The Texas Concurrent Cause Provision Requires Insured to Prove Risks Insured Against and Segregate its Claim from Risks not Insured Against

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The Texas Concurrent Cause Provision Requires Insured to Prove Risks Insured Against and Segregate its Claim from Risks not Insured Against


Read the full article at https://www.linkedin.com/pulse/when-hail-damages-swiss-cheese-roof-coverage-limited-barry and at https://zalma.com/blog plus more than 3400 posts.


The Texas Court of Appeal was asked to decide whether an insured that receives a payment from the insurer on its claim is excused from complying with the requirement to segregate covered losses from non-covered losses under the doctrine of concurrent causes if it later brings a suit for breach of contract. In Prime Time Family Entertainment Center, Inc .v. Axis Insurance (October 16, 2020) the insured claimed payment of undisputed amount excused requirement to segregate covered from non-covered damage.


ZALMA OPINION


The Texas version of the concurrent cause doctrine protected the insurer, AXIS, from paying for damages not covered by the policy could not delete from its claim the wear and tear problems with the roof. What neither the parties nor the court dealt with was the fact that the insured, Prime Time, made a claim with knowledge that the roof was a total loss before the hail storm, and fraudulently sued for both damages..

 

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