There must be a good reason for the denial of a homeowners claim. The decision to deny coverage is complicated. It may sound simple, but it isn’t.

In Oklahoma, you really need an attorney involved before denial. Not just any attorney, but one familiar with Oklahoma law. There is a balance the courts strike in being fair to the insurance company and the homeowner. You don’t want to end up on the wrong side of the courts.

Nearly every insurance policy has a clause requiring cooperation during the claim. You can rest easy knowing the Oklahoma courts honor the insurance policy terms. As an insured, you have the obligation to reasonably cooperate with a claim. If you don’t, the courts protect against prejudice to the insurer. The insurance company has a right to information about how the loss occurred and the damages. A homeowner who blocks that right can end up not being paid.

If you’re an adjuster trying to pay a claim, nothing is more frustrating than an uncooperative insured. Here you are ready and willing to pay what you owe. But, you don’t just write checks for no reason. You have to document the loss. Otherwise, you can’t make payment. When the insured ignores your efforts, it’s really aggravating because your claim count expands.

One question that springs to mind is why wouldn’t the homeowner want to cooperate. Common sense suggests giving the information to the adjuster will result in faster payment. As the adjuster, you see all sorts of claims and most people cooperate. Still, there’s always a few who don’t return calls and refuse to reply to e-mails.

There are several reasons a homeowner may not cooperate. Many homeowners don’t have a great deal of experience in claims. If your a homeowner making a claim, you may not understand the normal adjusting practices. It may be that you don’t trust the insurance company. Maybe you are concerned the adjuster isn’t going to be fair.

Here’s the deal. Information is vital to paying claims. As the adjuster you can’t pay without proper validation of the cause of the loss and the amount of the damages. As the insured homeowner, you shouldn’t expect to be paid on a whim.

Courts balance the competing interests between the insurance company and the homeowner. The courts want justice. There are occasions where the homeowner may not be able to comply. If you’re the insured and can’t provide the necessary information, then you should let the adjuster know.

Situations arise where the homeowner is slow in giving the needed information. As the adjuster, it’s important to know the courts don’t want to see insurance companies looking for “legal loopholes“. The courts expect valid claims to be paid. Judges aren’t going to approve of insurers looking for ways to deny legitimate claims. This is why experienced attorneys are needed to guide you in following Oklahoma law.

Denial of a claim for the wrong reason can be bad faith. As insurance companies know, bad faith occurs when a claim is denied for an improper reason. Although bad faith is more than making the wrong decision, the motive for denial will be examined. If the facts suggest the insurance company adjuster was looking for reasons to deny a claim that should have been paid, then there’s a problem.

The hard question for you as the adjuster becomes, “Do I have to beg for information? If so, for how long?” Sorry, there’s no hard fast answer. You have to treat the homeowner reasonably and in good faith in the claim adjustment. As the homeowner if you don’t cooperate, you could end up not getting your claim paid.

In Johnson v. Geo Vera Specialty Ins. Co., 2016 U.S. App. LEXIS 17530 (5th Cir. September 27, 2016) the homeowner, Johnson, had damage from strong winds. Later, in a separate event, the house was damaged by fire. The homeowner asked for payment for both losses. However, the adjuster was not given information about the claims in a timely manner. Like most homeowner policies, the insurance policy required cooperation.

” GeoVera’s policy imposed the following duties of cooperation on Johnson: (1) “cooperate with GeoVera in the investigation of a claim,” (2) “prepare an inventory of damaged personal property showing the quantity, description, actual cash value and amount of loss,” (3) “attach all bills, receipts and related documents that justify the figures in the inventory,” (4) “show the damaged property as often as GeoVera reasonably required,” (5) “provide GeoVera with requested records and documents,” and (6) “submit to examination under oath.” The policy provided that GeoVera would owe no coverage if Johnson’s breach of any cooperation duty prejudiced GeoVera.

