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In Harvey's Wake, Some Worry About State Insurer's Pace at Paying Claims From Ike

Texas City Independent School District leads the list with more than $172 million in outstanding Ike claims.

Harvey add
Flooding from Harvey.
(TNS) - As thousands wait for insurance money to make repairs in the wake of Hurricane Harvey, more than a half-dozen school districts, cities and other government agencies are still awaiting payment from the Texas Windstorm Insurance Association on nearly $60 million in claims from Hurricane Ike.

Texas City Independent School District leads the list with more than $172 million in outstanding Ike claims, followed by Dickinson ISD with $10.5 million and Chambers County with $9.5 million. Three other school districts, two cities and a community college are awaiting payment on additional claims of more than $22 million, according to a Houston Chronicle analysis.

Officials said they have little faith that TWIA - the insurer of last resort - will pay the claims without further legal battles.

"It's scary," said Dickinson ISD Superintendent Vicki Mims, whose community was also hit hard by Harvey. "As a school district, we have some resources to use. … If you're a homeowner, what do you do? Fight TWIA for 10 years?"

Of the nine entities still seeking funds for Ike damages, five are trying to work through an appraisal process to determine how much TWIA should pay. Dickinson ISD filed a lawsuit, turned to an independent judge and has battled a legal appeal in an effort to recover the losses.

Jennifer Armstrong, vice president of communications for TWIA, said the pending Ike claims are anomalies that don't portend problems for Harvey claims.

"We want to resolve anyone's concern as best we can outside any process," Armstrong said. "When we set payment on a claim based on an estimate, we realize it could be a different number when people do repairs. We always encourage policyholders to come back and work with us to make sure everyone's satisfied."

Claims through TWIA have gotten more complicated, however, since Ike struck Texas in 2008. In 2011, the state Legislature passed a series of laws making an appraisal process the sole avenue through which policyholders can dispute claims and capping the amount of damages if a court finds TWIA guilty of wrongdoing.

The more than 73,000 claims filed since Harvey will be the first major test of how the new policies could affect payouts.

Some consumer advocacy groups and insurance experts worry that the new rules will allow the insurer to drag policyholders through years of proceedings without being held accountable for wrongdoing.

"TWIA has a recognizable pattern of stall tactics and attempts at non-payment," Anahuac ISD Superintendent James Hopper wrote in a letter to a state lawmaker over his district's attempt to collect $7.6 million in claims.

A quasi-governmental entity, TWIA provides insurance covering only wind and hail for 234,861 homeowners, businesses and government policyholders in a 14-county area of coastal Texas plus a portion of Harris County. It does not cover claims arising from flooding, such as that caused by Harvey, which dumped more than 50 inches of rain on parts of the Houston area.

Familiar feeling

In Dickinson ISD, about 40 miles southeast of Houston, officials say they know all about the slow process of recovering damages.

After Hurricane Ike blew through Galveston Bay, Dickinson ISD spent about $1 million to replace the high school roof, which was lifted several inches by the storm and plopped back down, full of holes.

San Leon Elementary and a gymnasium similarly had their roofs lifted and damaged, requiring substantial maintenance work. Other district schools suffered less-severe wind damage.

TWIA offered to pay $238,000 for all the damages, later upping the offer to $1.2 million on the condition that the district wouldn't ask for more. Dickinson ISD disputed the claim by filing a lawsuit, and the insurer asked that they resolve the matter through a process known as appraisal.

The process required the insurance company and Dickinson ISD to hire their own adjusters, both of whom agreed on a third-party "umpire" adjuster to oversee their work. If two of the three adjusters reached a decision on how much damage was sustained, that would be the amount the insurer would pay.

Dickinson ISD's adjuster said the losses amounted to about $19 million; TWIA's calculated zero covered damages. An independent judge said the total damages were closer to about $11 million, a number to which the Dickinson ISD adjuster agreed.

But instead of paying the court-ordered amount, TWIA balked. When a jury again ordered the insurer to pay Dickinson ISD, it appealed the decision. The case is now pending in a state appeals court.

