For insurance lawyers, the above question captures the ultimate question.  Most cases do not involve bad faith.  They are simple breaches of the insurance contract.  The Northern District, Dallas Division discussed the law in a recent opinion.  The opinion is styled, Yasser Alhamzawi v. Geico Casualty Company.

This is a summary judgment opinion.  Plaintiff had insurance with Geico and sustained a hail damage loss to his insured car.  After an estimate, Geico issued two checks totaling $5,819.19 to Plaintiff and Plaintiff cashed the checks.

Plaintiff then got more estimates for amounts over $30,ooo.  Plaintiff sent these estimates to Geico for payment.  Geico had instructed Plaintiff to have the repair shop call if the amount they paid was insufficient so that a new estimate could be obtained.  Plaintiff did not do this, but instead got his brother to do the repairs.  Plaintiff then sued Geico for bad faith, for not fully paying the claim.  Geico asserted that Plaintiff had violated the policy by not cooperating with the policy provision requiring cooperation.

Bad faith attorneys need to know when bad faith in insurance occurs and when it does not.  A 1995, Texas Supreme Court case is worth reading.  It is styled, Republic Insurance Co. v. Stoker.

The Stokers were involved in a chain reaction car wreck caused by an unidentified pickup truck which dropped a load of furniture causing a chain reaction.  The truck was not struck by any of the vehicles.  The Stokers had no collision insurance and therefore submitted a claim under their uninsured/underinsured coverage.  Republic originally denied the claim because it concluded that Mrs. Stoker, the driver, was more than fifty percent at fault in causing the accident.

The Stokers sued for breach of insurance contract, breach of good faith and fair dealing, of violations of the Deceptive Trade Practices Act, and violations of the Texas Insurance Code.  The Stokers alleged that Republic gave an invalid reason for denial of their claim.

Life insurance lawyers need to know this 2008, 5th Circuit opinion.  It is styled, Liu v. Fidelity and Guaranty Life Insurance Company.

The importance of this opinion is the court stating that warranties are not favored in life insurance policies.

Liu filled out a life insurance application which stated that he had not been diagnosed with cancer within the previous ten years.  The policy was issued two days after he was diagnosed with cancer.  The carrier denied coverage arguing that the representation in the application was a condition precedent to coverage.  The trial court found coverage which was affirmed on this appeal.

Palo Pinto County insurance attorneys know the insurance companies want to litigate their cases in Federal Court.  Insurance attorneys representing individuals and small businesses know they can often times get a better result for their clients in State or County Court.

Another U.S. McAllen Division opinion discusses the same issue as discussed here two days ago, yet with a different result.  The style of the case is, Pablo Martinez v. Allstate Texas Lloyds.

Martinez was insured with Allstate and sued Allstate based on their handling of a claim resulting from a storm.  Martinez alleged that Allstate failed to “fully compensate” them.  Martinez sued in State Court and Allstate removed the case to Federal Court.  Martinez sought a remand of the case.

Parker County insurance attorneys know that it is best for their clients to try and keep their case in State or County Court.  The insurance lawyers know it is best to get their case in Federal Court.  The U.S. McAllen Division had a case where the argument on this issue was a little different from what is usually seen.  The case is styled, Ida Rodriguez v. Allstate Texas Lloyds.

Rodriguez sued Allstate for a property damage claim that allegedly was not properly paid.  Rodriguez sued Allstate in State Court and Allstate removed the case to Federal Court.  Rodriguez filed a Motion to Remand the case back to the State Court.

One argument in this case was that the amount in controversy did not exceed $75,000.

A Weatherford insurance lawyer will always tell you “read the policy” or risk losing on a case where you otherwise thought you had coverage.  A recent case may change that advice, depending on the facts.

When a plaintiff fails to read an insurance policy, they usually don’t have much of a case against an insurer if they’re denied coverage.

But one insurance lawyer recently convinced Houston’s Fourteenth Court of Appeals that his client could sue an insurance company over a policy he’d never laid eyes on before filing a claim.

Parker County lawyers know that insurance policy’s have to be read.  Otherwise the result in a U.S. Eastern District of Texas case, can be the result.  The case is styled, Rita Jones v. Hartford Life and Accident Insurance Company et al.

This was a Rule 12(b)(6) Motion to Dismiss filed by Hartford.  The Court granted the motion.

Jones filed suit under ERISA, Section 1132 arising from Hartford’s decision to terminate long-term disability insurance benefits.

Grand Prairie insurance lawyers need to read this case for seeing one way to properly sue an insurance company adjuster.  The case is from the U.S. Western District, Del Rio Division.  It is styled, Alfonso Gaytan and Tere Gaytan v. State Farm Lloyds and Alberto Garza.

This litigation arises out of storm that hit Eagle Pass, Texas, in April 2014.  The Plaintiffs submitted a claim for repairs under the State farm policy and Garza was the adjuster assigned to handle the claim.  Garza’s inspection was unacceptable to Plaintiffs and a lawsuit was filed in State Court and State Farm had the case removed to Federal Court based on 28 U.S.C. Section 1441(a).

Plaintiff’s filed a motion to remand and there was an argument about the 30 day deadline imposed by 28 U.S.C. Section 1447.  The Plaintiffs prevailed on this argument.

Horror stories abound in the insurance claims arena, but what has happened to one Texas resident is at the top.  The Houston Press reported on a story titled, Eight Years After Ike, Insurance Firm Still Won’t Pay Homeowner.

It has been eight years since Hurricane Ike ripped through the Gulf and Houston’s surrounding areas, but homeowner Gail Menchaca’s insurance company has still not paid her a cent for the damages to her home.

In a case that could have sweeping implications for how thoroughly insurance companies choose to inspect property damage and whether firms have any real motivation to pay you anything, Menchaca’s insurance company, USAA Texas Lloyd’s Company, has fought her all the way to the Texas Supreme Court.  Even after a Montgomery County trial court and appeals court ordered USAA to pay Menchaca not only for the property damages covered under the policy, but also thousands more in court and attorneys fees, USAA has refused.  At the heart of the case is this: If an insurance company fights you in court for eight years, at the end of it all, are you entitled to recover any damages beyond the money you need to fix your house?

The Texas Supreme Court issued an opinion in October 2016, that needs to be read by Dallas and Fort Worth insurance lawyers.  It is styled, Van K. Martin v. State Farm Mutual Automobile Insurance Company.

This is a summary judgment appeal.

Martin’s son was involved in an auto accident with State Farm insured, Jeffery Lonsdale.  No one was injured in the accident, but Lonsdale filed a claim for property damage, which was submitted to State Farm under Part A of Martin’s liability policy.  Martin filed a claim for property damage to his vehicle under Part D of the policy.  State Farm settled Lonsdale’s claim and provided coverage for the property damage to Martin’s vehicle.  Martin alleges that State Farm unreasonably concluded his son was primarily responsible for the accident without interviewing Martin’s son or other witnesses in the car.  Martin alleges he paid the deductible to have his vehicle repaired and paid “incremental semi-annual premiums” related to the accident.