The Court found Johnson,  in violation of numerous cooperation duties. Johnson invoked her contractual appraisal right under GeoVera’s policy, but demolished and remodeled a significant portion of the house before GeoVera could conduct its appraisal. Johnson “almost completely gutted the interior, performed extensive framing repairs, and then terminated the appraisal process.” GeoVera, after invoking its own contractual appraisal right, subsequently requested that Johnson produce “several videos and thousands of photos of the fire damage” known to be in Johnson’s possession. Johnson refused to provide the requested videos and photographs until well after the coverage litigation had commenced. Johnson refused to testify under oath regarding the incident until over a year following the loss. Johnson further refused to provide documentation justifying the figures in her proof-of-loss list. The Court concluded that Johnson had clearly not complied with Johnson’s cooperation duties under GeoVera’s policy. “

In Oklahoma, two basic rules come to mind from the 30 plus years of litigating coverage disputes and bad faith cases. First, the insured needs to cooperate with the investigation of the claim. If the homeowner feels the insurance adjuster is being unreasonable, the homeowner should consult with a knowledgeable insurance attorney to find out their rights. Second, the adjuster should document any refusal to cooperate with letters, e-mails, or clearly stated requests for assistance. The right to cooperation does not exist in a vacuum. It has to be asserted by the adjuster and evidenced by documentation of the requests.

AgentOklahoma coverage questions like denial of a claim for the refusal to cooperate should be made with the advice of counsel. The risks in a wrongful denial can be severe which is why an adjuster should seek legal advice. Oklahoma policy holders need to cooperate with their insurance company. Any decision not to cooperate should be made with the help of an attorney who understands insurance law in Oklahoma. The risk in not cooperating can be high.

We enjoy the area of insurance law and helping to reach the right decision about insurance claims. Let us know if we can assist you. Call us 918-940-2222.


You don’t always think about a church needing CGL liability insurance. Churches aren’t bad, in fact,  churches are known for doing good. Some church groups engage in food banks, food drives, clothing centers, and all sorts of work to make this world a better place. Why would a church doing good have anything to worry about? Well, things happen!

Last Thanksgiving, one church served a meal with unexpected consequences. Three people were killed according to Food Safety News. It reported:

It remains unknown exactly what food, or foods, served by members of the Golden Hills Community Church on Thanksgiving Day was contaminated. Several hundred people ate the food, served at an American Legion auditorium in Antioch.

“But after extensive interviews we found most of the ill people ate turkey and mashed potatoes and they all ate around the same time. Some dishes served at the event, including cooked turkey, were brought to the site after they were prepared in private homes,” Marilyn Underwood, county environmental health director, said in the release.

The local officials had said it might take months for laboratory confirmation of the specific pathogen responsible for the more than two dozen illnesses and three deaths. However, the U.S. Centers for Disease Control and Prevention notified the county it had confirmed the illnesses were caused by Clostridium perfringens.

Many of the estimated 800 people who ate the church meal on Nov. 24 were elderly or infirmed residents of assisted living centers, including the three people who died. They were 43-year-old Christopher Cappetti, 59-year-old Chooi Keng Cheah, and 69-year-old Jane Evans, according to the Associated Press.

All of the reported illnesses occurred within 24 hours of consuming food at the church dinner, which is in line with the CDC’s published information on Clostridium perfringens.

The bacteria is commonly found in meat and poultry, but thorough cooking kills it. However, extremely small amounts of it can survive on utensils and surfaces and cross contaminate cooked foods. It multiplies very quickly when foods are left at room temperature.

Danger zone temperature graphic

The food was undoubtedly served with every good intention and with many kind thoughts. Unfortunately, mistakes can happen even while doing good works or perceived errors can be inferred. Charitable acts don’t alleviate the need for safety. Although many states have laws that protect good samaritans, these statutes are usually designed to protect aid rendered during an emergency or crisis. Whether the good samaritan laws apply to serving food will clearly depend upon the jurisdiction, but in many venues it is not going to prevent lawsuits for contaminated foods or improperly prepared meals.

