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March 18, 2025
Unsubstantiated Legal Conclusion Defeats Bad Faith Claim

When Common Law Bad Faith Claim Fails so Does Statutory Bad Faith Claims

Post 5023

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In Cowboy Christian Missions, Plaintiff v. Church Mutual Insurance Company, SI, Civil Action No. 4:24-cv-00057-O, United States District Court, N.D. Texas (March 7, 2025) a bad faith claim was dismissed before trial.

Defendant Church Mutual Insurance Company moved the court for Partial Summary Judgment to eliminate charges of the tort of Bad Faith.

BACKGROUND

Plaintiff’s building complex sustained damage as a result of an EF3 tornado (the “Loss Event”). At the time of the Loss Event, the Property was covered under an insurance policy issued by Defendant Church Mutual (the “Policy”). The Policy provided coverage for damages caused by the Loss Event, subject to the terms and conditions of the Policy.

Plaintiff submitted a claim for coverage under the Policy for damages allegedly sustained as a result of the Loss Event. Within two days of the Loss Event, Defendant conducted its initial inspection of the Property, which included (1) Defendant’s adjuster, Ben Hodges; (2) a third-party engineer, Travis Ebisch, of Nelson Forensics, LLC; and (3) a “building consultant,” Mani Siaosi, of Cavalry Construction (“Cavalry”). Based on an estimate produced by these individuals, Defendant issued payments for coverage of the claim in the amounts of $100,000.00 and $ 291,535.53.

Defendant refused to issue additional payments for expenses and/or losses that Plaintiff believes were covered under the Policy. Among those are “relocation” costs that Plaintiff allegedly incurred while repairs were being conducted on the Property and other “non-salvageable items” damaged during the Loss Event.

Nearly one year after the Loss Event, Plaintiff sent Defendant a demand letter requesting $1,626,859.31, which Church Mutual refused.

Plaintiff sued seeking breach of contract damages and “extra-contractual” claims for alleged violations of the Texas Insurance Code, the Texas Deceptive Trade Practices Act (“DTPA”), fraudulent misrepresentations, and breach of the common-law duty of good faith and fair dealing.

Trial is currently scheduled on the Court’s docket beginning March 24, 2025.

ANALYSIS

Defendant contended that Plaintiff failed to show that Defendant acted in bad faith during its processing of Plaintiff’s insurance claim. Defendant argued that the evidence reflected only a bona fide coverage dispute, which necessarily bars the extra-contractual claims that involve elements of bad faith, malice, or similar ill-intent. The Court agreed.

Common-Law Claim: Breach of Duty of Good Faith & Fair Dealing

Insurance companies have a duty to deal fairly and in good faith with an insured in the processing of claims. This means that as long as the insurer has a reasonable basis to deny or delay payment of a claim, even if that basis is eventually determined by the fact finder to be erroneous, the insurer is not liable for the tort of bad faith.

Plaintiff cited to no legal authority or industry standard that suggests who is responsible for investigating new evidence, or why, once counsel and third-party experts are involved, they cannot fulfill this duty. Defendant argued that it did not need to adjust its payment for extra expenses because Plaintiff did not meet its burden of showing that its relocation expenses were necessary. Under Texas law, it is the policyholder’s burden to demonstrate that a claim is covered under the policy.

Plaintiff did not attempt to list its relocation expenses so the Court could not determine which expenses were “necessary.” Instead, Plaintiff refers generally to “American Express charges” and “an invoice from M&M Construction” that Plaintiff submitted to Defendant, which Plaintiff’s representative, Kort Weldon, was asked about in his deposition. Mr. Weldon testified that these were expenses incurred when Cowboy Christian had to relocate to another building to resume operations. Absent an itemized list and specific support for each item, Plaintiff’s contention that it incurred “extra expenses” is an unsubstantiated legal conclusion.

