Farmer’s Group Failing to Pay a Fire Claim

Our firm is currently handling a case against Farmers Group, Inc. for failing to pay a fire claim on a rental property.

Rackohn & Rackohn files lawsuit against Fire Insurance Exchange and Farmers Group, Inc. for wrongful denial of a fire claim under a landlord protection package policy of insurance

Date: November 22, 2013

Syron v. Farmers Group, Inc. Los Angeles Superior Court, Stanley Mosk Courthouse

Plaintiff’s trial law firm Rackohn & Rackohn filed a wrongful denial of insurance benefits lawsuit on behalf of Joseph Syron against the Farmers Insurance Group, Inc. and Fire Insurance Exchange. The case was filed in Los Angeles Superior Court in downtown Los Angeles.

The suit alleges that Famers Group Inc. and Fire Insurance Exchange wrongfully denied paying a fire claim by relying on its vandalism vacancy exclusion, and intentionally disregarded evidence that supported paying this claim. That Farmers Group, Inc. committed a fraud by not specifically defining arson as a form of vandalism in the policy, knowing that for years it has been denying arson claims by relying on the vandalism vacancy exclusion.

Attorney Craig Rackohn stated: “The purpose of this lawsuit is to prove that policy holders have rights pursuant to the terms of their insurance policy that they have paid for and are entitled to. Policy holders are entitled to their insurance benefits when there is a covered fire claim. Farmers Group, Inc. and the Fire Insurance Exchange should not be allowed to collect premiums knowing that if there is a fire claim caused by arson Farmers Group, Inc. and its companies are not going to pay the claim if the insured dwelling has been vacant longer than permitted under the vandalism vacancy exclusion contained in the policy.

Rackohn & Rackohn specialize in wrongful denial of insurance claim cases. Information about the firm, can be found at www.rackohn.com

Homeowner’s Claims Not Getting Paid?

HAS YOUR INSURANCE COMPANY REFUSED TO PAY YOUR HOMEOWNER’S INSURANCE CLAIM?

Your insurance policy is a contract that is enforceable under the law. Once you suffer a covered loss under the policy your insurance company is under an affirmative obligation to investigate your claim, and to timely pay your claim pursuant to the terms of your policy.

As an insured you are responsible for cooperating with the insurance company’s investigation. You must timely report the claim. You must provide a proof of loss to support your claim. If requested you must provide a statement under oath. (Jordan v. Allstate Ins. Co. (2007) 48 Cal. App.. 4th 1062, 0178.) Prior to proving that the insurance company delayed paying your claim you first must prove that you have cooperated and that there is coverage for your loss.

Withholding of benefits can occur when the insurance company outright denies your claim and or pays you less than you are entitled to. (Mariscal v. Old Republic. Ins Co. (1996) 42 Cal. App. 4th 1617, 1623; Egan v. Mutual of Omaha, Insurance Co. (1979) 24 Cal. 3d 809, 820)

Intentional delay in the payment of your insurance benefits: It is not uncommon for insurance adjusters to delay their investigation or continue to ask for additional information prior to paying the claim, and then paying less than your claim is worth. (Waller v. Truck Insurance Co. (1995) 11 Cal. 4th 1, 36)

These are just a few examples of unreasonable conduct that insurance companies may engage in when investigating homeowners claims. Our firm will aggressively fight for the insurance benefits you are entitled to.

Insurance Claims & Pleading Punitive Damages Under California Law in Federal Court

Under Federal rule of Civil Procedure 8(a)(2), a pleading must contain a “short and plain statement of the claim showing that the pleader is entitled to relief.” The Rule 8 pleading standard does not require detailed factual allegations, but “[f]actual allegations must be enough to raise a right to relief above the speculative level.” Raisin Bargaining Ass’n v. Hartford Cas. Ins. Co. 715 F. Supp. 2d 1079, 1084 (E.D. Cal. 2010), citing Bell Atl. Corp. v. Twombly, 550 U.S. at 555. Twombly explains that mere labels and conclusions or a formulaic recitation of the elements of a cause of action will not do; rather, there must be “enough facts to state a claim to relief that is plausible on its face.” Id. In other words, the “complaint must contain sufficient factual matter, accepted as true, the state a claim to relief that is plausible on its face.” Ashcraft v. Iqbal, 556 U.S. at 677.