Regardless of whether the church was at fault in this story, our point is the need for liability insurance for all activities, nonprofit or for profit ventures. Even if you didn’t make a mistake, it doesn’t mean your actions will not be brought into question. The use of prudence and good judgment are sufficient to keep you out of trouble. Liability insurance is there for good reason. If for no other reason, then defending lawsuits. The duty to defend under a liability insurance policy is invaluable.

We help businesses, churches, nonprofits, and others in a review of their risk management practices by starting with their liability insurance coverage. A comprehensive liability insurance policy that fits your needs is critical. You want to make sure you have the right coverage.


Living in Oklahoma means having to deal with insurance claims for tornado damage. We have tornados almost every Spring.

The damage caused by tornadoes can be catastrophic. The aftermath can leave whole towns devastated. Comfort can be found in knowing that a homeowners insurance policy can help with repair of the damage.

Many of today’s homeowners insurance policies will contain language providing coverage for wind, wind-driven rain, trees or other falling objects, and collapse of the home. An insurance policy may not technically say that it covers tornados, But, there’s likely coverage for the types of damage that typically come from a tornado.

If you’re a property owner, it’s important to know if tornado damages are going to be covered if a tornado strikes. You don’t want to be surprised after the roof blows off. You need to know when you purchase the insurance if something isn’t covered. You find out by reading the policy.

Insurance policies usually contain exclusions and limitations as to coverage. If you’re an adjuster, it’s your job to figure out if these exceptions to coverage apply. You may want to talk with coverage counsel about the policy language. Insurance coverage can be tricky. You don’t want to tell the insured there’s not coverage, then find out you were mistaken.

Looking at past claims for tornado damage, it appears some homeowners don’t understand the terms of their insurance policy before a tornado strikes. Statistically, 64% of policyholders have been found to have their homes under insured. The various exclusions and limits reduce the amount available. A study showed that many homes were only insured for 81% of the cost to rebuild the house.

As a homeowner, sometimes we don’t always realize how much we own. It’s also easy to forget the cost of housing keeps going up.

In the event a tornado carries away your house,, then you’ll want to recover 100% of the home value. If you haven’t bought the right amount of coverage, there just won’t be enough to put back to the same position.

Roughly 1,000 tornadoes hit the United States every year. Most of these tornadoes touchdown in Oklahoma, Kansas, Texas, and Nebraska, but can occur anywhere in the United States. Tornado warning systems have on average a 13 minute lead time with a 70% false alarm rating. Tornadoes can happen during any time of the year, but they most frequently occur in the Spring time. If you have a tornado claim, insurance is there to protect you and your family from the loss. Always keep in mind, the house and contents can be replaced, they are merely property.

Before the next Oklahoma tornado touches down, you should review the insurance policy and reevaluate the value of your home. Renters and homeowners alike should take inventory of all personal belongings and compare these with their insurance policies. Again, it’s easy to not to realize how much you have accumulated. You want to be fully covered if a storm destroys it all.

Understanding the coverage, exclusions and limitations can help with the settlement process. Tornado claims are no different than other claims. There’s either going to be coverage or there’s not. If you’re faced with a storm claim with coverage questions, give us a call before the denial.

Our Tulsa based law office has experience in tornado coverage. We have reviewed claims in Tulsa, Oklahoma City, Skiatook, Sapulpa, Stillwater, Cleveland, Foyil, Muskogee, Moore, Sand Springs, Norman, Broken Arrow, Enid, and all over the state of Oklahoma helping both homeowners and adjusters understand the coverage. Call us 918-940-2222.

Team Work

You can learn a lot by observing what others do. If they have a better way of adjusting claims, then it probably pays to imitate their processes. You should also pay attention to things that don’t work. Intelligent people imitate success and steer clear of failure.

