Bad Faith Insurance claims in Texas are not as easy as many people think.  This is illustrated in this 2024, opinion from the Western District of Texas, Austin Division.  The opinion is styled, Franklin Square Condo Owner Ass’n v. Amguard Insurance Company.  This is a summary judgment opinion.

After Franklin Square submitted a claim for the damage caused by the hailstorm, AmGuard sent an adjuster to inspect the property damage, notified Franklin Square that its inspector had assessed $13,034.90 in damages, and sent Franklin Square a check for an amount of $5,534.90 (the $13,034.90 in damages minus the deductible).  Franklin Square indicated that they disagreed with the assessment of the roof damage.  In response, AmGuard sent an engineer, Wyatt Hardenberg, to inspect the property on October 26, 2022, who found that 41 roof tiles exhibited hail damage, but observed that other cracked tiles lacked “a centralized focal (impact) point on the tile surface” as would indicate hail damage.  Hardenburg further observed that the cracked tiles evidenced earlier damage than the hailstorm and that the roof had been treated with sealant prior to the hail damage, indicating “prior maintenance activities to arrest known water intrusions.”  After Hardenburg’s assessment, AmGuard notified Franklin Square that it had readjusted its estimate and provided an additional check for $2,409.20 to replace the 41 cracked tiles and a broken window screen.

Franklin Square was dissatisfied with the amount paid and sued AmGuard for breach of contract damages, Insurance Code violations and bad faith the way the claim was handled.  There were other issued in the case related to experts that will not be discussed here.

Life insurance cases.  When is there a settlement?

Here is a 2024 opinion from the Western District of Texas, San Antonio Division that is worth reviewing.  The opinion is styled, Arch Insurance Company v. Rita Candelario.

The opinion does not deal with life insurance specifically, rather it deals with an insurance situation wherein the insurance company believed an agreement had been reached via a Rule 11 agreement.  A proper Texas Rule 11 of Civil Procedure Settlement Agreement is commonly used to memorialize that the respective parties have reached an agreement to settle a case.

This 2024 opinion is from the United States Court of Appeals for the Fifth Circuit.  The opinion is styled, Johnetta Askey Hunt v. Meridian Security Insurance Company.  This is a case that had resulted in a summary judgment for the insurance company Meridian.

On June 16, 2020, Johnetta Askew Hunt purchased a property in Dallas Texas.  On June 27, 2020, she entered into a homeowner’s insurance policy with Meridian Security Insurance Company.  The policy had a backdated effective date of June 16, 2020.

The policy provided coverage for the dwelling, other structures, personal property, and loss of use.  Under the terms of the policy, dwelling coverage extended only to the dwelling on the “residence premises.”  Coverage for other structures likewise extended to structures on the “residence premises” set apart from the dwelling.  Loss of use coverage was available only if part of the “residence premises” is not fit to live in.  Thus, for the coverages (except personal property) to apply, the property must be

Insurance claims usually don’t need an expert to testify but an attorney handling these types of claims needs to know when to hire an expert.  This is illustrated in a 2024 opinion from the Fort Worth Court of Appeals.  The opinion is styled State Farm Lloyds v. John Hilmi.

Hilmi had his home and contents insured by State Farm.  Helms asserts a lightening strike caused almost $200,000 of personal property at his home to be ‘fried”.   State Farm disagreed and this lawsuit was filed against State Farm for breach of contract and violations of the Texas Insurance Code.

A jury trial was conducted and resulted in a favorable verdict for Hilmi.  State Farm appealed and this Court reversed the judgment.  The opinion should be read to get an understanding of the facts and testimony at trial.  What follows is the legal logic.

Insurance claims, like all claims, have time periods within which lawsuits must be filed, otherwise, the statute of limitations will run.  This is illustrated in a 2024 opinion from the Corpus Christi Court of Appeals.  The opinion is styled, Jessica Galvin v. RVOS Farm Mutual Insurance Company.

The facts of this case are unusual and a reading of the facts helps to understand the ultimate ruling by the Court.  This is a summary judgment case decided in favor of RVOS.

The controlling question in this case is when Galvan’s claims accrued.  Generally, a claim accrues, and limitations begins to run, “when the defendant’s wrongful conduct causes the claimant to suffer a legal injury, which gives the claimant the right to seek a judicial remedy.”  That is, a claim accrues “when injury occurs, not afterward when the full extent of the injury is known.”  According to the Texas Supreme Court, “Generally, a cause of action accrues when a wrongful act causes a legal injury.”

