Here is a life insurance claim denial that is interesting factually and legally, and a must read for lawyers handling life insurance claims.  This is a case handled by the Law Office of Mark S. Humphreys.

The opinion is a December 10, 2021, summary judgment ruling from the Northern District of Texas, Dallas Division.  It is styled, Pham v. TransAmerica Premier Life Insurance Company.  Johnny Pham sues in his own right and Kim Van Bui sues on behalf of minor children SKB and BDB.

This case will be presented in multiple blogs.

Here is a life insurance claim denial that is interesting factually and legally, and a must read for lawyers handling life insurance claims.  This is a case handled by the Law Office of Mark S. Humphreys.

The opinion is a December 10, 2021, summary judgment ruling from the Northern District of Texas, Dallas Division.  It is styled, Pham v. TransAmerica Premier Life Insurance Company.  Johnny Pham sues in his own right and Kim Van Bui sues on behalf of minor children SKB and BDB.

This case will be presented in multiple blogs.

Here is a life insurance claim denial that is interesting factually and legally, and a must read for attorneys handling life insurance claims.  This is a case handled by the Law Office of Mark S. Humphreys.

This is a December 10, 2021, opinion from the Northern District of Texas, Dallas Division.  It is styled, Pham v. TransAmerica Premier Life Insurance Company.  Johnny Pham sues in his own right and Kim Van Bui sues on behalf of minor children SKB and BDB.

This case will be presented in multiple blogs.

The Employee Retirement Income Security Act of 1974 (ERISA) applies to a lot of employer benefit plans.  Each of these cases need to be examined by looking at the wording of the plan and the facts of the case.

A 2021 opinion from the Northern District of Texas, Dallas Division, is a good opinion to look at when there is a cause of action for Promissory Estoppel.  The style of the case is, Medarc, LLC vs. Meritain Health, Inc.

Promissory Estoppel is the legal principle that a promise is enforceable by law, even if made without formal consideration when a promisor has made a promise to a promisee who then relies on that promise to his subsequent detriment.

ERISA stands for Employee Retirement Income Security Act of 1974.  The way ERISA cases are handled is unique from a legal perspective.  This is illustrated in a 2021, opinion from the Eastern District of Texas, Sherman Division.  The opinion is styled, Carol Sue Allen, Et Al. v. Sherman Operating Company, LLC.

This is an appeal from a Magistrate’s summary judgment ruling in favor of Sherman.

Allen was injured at work.  She made a claim for disability benefits under a plan provided by her employer, which is an ERISA plan.  Her claim for benefits was denied by the plan administrator.  She filed suit alleging various causes of action.  The cause of action discussed here has to do with her assertion there were violations of the ERISA plan.  She claims the plan administrator abused its discretion when her clam for benefits.

Life Insurance lawyers have to know this case.  It is an opinion that has been discussed here recently.  The opinion was issued on November 10, 2021, by the United States Fifth Circuit and is styled, Mirna Guzman v. Allstate Assurance Company.

Saul Guzman died after suffering a seizure at age 28.  Mirna, his wife and beneficiary file to collect on a life insurance policy issued by Allstate.  Allstate denied the claim.  A lawsuit was filed and the local district court granted summary judgment in favor of Allstate.  This Court reverses that decision.

When applying for the insurance policy, Saul disclosed his history of seizures but denied using tobacco or nicotine products.

Lawyers handling insurance claims that have been denied frequently have a conversations with clients about “bad faith” insurance.  Bad faith, generally speaking, often times centers around whether or not an insurance company has committed a fraud.

If allegations of fraud are going to be alleged, insurance lawyers need to understand that those claims that end up in a Federal Court are subjected to a higher pleading standard than those claims that are litigated in State or County Courts.  This is illustrated in a 2021, opinion from the Southern District of Texas, Galveston Division.  The opinion is styled, Smiley Team II, Inc. v. General Star Insurance Company.

Smiley made a claim against General Star after a vehicle was alleged to have crashed into Smiley’s building.  A lawsuit was eventually filed containing allegations that General Star failed to properly adjust the claim which resulted in an alleged underpayment of the claim.

Life insurance claims denial attorneys will rarely see this situation, but it is worth knowing about.  This is a 1987, Texas Supreme Court opinion styled, Davidson v. Great National Life Insurance Company.

Davidson is the beneficiary of life insurance policy insuring Dauod Alquassab.  Davidson filed suit after Great National denied the claim for benefits.  The trial trial found in favor of Davidson.  An appeal resulted in the verdict being reversed.  This Texas Supreme Court reversed the appeals court and remanded the case for further consideration.

In May 1980, a man identifying himself as Dauod Alquassab applied for an insurance policy on his life from Great National.  Although unknown to Great National at the time of the application, Alquassab had previously used the names of David Kassab and David Kay; he was convicted of felony fraud charges under each previous name.  Alquassab named Ilan Eiger, his partner in a real estate business, as the beneficiary when Great National issued the policy in June 1980.  In September 1980, Alquassab changed the beneficiary designation from Eiger to Phyllis Davidson, his former wife from whom he was divorced in 1968.  Alquassab then traveled to Tel Aviv, Israel, in February 1981.  Prior to his departure, the record indicates that Alquassab allegedly defrauded First City Bank in Houston, of approximately $1.5 million dollars, and committed additional acts of fraud upon other banking institutions.

Insurance lawyers need to understand every way possible for maintaining their case in State Court whenever possible.  It is not possible too often, so when it is possible it needs to be done.

This 2021, opinion from the Northern District of Texas, Dallas Division, shows how one case was allowed to be in State Court.  The opinion is styled, Richard Conrad and Brenda Conrad v. Cincinnati Insurance Company and John W. Schuster.

This is a property insurance coverage dispute.  The Conrads sued Cincinnati and Schuster, an employee of Cincinnati who adjusted the claim, for various violations of the Texas Insurance Code and breach of contract after the Defendants concluded there was minimal damage to the property.  Suit was filed in State Court and the Defendants had the case removed to Federal Court based on diversity jurisdiction and the assertion that Schuster was improperly joined in the lawsuit.  The Conrads filed a Motion to Remand the case back to the State Court.

Here is an opinion from the United States Fifth Circuit that deals with life insurance.  The opinion is styled, Mirna Guzman v. Allstate Assurance Company.

This is an appeal from the District Court wherein the District Court granted summary judgment in favor of Allstate.  This is a review of how the Court reviews the granting of a summary judgment.

Here is some basic background in the case:

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