Claim adjusting practices boil down simply to customer service. It is important not to create a sense of frustration in the policy holder during a claim. Aggravating the insured during a claim tends to lead to litigation. It also results in customers looking for other insurers for their future business. Granted, not everyone is going to be happy with the way a claim was adjusted, but it is important to aim for satisfaction.

A recent look at a handful of Oklahoma claims involving State Farm suggests a highly specialized approach to claim adjustment. For example, in a water damage claim to a commercial building, one file showed over 30 claim representatives had worked the file. Each part of the claim was broken into components such as structure, contents, business interruption, subrogation, etc. Specialized field adjusters wrote estimates. Inside adjusters reviewed and evaluated the estimates.

The adjusters were assigned to Teams. Each Team was led by a Team Leader. The Team investigated, evaluated and adjusted the claim. The work was done by the various claim specialists.

The intended benefit of tasking an adjuster with a limited segment of a claim appears to be efficiency. The assigned adjuster can move through the claim quickly, make decisions, and go to the next file. By having Teams, if the adjuster responsible for the file is unavailable, then questions, decisions, etc. are addressed by a Team leader. The Team members don’t need to time to review Oklahoma law, the Team continuously sees similar claims. No time is wasted by an adjuster having to think through the claim. The scope of adjusting is taken to the level of being a “specialist”. On the surface, the approach makes perfect sense. It is a highly efficient use of an adjuster’s time.

Just about everyone has heard of Henry Ford. He started Ford Motor Company. By focusing on the assembly of cars and using standard parts, Henry Ford made automobiles affordable to millions of Americans. Without his renown manufacturing concepts, most of us would not enjoy the luxury of owning a car. We would not be able to afford one. State Farm’s approach is remarkably efficient, but is it really a good way to adjust claims?

There is one distinction in manufacturing a product versus offering a service. Manufacturing requires focus on similarities. If you make a specific car, then it is always the same. The customer will buy the car if they like it. If not, the manufacturer will make changes or eventually discontinue the model if sales go down. With a service, the customer is anticipating someone meeting a need that varies from the expectations of the previous customer.

Much like a waiter at a restaurant promptly refilling your drink. You need more, but getting iced tea in your half full glass of Pepsi isn’t exactly what you call “service”.

Here are a few thoughts to consider:

  • Service is meeting needs. Going back to the restaurant analogy, if you have to keep asking for a drink refill, the inadequate service will be reflected in the tip or the gratuity. Adjusting claims is about taking care of problems that usually weren’t expected. The insured didn’t plan for a tornado to strike, hail to pound the car, or little Jimmy to “play with the matches”. The day may have started off well, but now there’s a problem.
  • Efficiency for the claim team may frustrate the insured. One expectation of a claimant is genuine communication. If the insured does not feel heard, there’s a problem. When an insurer has 30 plus adjusters servicing a claim, the insured has to repeat himself over and over. As each individual adjuster speaks to the insured, questions are naturally asked about the loss and what happened. Invariably some of the questions are the same ones already answered by the insured. People become angry when they don’t think an insurer is listening.
  • Claim teams only work when there is responsible management. Communication must occur for a any team to effectively work. A simple example is a routine car accident. The insured sends medical bills to the Medpay adjuster. The same medical bills are important to the UM adjuster. The insured is not going to know the bills sent to one adjuster may not be available to the other adjuster. It doesn’t take a lot of foresight to see frustration if the Team doesn’t act as a “Team”.
  • Bad Faith Claims are expensive. Every insurance company recognizes that bad faith litigation drains resources. Avoiding litigation has value and impacts the company’s bottom line. Bad faith lawsuits generally arise from unmet expectations. It is rare for a satisfied policy holder to go looking for an Oklahoma attorney.

Job satisfaction reports show people become bored with the mundane. State Farm employee satisfaction ratings reflect some employees aren’t pleased with the focus on efficiency.

With an average rating of 3.5, some claim representatives at State Farm are not satisfied with the job. Adjusters, just like other people, burn out when the perform the same receptive work and never experience a change.