“A claim has facial plausibility when the plaintiff pleads factual content that allows the Court to draw the reasonable inference that the defendant is liable for the misconduct.” Iqbal, 556 U.S. at 678. Iqbal and Twombly make clear that the plausibility standard is not akin to a “probability requirement,” but it asked for more than a sheer possibility that a defendant has acted unlawfully. Id.

The Ninth Circuit has summarized the governing standard, in light of Iqbal and Twombly, as follows: “In some, for a complaint to survive a motion to dismiss, the non-conclusory factual content, and reasonable inferences from that content, must be plausibly suggestive of a claim entitling the plaintiff to relief.” Moss v. U. S. Secret Serv., 572 F. 3d 962, 969 (9th Cir. 2009) (internal quote omitted). Apart from factual insufficiency, a complaint is also subject to dismissal under rule 12(b)(6) where it lacks cognizable legal theory, or where the allegations on their face “ show that relief is barred” for some legal reason. Raisin Bargaining Ass’n, 715 F. Supp. 2d at 1084, citations omitted.

There is no question that under California law, plaintiffs in insurance bad faith cases are legally entitled to seek punitive damages. “The availability of punitive damages [in bad faith cases] is thus compatible with recognition of insurers’ underlying public obligations and reflects an attempt to restore balance in the contractual relationship.” 20th Century Ins. Co. v. Superior Court, 90 Cal. App. 4th 1247, 1265-1266, 109 Cal. Rptr. 2d 611, 625-626 (2001), Citing Egan v. Mutual of Omaha Ins. Co., 24 Cal. 3d 809, 820, 169 Cal. Rptr. 691, (1979).

In Clark v. State Farm Mut. Auto Ins. Co., 231 F.R.D. 405, 406-407 (C. D. Cal. 2005) the court denied the insurer’s motion to strike the plaintiffs’ punitive damages allegations in a bad faith case as too conclusory under state law standards, explaining:

While California law governs plaintiff’s substantive claim for punitive damages under California Civil Code section 3294, the Federal Rules of Civil Procedure govern the punitive damages claim procedurally with respect to the adequacy of pleadings. See Bureerong v. Uvawas, 922 F. Supp. 1450, 1480 (C.D. Cal. 1996) See also, Clark, 106 F. Supp. 2d at 1018 (“Where state law directly conflicts with applicable provisions of the Federal Rules of Civil Procedure, federal courts must apply the Federal Rules-not state law.”); Jackson v. East Bay Hosp., 980 F. Supp. 1341, 1353-54 (N.D. Cal. 1997) (“[D]espite section 3294’s specific requirement that a pleading alleging oppression, fraud, or malice, these may be averred generally’”) (, quoting Fed. R. Civ. P. 9(b)). Clark v. State Farm Mut. Auto .Ins. Co., 231 F.R.D. at 406-07

The Clark court noted that whether the plaintiff would ever be able to prove the allegations made in the complaint and recover punitive damages was a wholly distinct inquiry from whether the complaint properly sought the remedy. (Id, at 407). Here plaintiff’s allegations of malice, fraud or oppression in support of her punitive damage meet the standard set forth in Clark, and are sufficient under rule 9(b).

Don’t Settle For Less on Your Homeowner’s Insurance Claims!

Your homeowner’s insurance policy provides coverage to replace damaged property to its pre-loss condition. Oftentimes your insurance company will pay to repair a covered loss rather than replace the damaged property to save money, even though California law requires replacement if the repair cannot restore the damaged property to its pre-loss condition. As a policy holder you are entitled to “replace the property with like kind and quality within a reasonable time after the loss.” (In Fire Ins. Exchange v. Superior Court, 116 Cal. App. 4th 446, 459)

For example if your hardwood floors have a beveled edge that provides a distinct appearance, yet the insurance company wants to sand the floors as a repair, if the sanding takes away the beveled edge you are entitled to replace your floors. Don’t settle for less!

Vandalism and Vacancy

UNDER CALIFORNIA LAW  VANDALISM-MALICIOUS MISCHIEF ADDITIONAL COVERAGE DOES NOT SPECIFICALLY INCLUDE FIRE OR ARSON AS VANDALISM

Under California law there isn’t one reported opinion that interprets fire as vandalism.  For obvious reasons fire is a covered peril under the standard fire policy.  (Insurance code section 2071)

In Croskey et al., Cal. Practice Guide: Insurance Litigation (The Rutter Group 2012) 6B-26-27 it states:

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