The case discussed here is from the Houston Division, Southern District. The style of the case is Connecticut General Life Insurance Company, et al v. Elite Center For Minimally Invasive Surgery LLC, et al. This is a Motion for Clarification. Connecticut (Cigna) sued under ERISA, Section 502(a)(3) to enforce and…
The Fort Worth court of Appeals issued an opinion in May 2017, that illustrates the wrong way to pursue a claim and lawsuit for storm and hail damage. The opinion is styled, Richard Seim and Linda Seim v. Allstate Texas Lloyds and Lisa Scott. This a motion for en banc…
Either the insurance company or the insured has a right to demand an appraisal in lots of property insurance contracts. The Waco Court of Appeals issued an opinion recently that discusses these appraisal clauses. The case is styled, In Re GuideOne Mutual Insurance Company. This case is a writ of…
Lawyers handling Employee Retirement Income Security Act (ERISA) cases need to read this 5th Circuit opinion. It is styled, Ariana M. v. Humana Health Plan of Texas, Incorporated. Ariana is a dependent eligible for benefits under the Eyesys Vision Inc. group health plan administered by Humana. The plan’s benefits include…
Stephenville insurance lawyers know that Credit Life and Disability claims are denied way too often. The reason for denial is almost always the allegation that there was a misrepresentation in the policy application. This issue is discussed in a 1983, Houston Court of Appeals [1st Dist.] opinion. The opinion is…
As all insurance attorneys should know, intent to deceive is a requirement that has to be proved for an insurance company to deny a claim based on a misrepresentation. Even when faced with irrefutable evidence of a misrepresentation, intent to deceive still has to be proved. Due to the inherent…
Whether you are an attorney in a small town like Hamilton or Evant Texas or the Dallas Fort Worth metropolitan area, life insurance lawyers can tell you that the most common reason claims for life insurance benefits being denied is that there was a misrepresentation in the policy application. A…
The above question is usually not easy to answer. Aledo insurance lawyers need to read a 1976 case from the Waco Court of Appeals. The opinion is styled, Westchester Fire Insurance Co. v. English. Posing as husband and wife when in fact they were not married, a couple purchased a…
Tarrant County insurance attorneys will learn real fast that when asserting a claim against an insurance adjuster, the claim needs to be pled with specificity. This is illustrated in a recent case from the Southern District, McAllen Division. The opinion is styled, Ada Elizondo v. Great Lakes Insurance SE. et…
Stephenville homeowner lawyers need to read this opinion from the United States 5th Circuit Court of Appeals. The opinion is styled, State Farm Fire & Casualty v. Cedric Flowers. This is a appeal from a summary judgment granted in favor of State Farm in a declaratory judgement action. In 2008,…