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Management always has to consider the bottom line. Insurance is a business that needs to earn a profit. Undoubtedly, efficiency is important. But the insurance industry is also a service with responsibilities to its customers and also to its employees and staff. The greatest customer service satisfaction can readily be traced to the greatest employee satisfaction. Ultimately, the very best insurance companies learn the greatest profits come from happy customers and long term employees.

Our Oklahoma law firm has defended bad faith claims, coverage matters, policy disputes, pursued declaratory judgment actions and worked with thousands of adjusters. You can gain a lot of knowledge listening to others. If you pay attention long enough, trends become clear. We all want the same thing, respect, fair treatment, and thought that somewhere along the way we made a difference.

Hail6One Allstate Insurance customer complained the adjuster said there was no hail damage while the neighbor’s roof was being replaced due to hail:

I had a hail storm happen in my neighborhood in July 2015, and many roofs (over 100 in my area based on roofing permits issued in the village I live in) were replaced due to hail damage. Many houses on my block have new roofs due to the hail storm. I had a roofer check my roof and he saw hail damage and took pictures,

Allstate came out to review my roof and claimed that there was no hail damage. Ironically, State Farm was reviewing a house two doors away from me. Can you guess what they saw? Hail damage and their roof is currently being replaced.

We don’t know the specific facts in the Allstate customer’s complaint. Someone could reach the conclusion the next door neighbor had an experienced adjuster. The neighbor’s roof was replaced quickly and without question. The Allstate insurance adjuster found no hail damage. Maybe there wasn’t any damage. If not, the Allstate claim file should contain the evidence necessary such as photographs, inspections, etc.

Allstate recognizes, “. . . hailstones fall to earth from 30,000 feet, reaching up to 120 mph before they hit people, animals, vegetation, vehicles and structures. These storms cause $1 billion in damages to crops and property each year . . .” A hard piece of ice traveling that fast can cause a serious dent to a car or permanently destroy an asphalt shingle. No wonder hail causes so much damage to Oklahoma property owners!

Most insurance storm claims are adjusted by properly trained adjusters with the knowledge and training to locate hail damage. These hard working claim representatives fairly value the loss. They also timely pay the claim. Good adjusters make the claim simple. They know their job and do it!

The insured has to provide proof of damage, that’s Oklahoma law. The insurance company has to be able to defend its position. Education is the bridge. Adjusters should always be ready to explain things. The insured homeowner may not understand the Allstate complaint because someone didn’t take the time to give an explanation. The Allstate insured could just be trying to get a new roof for free. Not every insured is honest and not every homeowner is reasonable. It might have been useful to involve a lawyer to work out a settlement.

Someone will exclaim, “It’s a roof claim! It shouldn’t take a lawyer.” True, it shouldn’t, but sometimes it does. A lawyer experienced with hail and storm insurance can help with the communication breakdown.

The Allstate customer’s complaint might have been resolved. Having a professional help is important. Oklahoma lawyers serve the purpose of fair settlements.

An Oklahoma insurance attorney benefits in many ways:

  • Saves your valuable time.
  • Knows Oklahoma insurance law.
  • Provides credibility.
  • Settles claims.

If you have insurance claim questions, that’s what we do! Our Oklahoma attorneys and paralegals get claims settled! Give us a call 918-587-1525.


The failure to properly notify the insurance company presents a classic example of the need for sound legal advice. The typical insurance policy has a notice provision. The contract requires the insured individual or insured company to give timely notice of a claim. From the perspective of an insurance company, notice is important. Early investigation gives the adjuster the chance to find out the facts. The passage of time can be harmful to a claim. Not to mention, the insurance company needs to know about losses to set reserves and make suitable financial decisions.