'Majority of the risk'

The Legislature created the Texas Catastrophe Property Insurance Association after several hurricanes slammed into the Texas coast in the late 1960s and in 1970, scaring many wind insurers out of coastal counties. The goal was to provide homeowners, business owners and government entities a way to get windstorm insurance in areas where private companies refused to write policies.

TWIA was given its current name in 1997 and had small but consistent growth until Hurricane Rita in 2005, after which another wave of insurers said they would no longer write wind-damage insurance policies along Texas' coast.

The number of policies written by the state-backed insurer subsequently skyrocketed, said David Nardecchia, a senior specialist for the Office of Public Insurance Counsel and a former underwriter manager at TWIA.

"It varies by county, but in certain counties it could be pretty high," Nardecchia said. "They have a majority of the risk in those counties."

The insurer faced major problems after Hurricane Ike, when more than 1,900 policyholders sued TWIA over its handling of claims. The insurer ended up settling a majority of those cases. However, state Sen. Larry Taylor, R-Friendswood, sponsored a series of changes to the agency in 2011 after alleging an outsized portion of the settlements went to pay attorneys' fees instead of policyholders. Those concerns were shared by then-Gov. Rick Pretty and tort reform groups.

The changes included a rule that makes the appraisal process the only way for policyholders to appeal TWIA decisions. Another new rule capped the amount that policyholders can recoup if a court finds TWIA guilty of wrongdoing: While other insurers in the state can be held liable for up three times the claim in case of wrongdoing, TWIA is liable only for the face value of the claim.

Seth Chandler, a law professor at the University of Houston who specializes in insurance, said the idea behind the appraisal process was that policyholders would benefit from potentially quicker payouts and settlements.

But he questioned why TWIA is the only insurer in Texas given such treatment.

"Why is TWIA special? You could make the same argument for State Farm and Allstate and the rest of industry," Chandler said.

Nardecchia said there are numerous reasons TWIA is treated differently: It's the state's insurer of last resort, it's funded differently than private insurers, and, at one point after Hurricane Ike, there were concerns whether the agency could remain financially solvent.

Lawsuits over claims can drag on for years even in the private market, Nardecchia said.

"I'm not sure that's unique to TWIA in itself," Nardecchia said.

In Texas City, the College of the Mainland is still waiting on $3.94 million it believes it is owed by TWIA from Hurricane Ike.

The insurer originally offered to pay the community college about $46,000 for light poles that had blown around campus but offered nothing for the damaged roofs, which school administrators say were full of holes.

Without the money from TWIA, the school patched the holes, but they continue to spring leaks, causing ceiling tiles to bubble in the Student Center and water stains to creep along the upper walls of the school's dome-shaped gym.

'A cursory look'

Clen Burton, a vice president at college, said he's not surprised the insurer covered only damage that could be seen from sidewalks. He said that TWIA's original adjuster never looked on top of roofs or in crawl spaces and instead walked around the campus for about 90 minutes and left.

Dickinson ISD also questioned the insurer's actions during the appraisal process.

While the district's adjuster went onto school roofs and into crawl spaces after Harvey, Dickinson ISD Deputy Superintendent Ryan Boone said TWIA's adjuster did not.

"They basically did a cursory look on our buildings," Boone said. "It was a stop, look and listen, and then go about our business."

Armstrong said the insurer was concerned about the appraisal process in the nine remaining Ike cases, but not because it did anything wrong. She said those cases are more complicated because the appraisal processes didn't begin, in many cases, until four years after the storm. There had been other wind and hail events between Ike and the time some of those appraisals began, further compounding the issue.

Armstrong suggested there could be other concerns but said she could not elaborate because the cases are still working their way through the legal system.

"The situation with Harvey is dramatically different than these nine Ike cases," Armstrong said.

But Wade Wendell of Texas Watch, the consumer and insurance policyholder advocacy group, said TWIA policyholders should be concerned because the new appraisal process is difficult to navigate and because the insurer is less liable for damages if they do something wrong.

"They're rigging the process," Wendell said. "These changes further incentivize TWIA to test to see if policyholders can afford a lawyer or if they have the stomach to fight them in court for years."

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