Who are those who have an insurable interest in the life of a person? The answer is usually obvious, but not always.
Here’s an answer.
Those who have an insurable interest in the life of another fall into three general classes:
Hail claims are a frequent source of litigation. Sometimes and expert is needed in these cases. The issue of using an expert in a hail damage case arose in this 2023 opinion from the Northern District of Texas, Dallas Division. The opinion is styled, Mohamed Bakri v. Nautilus Insurance Company.
This case arises out of Plaintiff Mohamed Bakri’s insurance claims for wind and hail damage. Bakri alleges that a winter storm during the Policy Period caused significant damage to his properties. After an investigation, Nautilus refused to cover the damage, claiming that it was merely cosmetic. In addition, Nautilus determined that any impairment beyond cosmetic damage occurred before the Policy Period.
Bakri sued Nautilus claiming violation of the Texas Insurance Code and breach of contract. Bakri had an expert to help prove his damages. Nautilus filed a motion to exclude the testimony of Bakri’s expert, Johnson, and moved for summary judgment.
Insurance claims for late payment are a frequent issue when someone sees an insurance lawyer about the way they have been treated in an insurance claim. This late payment issue is addressed in a 2023 opinion from the Northern District of Texas, Dallas Division. The opinion is styled, Craig Collins v. State Farm Lloyds.
In this case the insured suffered damages from a tornado. A claim was made immediately and State Farm sent out an adjuster. The initial found some damages and paid the damages. Collins asserted there were more damages and another adjuster investigated the claim and found more damages and paid those damages. Collins asserted there were still more damages and a third adjuster came out and additional damage was found and the damages were paid.
Collins sued for various causes of action including violations of the “duty of good faith and fair dealing,” Texas Insurance Code damages under Section 541, and finally for damages under Section 542. A reading of the case shows a discussion of the first two and here is the discussion under the Section 542, Prompt Payment of Claims.
What is the value of my/an insurance claim?
That questions is often asked and the answer will vary depending on many factors. However, one of the factors that is important and asked by people seeking legal advice is, “Can I get back my legal fees?”
This issue is discussed in a 2023 opinion from the Western District of Texas, Austin Division. The opinion is styled, Jyoti Singh v. Riversource Life Insurance Company. Only the part of this case discussing the standards for recovering legal fees will be discussed here.
Claims denial attorneys will on occasion find themselves in a position of needing to hire an expert to help with their case. The case referenced in the Blog is a hail damage case but the discussion is a discussion on what courts look at when determining whether an experts testimony will be allowed. The case is from Eastern District of Texas. The style of the case is, Hilltop Church of The Nazarene v. Church Mutual Insurance Co.
This case has other issues it discusses but here is what it says about experts.
Plaintiff claims that a March 2019 hailstorm caused damage to its property.
Here is a 2023 opinion that finds the suing of the insurance adjuster was improper. The opinion is styled, Hang Nguyen, et al v. AmGuard Insurance Company, et al. The opinion is from the Eastern District of Texas, Sherman Division.
Plaintiffs own a homeowners insurance policy with AmGuard. After a hail and windstorm that caused damage to their property, the Plaintiffs submitted a claim under the policy for repairs. The adjuster assigned to the case is Shawn Mitchell. Coverage was eventually denied.
The Plaintiffs eventually sued AmGuard for breach of contract and both faith causes of action and various violations of the Texas Insurance Code. They sued Mitchell for civil conspiracy and various violations of the Insurance Code. After the action was filed, AmGuard filed an Election of Legal Responsibility, accepting any liability on behalf of Mitchell.
Bad Faith insurance lawyers understand that when sending an insurance company a pre-suit demand for damages that sending an improper letter ends up like sending no letter at all under certain circumstances. One of the issues related to pre-suit notice letters was the topic in a January 2023 opinion from the Northern District of Texas, Dallas Division. The opinion is styled, J. David Koncak v. American Security Insurance Company.
Koncak suffered a hail damage claim in June 2019 and then again in October 2019. The claims resulted in a dispute and Koncak hired an attorney. The attorney sent a pre-suit demand letter as required by the Texas Insurance Code, Section 542A.003(b). The letter demanded damages in the amount of $550,000 plus $5,000 in attorney fees.
Koncak eventually filed suit. American Security filed motions contending the notice letter did not satisfy the requirements of 542A.003(b).
Many insurance claims are hard to justify a lawsuit unless the insured can make a claim for attorney fees. Most insurance claims do allow for recovery of attorney fees. The caveat is that the claim for attorney fees has to be presented properly. This includes notice prior to a lawsuit being filed.
Here is another recent (January 2023) case discussing attorney fees. The opinion is from the Northern District of Texas, Dallas Division. It is styled, Ghulam Sarwar d/b/a AR2S MGMT Inc. and AR2S MGMT Inc. v. General Star Indemnity Company.
This is a lawsuit arising out of a hail damage claim. General Star (Defendant) filed a motion to exclude Plaintiffs claim for attorney fees based on the assertion that the required pre-suit notice made via email was insufficient and untimely. Plaintiff counters that notice was sufficient, if not timely, was not timely due to concerns that the statute of limitations was running.
Bad faith insurance lawyers will always sue for recovery of attorney fee when forced to file a lawsuit. Here is a 2022, opinion dealing with attorney fees under Texas Insurance Code, Section 542A. The opinion is from the Western District of Texas, Waco Division, and is styled, Waco Hippodrome Inc. v. Central Mutual Insurance Company D/B/A Central Insurance et al.
Hippodrome filed a lawsuit against it’s insurer, Central and others alleging violation of the Texas Insurance Code and breach of contract. As part of the lawsuit, Hippodrome also sought attorney fees. Central filed a motion seeking that Hippodrome’s request for attorney fees be dismissed based on the assertion there was non compliance by Hippodrome with Section 542A.003(b)(2).
In order to prevail in its Attorney’s Fee Motion, Central has the burden to “prove that Central was entitled to but was not given a presuit notice stating the specific amount alleged to be owed by the insurer under Section 542A.003(b)(2) at least 61 days before the date the action was filed by the claimant Hippodrome.”
Attorney fees. Attorney fees. Attorney fees. It’s a big deal. Questions about attorney fees are common in cases involving insurance claims. The fairly new Texas Insurance Code, Section 542A deals with attorney fees in specific weather related events, such as hail storms. A 2022 opinion from the Northern District of Texas, Dallas Division discusses this issue. The opinion is styled, Fiberco, Inc. v. Acadia Insurance Company and Union Standard Lloyds d/b/a Union Standard Insurance Group.
The Defendants in this case filed a motion asking the Court to disallow attorney fees for Fiberco. The Court denied the motion.
A hailstorm damaged Fiberco’s property in 2020. Fiberco sued the Defendants. Counsel for Fiberco sent a demand letter in October 2020 demanding $406,678.05 to settle its claim. That letter also requested reasonable and necessary attorney’s fees but did not demand a specific amount.
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