For some, the questions seems quite simple. The insurance policy is a written contract. If the insurance policy says failure to properly notify the insurance company is a defense, then prompt notice should be given. If notice is not timely made, then there’s no coverage. The breach of the contract doesn’t always terminate the coverage. For example, let’s say the notice is one day late? The argument that failure to properly notify the insurance company should not end in denial of coverage carries some degree of logic. If you’re one day late on your mortgage payment,  you don’t expect the loan will be called due. Having to pay the entire loan balance in full the next day would mean scrambling for a new loan. It really would seem unfair to lose the house over a payment one day late. You aren’t going to get a new loan overnight.

The issue of timing as a defense to coverage is all or nothing. If late notice is a complete defense, then the insurance policy benefits are forfeited. In a large claim or a serious fact situation, the stakes are high. Denial of the coverage would be devastating to the insured. Therefore the denial of a claim for failure to properly notify the insurance company should involve an attorney. It’s better to get seasoned legal counsel with experience before the denial is made.

So why wouldn’t the insured give notice of a claim? The most obvious reason is fear over loss of future coverage entirely. Policy holders worry about being able to purchase insurance. Insureds are also concerned over the increase in premiums. If the situation “goes away”, then why risk the increase in premiums. Another reason can be the belief there is really not injury or damage. Suppose the manager of an apartment complex witnesses a 28 year old trip on the sidewalk. The young man falls to the grass. He looks athletic, strong, healthy. No obvious harm is present. He says not to worry, that he is fine. Calling the agent to report a claim seems over the top, downright silly. The claim goes unreported until the lawsuit arrives.

Jurisdictions across the country have reached different conclusions.

Recent decisions in Colorado and Wyoming illustrate the tension in the law on notice. The Colorado Supreme Court has twice cut back on its previous ten-year streak of expanding coverage for insureds by refusing to allow insurers to enforce technicalities in notice clauses to prevent coverage. Colorado’s neighbor to the north, Wyoming, headed in the other direction in 2016. Most states now employ the modern rule, which requires insurers to prove prejudice before they can void coverage. In May 2016, the American Law Institute adopted the modern rule for its Restatement of the Law, Liability Insurance, a position that could be influential in the courts.

More perilous to both insurers and policy holders are the courts that change their mind and reverse the rule announced just a few years earlier. Colorado seems to have some of these shifting winds:

Last year. . . the supreme court refused to apply the notice-prejudice rule to claims-made policies. Craft v. Philadelphia Ins. Co., 343 P.3d 951 (Colo. 2015). There, an officer of an insured company sought coverage under a D&O policy approximately 16 months after the policy period expired, even though the underlying lawsuit was filed during the policy period and the case had already been settled.

This year, the Colorado Supreme Court reversed a court of appeals ruling, holding that an insured cannot obtain coverage for a settlement of a claim or even a pending case with or without notice, if the carrier objects to the settlement. Stresscon v. Travelers Indem. Co., 370 P.3d 140 (2016) (Stresscon I). In 2013, the court of appeals had expanded the notice-prejudice rule to the “no voluntary payments clause” in Stresscon v. Travelers Indem. Co., 2013 COA 131. There, a concrete subcontractor, who admitted that it caused an accident at an U.S. Army base which delayed the project, notified its insurance carrier of the general contractor’s claims. The carrier arguably refused coverage, and the insured then settled with its general contractor on a series of contract claims (after allegedly inviting the carrier to the settlement meetings) and later sued for an indemnity. The court of appeals correctly rejected this technicality and found that the concrete company was well justified in its decision to settle and thus had successfully rebutted the arguable prejudice from the late notice and was entitled to recover.

Take Away – coverage counsel needs to be used to evaluate late notice as a defense. The law is changing. As it does, the courts go back and forth trying to reach the best answer. Until the answer to the question is firmly established, there is danger in denying a claim for late notice. Always involve trusted legal counsel with knowledge and expertise in insurance matters.

In Oklahoma, we will be glad to assist you. Coverage issues have been part of our practice and we have helped resolved several late notice claims. If you have questions about what constitutes late notice, call us. Don’t take on the decision without a good attorney familiar with Oklahoma law. 918-940-2222.


