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Insurance transactions tend to resemble one another, so disputes arising from them tend to resemble one another.  There are only so many ways that an insurance company and an insured can get crossways.  Most cases present recurring problems that can be grouped into several categories.  Insurance law is even more precedent driven than other areas, as courts try to construe similar policy language consistently.  It is not surprising that cases start to look alike.

The key is find good authorities that match your facts, or to emphasize the facts that match good authorities.

Of course, the starting point is the contract itself.  The initial inquiry almost always begins with the language of the contract to determine what is covered and what is not.  Other tort and statutory theories may logically depend on the existence of coverage, or may exist independent of coverage.  The interplay between recovery for breach of contract and recovery under other theories is discussed in numerous areas in this blog.  Beyond suit for breach of contract, most insurance cases can be grouped into these categories – misrepresentations – non-disclosures – unfair settlement practices  – and other misconduct.

Here is some very basic information that every insurance lawyer should be aware of.  It is also information that every insurance consumer should know.

To understand the different ways disputes can arise, it is helpful to consider the sequence of events that is likely to occur involving an insurance issue.  At its very simplest, the insurance transaction can be divided into the initial sale of the policy, and subsequent handling of claims.  These can be broken down further to include:

(1)  The sale of the policy:  Initially, the consumer and insurance company  or insurance company’s agent must communicate to establish a contractual relationship.  Disputes may arise over what was asked for by the applicant, what was represented by the insurance company or agent, or the timeliness of the insurance company or agent in providing coverage.  Issues may also arise about the truthfulness of the applicant or agent in disclosing information requested by the insurer;

The New York Times published a story in July 2017, about forced insurance on autos.  The title of the story is Wells Fargo Forced Unwanted Auto Insurance On Borrowers.

More than 800,000 people who took out car loans from Wells Fargo were charged for auto insurance they did not need, and some of them are still paying for it, according to an internal report prepared for the bank’s executives.

The expense of the unneeded insurance, which covered collision damage, pushed roughly 274,000 Wells Fargo customers into delinquency and resulted in almost 25,000 wrongful vehicle repossessions, according to the 60-page report, which was obtained by The New York Times.  Among the Wells Fargo customers hurt by the practice were military service members on active duty.

For people having events that can be large, such as wedding, big, family re-unions, company parties, and other types of celebrations, looking to purchase insurance for those events can be a smart thing to do.  The Claims Journal published an article about events insurance that is good to read.  The article is titled, Disastrous Fyre Festival Sheds Light On Events Insurance.

Already facing numerous lawsuits, Fyre Festival organizer Billy McFarland was arrested on federal charges last week.  The government alleged he defrauded investors who bought into Fyre Media Inc., the company behind the music festival that collapsed so spectacularly in the Bahamas a few months back.

But the fiasco’s graduation to prosecution is almost beside the point as far as the festival industry is concerned.  Events constructed to attract free-spending youth tend to include some who drink too much or take drugs and consequently do all the risky things that come with both.  Organizers already had it tough when it came to getting insurance.  Then Fyre Festival came apart, replete with tent cities, stranded teens, broken promises, and a global media spotlight covering it all.

Most insurance lawyers will want to depose an insurance company representative not long after a lawsuit is filed.  This situation arose in recent a Corpus Christi Court of Appeals case.  The opinion is styled, In Re Safeco Insurance Company Of America.  There is a glaring problem with this opinion.  It does not discuss the underlying reasons for wanting to take the deposition of the insurance company corporate representative.  There is no discussion of the merits or lack thereof in the underlying case.  What is does illustrate is the power of the courts to allow the deposition even when the insurance company does not want the deposition to be allowed.  It also discusses the elements that are looked at in reaching a determination.

By petition for writ of mandamus, Safeco seeks to vacate the trial court’s order granting a motion to compel the deposition of its corporate representative.  This Court requested and received a response to the petition from the real party in interest, Marvin Bryant.  The writ was denied.

Mandamus is an extraordinary remedy.  Mandamus relief is proper to correct a clear abuse of discretion when there is no adequate remedy by appeal.  The relator bears the burden of proving both of these requirements.

