Let’s list some of the conduct that is actionable against an insurance company.
The Texas Insurance Code, Chapter 541, defines and prohibits unfair and deceptive insurance practices. The Sections include Sections 541.001 to 541.061, 541.151 to 541.162, and 541.453. Prior to April 1, 2005, the statute appeared as Article 21.21, so most authorities cite that version of the statute.
Section 541.151 allows a private cause of action by any person who has sustained actual damages caused by another’s engaging in any act or practice that is defined as an unfair method of compensation or unfair or deceptive practice in the business of insurance, or defined as an unlawful deceptive trade practice. The definitions of unfair and deceptive practices are found in two places. Those two places are the Texas Insurance Code, Sections 541.051 to 541.061 and the Texas Business & Commerce Code, Section 17.46(b).
The Texas Insurance Code specifically prohibits:
- misrepresentation and false advertising of policy contracts;
- false information and advertising generally;
- defamation of insurers and persons engaged in the business of insurance;
- boycott, coercion, and intimidation in the business of insurance;
- false financial statements;
- stock operations and board contracts;
- unfair discrimination;
- deceptive names, words, symbols, devises, and slogans;
- unfair settlement practices; and
- misrepresentation of insurance policies.
The most commonly used provisions are relating to unfair settlement practices and misrepresentations of insurance policies.
If you have a claim denied, and any of the above seem to have occurred, an Experienced Insurance Law Attorney should be contacted.