Business fires can bankrupt a company. There’s a lot at stake in business fires. The company’s loss may not just be a building and the contents. It may interrupt the income stream. If so, then the financial impact may extend to the employees.

The typical business is insured for loss of property and usually the interruption of business operations. But, the standard business insurance policy doesn’t necessarily cover the employees who lose their jobs due to the fire. The fire in Cleveland, Oklahoma at ICES Corporation, a aerospace parts manufacturer is an example.

Right now, about 35 people don’t have a job to go to come Monday. Mayor Brian Torres said the airplane parts manufacturer is one of the town’s largest employers.”

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The plant has grown and is considered an important part of the Cleveland community; it’s where many people in Cleveland have worked for nearly two decades.

Now, 35 hard workers don’t know what the future holds.

Business fires damage the most valuable assets of the company, its hardworking people. The sudden loss of a job is financially devastating. But, it is not just the loss of a pay check that hurts. When you spend 15 -20 years of your life working as a team with other similarly like-minded people, the loss of your job is like losing a part of the family.

The owner is waiting on a determination as to the insurance and a settlement to determine whether the facility will be rebuilt or not. A satisfactory insurance claim payment may be the difference in the company reopening and the staff being able to return to their jobs. Still, even with prompt payment of the insurance claim, it will take time to restore what was formerly there.

Fires like this one happen, it is part of life we don’t like, but it is there nonetheless. This fire started while two workers were doing their job. The fire marshall reportedly said, “a malfunctioning floor buffer ignited a chemical that workers were using to clean the floor”. It is the reason for insurance coverage. You never know when or how a fire may start. Insurance is for those unexpected occurrences  businesses sometime must face. The hard working staff must also endure the damages and the loss.

The number of fires in Oklahoma as the year closed were significant. Almost everyday, you heard or read about another fire. Some days there were multiple fires. House fires, apartment fires, mobile homes, restaurant fires, businesses hit by fire, the list goes on and on. Sources such as space heaters, grease fires, fire places, electrical shortages, and many others are potentially the causes for most of these fires that occur. Whether we hear about it while watching the local news channel each day or reading the morning paper, it seems as if fires are among the most talked about topic as the last few months of the year came to a close.


Here’s a short list of the fires reported in local news:


Hail damage hits the bottom line of an insurance company’s net profits in Oklahoma. Some years the number of hail claims is much greater, making less profits for the insurance industry. Other years the hail losses are greatly reduced. The decrease in hail claims allows insurance companies like State Farm to make greater profits. The insurance premiums charged Oklahoma homeowners for the insurance protection is not paid out in claims.

According to News Channel 4 in Oklahoma City, State Farm reported 33,790 hail storm claims in 2013 in Oklahoma. In 2014, there were only 8,089 reported losses of damage caused by hail stones. Since insurance premiums are based upon an average, profits should increase significantly when there is a decrease in the number of storms.

The news reports that State Farm says, “. . . hail is the most frequent cause of property damage, costing State Farm policyholders more than $2.4 billion in 2014.” Oklahoma homeowners well know the need for good insurance coverage to protect against these types of storm losses and claims.

As there were far fewer losses in 2014, State Farm knows it will have to be prepared for future hail loss claims:

“While last year was much quieter on the hail front, Oklahomans know all too well the rumbling under their feet with recent earthquakes and the ongoing threat of tornadoes,” State Farm spokesperson Jim Camoriano said. “State Farm stands ready to help customers, no matter what nature throws at us this year. We encourage people to visit with their insurance agent to discuss different types of weather and events that could affect their property.”Hail5

Insurance companies set aside funds for future claims, knowing the purpose of insurance is to pay claims and protect property owners. Setting aside the proper financial resources makes the claim process simple. A company like State Farm knows the claims will come and proper reserving measures assure the funds will be ready to promptly pay when the time comes.