The Federal Employee Group Life Insurance (“FEGLI”) program is governed by Federal Law.  This law was enacted in 1954 and is found at 5 U.S.C., section 8701.  A 2024 opinion from the Northern District of Texas, Fort Worth Division, discussed FEGLI and how it applied to the case at issue.  The facts are lengthy and the discussion is somewhat complicated.  A reading of the opinion is necessary to comprehend and apply.  The opinion is styled, Metropolitan Life Insurance Company vs. Rebecca D. Vasquez, et al.

Metropolitan Life Insurance Company (“MetLife”), as of the date of this post handles all FEGLI cases for the Federal government.  The issues in most FEGLI cases are disputes over who is entitled to the life insurance proceeds.  As a result, like this case, they are interpleader cases.

If you have a FEGLI case, read the opinion and seek legal help for advice.

 

A claim being denied doesn’t necessarily mean an expert has to be hired in the case.  But when an expert is needed the correct legal process must be followed.  This is illustrated in a 2024 opinion from the Southern District of Texas, Houston Division.  The opinion is styled, Dora Doss Thompson v. State Farm Lloyds.

This case arises out of an insurer’s denial of a property damage claim.  Defendant State Farm Lloyds (“State Farm”) filed a Motion for Summary Judgment.  For the reasons that follow, State Farm’s motion was granted.

Plaintiff Dora Doss Thompson obtained an insurance policy (“Policy”) from State Farm, covering wind and hail damage occurring between April 12, 2021 and April 12, 2022 at her home located at 21014 Pricewood Manor Court, Cypress, Texas 77433 (the “Property”).  Thompson claims that a September 28, 2021 storm caused significant wind and hail damage to her Property.

Insurance usually covers accident that happen or acts of God, negligence, etc., things that are Unintentional.  Policies will rarely cover willful or intentional conduct that causes harm.

The above is illustrated in a 2024 opinion from the Eastern District of Texas, Sherman Division.  The opinion is styled, Jacksonville, Realty, LLC v. Certain Underwriters At Lloyds.

The Plaintiff, Jacksonville, filed a summary judgement seeks the Court to rule that the policy contract had been broken by the Defendant.  The policy at issue is an errors and omissions policy.  Miller Title acted as the escrow agent for a real estate transaction between Jacksonville and IBF Retail I, LLC.  As part of the transaction, IBF deposited $2,750,000 in earnest money with Miller Title.

Insurance claims that are not timely paid and in violation of the Texas Prompt Payment of Claims Act, do those claims survive the death of the insured?  This topic is discussed in a 2024 opinion from the Eastern District of Texas, Beaumont Division.  The opinion is styled, Brenda barron, Temporary Administratrix Of The Estate Of Larry Barron, Deceased v. Century Surety Company, d/b/a Century Insurance Group.

The issue here is whether an insured’s claim for statutory interest and attorney fees under chapter 542 of the Texas Insurance Code survives their death.  In February 2021, Larry Barron’s commercial building was damaged by a winter storm.  The building was insured by Century.  After Century refused to pay all of Barron’s claim, he sued Century for breach of contract, statutory bad faith, and statutory interest and attorney fees under chapter 542.  Following the parties’ motions for summary judgment, the court dismissed his claim for bad faith.

Sadly, Larry Barron passed away on December 17, 2023.  Brenda Barron replaced him in this lawsuit as the administratrix of his estate.  In Century’s present motion for summary judgment, it argues that none of the insured’s extra-contractual claims survive his death.  In response, Barron says that at least the claim for statutory bad faith should survive.  But because that claim has already been dismissed, the undersigned only needs to address the remaining extra-contractual claims for statutory damages and attorney fees under chapter 542.

Cooperating with the your own insurance company when making a claim for policy benefits is almost always a requirement in the policy.  An opinion discussing this was issued by the Tyler Court of Appeals in 2024.  The opinion is styled, Kenneth R. Cade v. State Farm Lloyds.

On April 18, 2019, a windstorm blew a large tree onto a portion of Cade’s house that was insured by State Farm.  Cade eventually made a claim for damage to the structure and contents.  Several inspections were made and payment was made totaling approximately $30,000.  The personal property claim was not made until about 18 months later, claiming several items of personal property were damaged or destroyed.  A lawsuit resulted after State Farm denied paying further damages citing a lack of cooperation by Cade with the claim.  State Farm filed a motion for summary judgement which was granted.

The opinion details many more of the facts and testimony in the case which should be read.  This article will cite the law related to this type of claim.

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