To the extent that Plaintiff argues that Cavalry conducted an inventory of all non-salvageable items and Defendant never produced that inventory, then Defendant should produce that inventory if it was requested.

The Court granted Defendant’s Motion with respect to Plaintiff’s claim for common-law breach of duty of good faith and fair dealing.

Statutory Claims: Violations of the Texas Insurance Code & Texas DTPA

Texas courts have recognized the close relationship between common-law bad-faith claims and the statutory bad-faith claims found in the Texas Insurance Code and DTPA. Because the statutory and common law standards are now the same, a finding that there is no common law violation as a matter of law also eliminates the statutory claims alleged by plaintiffs in this case.

Defendant’s Amended Motion for Partial Summary Judgment was granted and Plaintiff’s statutory claims under the Texas Insurance Code and the DTPA and Plaintiff’s common-law claim for breach of duty of good faith and fair dealing were dismissed with prejudice.

The remaining claims for trial are breach of contract and fraudulent misrepresentations.

ZALMA OPINION

Refusing to pay a claim presented by the insured is not evidence of the tort of bad faith. Although Cowboy Christian was upset and didn’t receive the money it wanted, that is not evidence of bad faith, it is just a dispute over numbers. The trial will go forward and Cowboy Christian will present evidence to the court of the amount it believes is covered by the policy to indemnify it for its losses and will not receive a bonus of exemplary or punitive damages.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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00:09:40
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Dr. Segun Patrick Adeoye, a medical doctor, filed a lawsuit against the United States of America, seeking damages for alleged violations during his criminal prosecution. He was acquitted by a jury but claims to have suffered significant harm, including financial losses, damage to his professional reputation, and personal distress.

In Dr. Segun Patrick Adeoye v. The United States Of America, Civil Action No. 4:25-cv-83, United States District Court, E.D. Texas, Sherman Division (July 23, 2025) the USDC dismissed Adeoye’s suit.

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Dr. Adeoye was indicted on charges of conspiracy to commit wire fraud and money laundering. The indictment alleged that he and his co-conspirators obtained at least seventeen million dollars through various fraudulent schemes. Despite being acquitted, Dr. Adeoye claims that his ...

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14 hours ago
Amount of Loss Set by Appraisal Award

Payment of Appraisal Award Defeats Claim of Bad Faith
Post 5163

Read the full article at https://lnkd.in/dNpKKcYx, see the full video at https://lnkd.in/dNgwRP8q and at https://lnkd.in/dA9dvd-D, and at https://zalma.com/blog plus more than 5150 posts.

Hurricane Damage to Dwelling Established by Appraisal Award

In Homeowners Of America Insurance Company v. Emilio Menchaca, No. 01-23-00633-CV, Court of Appeals of Texas, First District (July 31, 2025) after a hurricane Homeowners of America Insurance Company (“HAIC”) estimated that the cost of covered repair to Menchaca’s house was $3,688.54, which was less than his deductible, and therefore no payment would be made.

FACTS

After Menchaca retained counsel HAIC advised that, under the terms of the policy, Menchaca was required to first invoke the appraisal process prior to filing suit, and that HAIC reserved the right to request that Menchaca and any adjuster hired on his behalf submit to an Examination Under Oath (“EUO”).

On August 23, 2018, Menchaca’s counsel ...

00:08:45
August 07, 2025
Amount of Loss Set by Appraisal Award

Payment of Appraisal Award Defeats Claim of Bad Faith
Post 5163

Read the full article at https://lnkd.in/dNpKKcYx, see the full video at https://lnkd.in/dNgwRP8q and at https://lnkd.in/dA9dvd-D, and at https://zalma.com/blog plus more than 5150 posts.

Hurricane Damage to Dwelling Established by Appraisal Award

In Homeowners Of America Insurance Company v. Emilio Menchaca, No. 01-23-00633-CV, Court of Appeals of Texas, First District (July 31, 2025) after a hurricane Homeowners of America Insurance Company (“HAIC”) estimated that the cost of covered repair to Menchaca’s house was $3,688.54, which was less than his deductible, and therefore no payment would be made.