Oklahoma insurance companies have a legal responsibility to promptly investigate and pay claims. This obligation includes hail damage claims to cars, homes, commercial properties, roofs, boats, and all types of covered property. It’s no surprise that hail losses happen. The difficult things to predict are when and where the next storm will hit. Insurance companies should be fully prepared to act with speed in the claim adjustment and payment. Based upon the company statements, State Farm customers can expect to be treated fairly in Oklahoma.

Insureds that don’t feel like they were given a fair shake file lawsuits and want their attorney fees paid. The Oklahoma insurance laws let the policyholder get back attorney fees for claims that are underpaid. Therefore, a well-documented claim file is a must. The adjuster may be asked to explain the amount paid. Since bad faith lawsuits take time, the details may not be fresh. The claim file needs to document the facts.

In summary, the lull in the number of Oklahoma hail claims has benefited the insurance industry in Oklahoma. But, don’t forget the calm before the next Oklahoma storm.

Our Oklahoma attorney firm has been litigating insurance matters for over 30 years serving Tulsa, Oklahoma City, Muskogee, Bristow, Moore, and the entire state. 918-587-1525, call now!


Being accused of insurance fraud is a serious offense. Regardless of the circumstances, your reputation is on the line. In this case, State Farm was alleged to have defrauded the United States government by avoiding the payment of storm claims under homeowners’  insurance policies. State Farm was said to have improperly shifted the burden for the storm damage to the Federal government, thereby reducing its own expenses. The appeal involved a procedural issue. State Farm tried to argue that disclosure of the False Claims Act lawsuit to the media instead of allowing it to remain confidential should result in the claim being dismissed.

The Supreme Court on Tuesday handed a victory to two whistleblower sisters by upholding a jury verdict that found State Farm defrauded the U.S. government when the insurance company assessed damage caused by Hurricane Katrina along the Gulf of Mexico coast in 2005.

The court ruled 8-0 to reject State Farm’s challenge to a 2015 lower court decision upholding the verdict in a 2006 lawsuit brought by sisters Cori and Kerri Rigsby under the False Claims Act, which lets people sue on behalf of the government over allegations it has been defrauded.

The United States Supreme Court issued an opinion written by Justice Anthony Kennedy, that said “the seal requirement is intended to benefit the government because it prevents those suspected of defrauding it from being alerted about a potential case alleging that fraud took place.”

As a result, “it would make little sense to adopt a rigid interpretation of the seal provision that prejudices the government by depriving it of needed assistance from private parties,” Kennedy wrote.

The Obama administration took the position of the whistleblowers who reported the misconduct.

The jury determined State Farm had committed fraud. State Farm was ordered to pay $758,000 in damages plus almost $3,000,000 in attorney fees. The jury award was appealed to the Court of Appeals who affirmed the jury verdict before the appeal was made by State Farm to the United States Supreme Court.

The overall cost to the insurer isn’t known. Undoubtedly State Farm incurred significant attorney fees and costs in the litigation attempting to avoid the judgment. It was clearly expensive litigation with a negative outcome for the insurance company.

In most jurisdictions insurance fraud, whether accusations against an insurance company or claims that the insured committed fraud, are a question of fact. The importance of whether insurance fraud is a question of law or question of fact determines who will make the ultimate decision. Questions of fact are typically resolved by a jury. Legal issues are settled by the court with the judge making the final determination. Appellate courts tend to be reluctant to reverse a decision on a question of fact if the trial transcript indicates there was a fair trial.

Fraud committed in an insurance claim usually requires a higher level of proof than a typical lawsuit. For example, bad faith in Oklahoma must be established by a preponderance of the evidence, a lower standard. Insurance fraud, however,  has a higher standard, clear and convincing evidence. In other words, the evidence and proof at the jury trial must show by clear and convincing proof that insurance fraud occurred.

The clear conclusion is insurance fraud is serious. It should never be taken lightly by anyone, an insurer or an insured. It can prosecuted both as a civil action seeking money damages or as a criminal action. Legal counsel should be retained immediately at the first indication that someone is going to accuse you of fraud or bad faith.