulation and flooring.
Alan Galvan, an independent adjuster sent by State Farm to the home, found damage to only two of the four slopes on the roof. Galvan also estimated to clean the carpet in a bedroom that had been soaked during the storm as well as other minor damages to the exterior of the home. Once it was determined that the money State Farm paid was significantly lower than what it would take to repair their storm damages, Bonilla and Guzman filed suit.
Bonilla and Guzman believe that the claims adjusters who worked on their case, were improperly trained. This isn’t the first time such an accusation has come up in a case involving State Farm. Angelica Moreno Gongora, another Texas resident, made the same allegation about a State Farm adjuster who came out to her home after it was damaged by hailstorms in March and April of 2012.
In the case of Bonilla and Guzman, Galvan failed to investigate the path of water entering their home from the roof. He also failed to inspect the attic or the damaged air conditioning unit to see if it was running properly, according to court documents. From Bonilla’s perspective, Galvan stood out among the adjusters because he appeared to be willfully downplaying the damages her home had suffered.
“During the inspection, I pointed out for Galvan the damages that the storm caused to the property, but Galvan disregarded many of the damages, and acted from the start as if his intention was to minimize my damages,” Bonilla wrote in a sworn statement.
Bonilla and Guzman’s lawsuit alleges that the behavior of State Farm and its adjusters violated the Texas Insurance Code and breach of contract among other causes of action. The trial court, upon motion by State Farm, severed and abated the extra-contractual causes of action from the breach of contract cause of action. As a result, two separate lawsuits would be tried, one for breach of contract and the other for extra-contractual causes of action.
In May, during the breach of contract trial, a jury found that State Farm did not breach its contract with Bonilla and Guzman. Following the trial, State Farm filed a motion for summary judgement on the remaining causes of action that were severed into the separate lawsuit. In July, Judge Tillery took State Farm’s Motion for Summary Judgment under advisement and there is no ruling at this time.
Mostyn Law notes in its response to State Farm’s Motion for Summary Judgment that several prior court cases have established that even when a jury says that an insurance company did not breach a contract with a policyholder, the company can still be held liable for dealing unfairly with that policyholder.
Despite media reports stating otherwise, Bonilla and Guzman have not settled with State Farm.
“Bonilla and Guzman never accepted a settlement nor agreed with State Farm’s decision on their claim,” said Andrew Taylor, an attorney at Mostyn Law. “State Farm made a partial payment during the claims investigation, but refused to pay Bonilla and Guzman the full amount of their damages.” “
It remains to be seen whether the judge will allow the remaining claims in the case to go forward. Until then, Bonilla and Guzman will wait to see if they will be able to try their claims handling case to a jury, and ultimately, hold State Farm accountable for payment on their hail claim.