FACTS

After Menchaca retained counsel HAIC advised that, under the terms of the policy, Menchaca was required to first invoke the appraisal process prior to filing suit, and that HAIC reserved the right to request that Menchaca and any adjuster hired on his behalf submit to an Examination Under Oath (“EUO”).

On August 23, 2018, Menchaca’s counsel ...

00:08:45
July 16, 2025
There is no Tort of Negligent Claims handling in Alaska

Rulings on Motions Reduced the Issues to be Presented at Trial

Read the full article at https://lnkd.in/gwJKZnCP and at https://zalma/blog plus more than 5100 posts.

CASE OVERVIEW

In Richard Bernier v. State Farm Mutual Automobile Insurance Company, No. 4:24-cv-00002-GMS, USDC, D. Alaska (May 28, 2025) Richard Bernier made claim under the underinsured motorist (UIM) coverage provided in his State Farm policy, was not satisfied with State Farm's offer and sued. Both parties tried to win by filing motions for summary judgment.

FACTS

Bernier was involved in an auto accident on November 18, 2020, and sought the maximum available UIM coverage under his policy, which was $50,000. State Farm initially offered him $31,342.36, which did not include prejudgment interest or attorney fees.

Prior to trial Bernier had three remaining claims against State Farm:

1. negligent and reckless claims handling;
2. violation of covenant of good faith and fair dealing; and
3. award of punitive damages.

Both Bernier and State Farm dispositive motions before ...

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May 15, 2025
Zalma's Insurance Fraud Letter - May 15, 2025

ZIFL Volume 29, Issue 10
The Source for the Insurance Fraud Professional

See the full video at https://lnkd.in/gK_P4-BK and at https://lnkd.in/g2Q7BHBu, and at https://zalma.com/blog and at https://lnkd.in/gjyMWHff.

Zalma’s Insurance Fraud Letter (ZIFL) continues its 29th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma. It is provided FREE to anyone who visits the site at http://zalma.com/zalmas-insurance-fraud-letter-2/ You can read the full issue of the May 15, 2025 issue at http://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-05-15-2025.pdf
This issue contains the following articles about insurance fraud:

Health Care Fraud Trial Results in Murder for Hire of Witness

To Avoid Conviction for Insurance Fraud Defendants Murder Witness

In United States of America v. Louis Age, Jr.; Stanton Guillory; Louis Age, III; Ronald Wilson, Jr., No. 22-30656, United States Court of Appeals, Fifth Circuit (April 25, 2025) the Fifth Circuit dealt with the ...

May 15, 2025
CGL Is Not a Medical Malpractice Policy

Professional Health Care Services Exclusion Effective

Post 5073

See the full video at https://lnkd.in/g-f6Tjm5 and at https://lnkd.in/gx3agRzi, and at https://zalma.com/blog plus more than 5050 posts.

This opinion is the recommendation of a Magistrate Judge to the District Court Judge and involves Travelers Casualty Insurance Company and its duty to defend the New Mexico Bone and Joint Institute (NMBJI) and its physicians in a medical negligence lawsuit brought by Tervon Dorsey.

In Travelers Casualty Insurance Company Of America v. New Mexico Bone And Joint Institute, P.C.; American Foundation Of Lower Extremity Surgery And Research, Inc., a New Mexico Corporation; Riley Rampton, DPM; Loren K. Spencer, DPM; Tervon Dorsey, individually; Kimberly Dorsey, individually; and Kate Ferlic as Guardian Ad Litem for K.D. and J.D., minors, No. 2:24-cv-0027 MV/DLM, United States District Court, D. New Mexico (May 8, 2025) the Magistrate Judge Recommended:

Insurance Coverage Dispute:

Travelers issued a Commercial General Liability ...

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