Insurance Recovery Solutions

Solutions – that is what someone in Grand Prairie, Arlington, Fort Worth, Bedford, Hurst, Euless, North Richland Hills, Keller, Colleyville, Grapevine, and other Tarrant County cities want when they are having problems with their insurance company.
One thing that can be recovered in an insurance claim situation is “actual damages.” Actual damages are the real damages someone suffers. Actual damages are also called compensatory damages. Compensation paid for harm, loss or injury suffered by an aggrieved party due to an act or a failure to act by another party/parties. Actual damages can be measured. For example, ‘A’ suffers a loss of income and or wages due to injuries that resulted in A’s unemployment. They also include medical expenses and specific losses due to breach of contract, like in insurance cases where a house burns down or a car suffers hail damage. It is usually amounts that can be easily proven. Examples that are not so easy to prove are, pain and suffering, impairment, disfigurement, mental anguish, loss of comfort.
The Texas Supreme Court, in 1997, set out the following principles that govern recovery of “actual damages” under the similar language that existed under the Texas Deceptive Trade Practices Act – that is that the same analysis should apply to the Texas Insurance Code, Section 541.152(a)(1). The relevant case was, Arthur Andersen & Company v. Perry Equipment Corporation.
Here is the language the court used:
The amount of actual damages recoverable is “the total loss sustained as a result of the deceptive trade practice.”
Actual damages are those damages recoverable under common law. At common law, actual damages are either “direct” or “consequential.” Direct damages are the necessary and usual result of the defendant’s wrongful act; they flow naturally and necessarily from the wrong. Direct damages compensate the plaintiff for the loss that is conclusively presumed to have been foreseen by the defendant from his wrongful act.
Consequential damages, on the other hand, result naturally, but not necessarily, from the defendant’s wrongful acts. Under the common law, consequential damages need not be the usual result of the wrong, but must be foreseeable, and must be directly traceable to the wrongful act and result from it. Of course, foreseeability is not an element of producing cause under the DTPA. Still, if damages are too remote, too uncertain, or purely conjectural, they cannot be recovered.
Under Texas common law, direct damages for misrepresentation are measured in two ways. Out-of-pocket damages measure the difference between the value the buyer has paid and the value of what he has received; benefit-of-the-bargain damages measure the difference between the value as represented and the value received. Under the DTPA, a plaintiff may recover under the damage theory that provides the greater recovery. Both measures of damages are determined at the time of sale.
Here is an example of an “actual damage” you may not normally consider. The Texas Court of Appeals, Houston 14th District, in 1989, in the case styled, Paramount National Life Insurance Company v. Williams, allowed an insured to recover actual damages for loss of credit or injury to credit reputation based on receiving notice letters from bill collectors arising from medical expenses the insurer misrepresented would be paid.
There are other damages that can be recovered besides “actual damages” when you are dealing with violations of the Texas Insurance Code and the Texas Deceptive Trade Practices Act. What this means is that an experienced Insurance Law Attorney needs to be consulted to make sure that all allowable theories of recovery are considered.