The need to get an insurance lawyer is illustrated in a recent opinion from the Southern District, Houston Division.  The opinion is styled, Trudy Sawyer v. Geico General  Insurance Company.

On December 28, 2015, Sawyer filed a complaint and an application to proceed in forma pauperis in this case, which was granted. On October 26, 2016, the court ordered the parties to submit a Joint Discovery/Case Management Plan.  Nevertheless, the parties filed independent discovery plans.  In its discovery plan, Geico stated its intention to take Sawyer’s deposition between December, 2016, and May, 2017.
Geico did make arrangements to take Plaintiff’s deposition on January 18, 2017.  Sawyer was given proper notice of the deposition, but she did not appear, and belatedly informed Defendant that she would not attend, because she was “the victim” in the action, and so she should not have to endure “such depressive measures.”  Geico then rescheduled Sawyer’s deposition for February, 2, 2017.   Again, she was properly notified of the deposition, but she again failed to appear, claiming that she could not, because she had been the “victim of robbery,” the night before.

Insurance lawyers know that in a first pary insurance claim lawsuit, a claim for attorney fees can be made.  When the insurance company challenges the attorney fees claim of the insured, a natural response by the lawyer is to seek to get the information related to what the insurance company paid their lawyers in attorney fees.

Can that be done?  The question was answered by the Texas Supreme Court in this recent 2017, opinion.  It is styled, In Re National Lloyds Insurance Company, Wardlaw Claims Service, Inc., And Ideal Adjusting, Inc. Relators.

The discovery dispute in this mandamus proceeding arises in the context of multi-district litigation involving allegations of underpaid homeowner insurance claims.  The issue is whether a party’s attorney billing information is discoverable when the party challenges an opposing party’s attorney fee request as unreasonable or unnecessary but neither uses its own attorney fees as a comparator nor seeks to recover any portion of its own fees.  This Court held that under such circumstances, (1) compelling en masse production of a party’s billing records invades the attorney work product privilege; the privilege is not waived merely because the party resisting discovery has challenged the opponent’s attorney fee request; and (3) such information is ordinarily not discoverable.

The Insurance Journal published a story on June 6, 2017, that is titled, Private Insurer Will No Longer Fund Fraud Prosecutions In Texas.

Thanks to new money and oversight from the Texas Legislature, the state can now pursue workers’ compensation fraud cases without relying on an unusual and much-criticized funding deal between a private insurance company and the Travis County district attorney’s office.

The fix comes nearly two years after The Texas Tribune and the Austin American-Statesman revealed the controversial relationship between Texas Mutual Insurance Co., the largest provider of workers’ compensation insurance in Texas, and government prosecutors in Austin.  Under the exclusive funding deal, which stretched back at least to the early 2000s, the giant insurer paid millions to fund a four-person team to investigate and prosecute alleged “crimes committed against the company.”

Hopefully Texas Hill Country insurance lawyers and their clients read this article in the Austin American Statesman, and reacted to it by calling their respective representatives.  The article is titled, Commentary: ‘Blue Tarp Bills’ Threaten Texas Property Owners.

Your property rights are under assault at the Texas Capital.  Insurance lobbyists and their allies at the self-styled “Texans for Lawsuit Reform” are pushing legislation that will mean insurance companies pay you as little as late as possible for claims.

House Bill 1774 and Senate Bill 10, better known as the “blue tarp bills,” strengthen the hand of insurance companies in property-claims disputes.  The end result is homes, businesses, schools and churches will be blanketed in blue tarps after storms when they’re cheated out of their policy benefits.

Many insurance lawyers representing claimants want to avoid Federal Court due to the procedural rules and the court’s interpretation of those rules.  These rules and their interpretation generally work in favor of the insurance companies which is why insurance companies always want a case in Federal Court and why lawyers representing insureds generally try to avoid Federal Court.

A 2017, opinion discusses some basic Federal Court rules.  The case is styled, Campmed Casualty & Indemnity Company, Inc. v. Specialists on Call, Inc., et al.  The opinion was issued by the Eastern District Court, Sherman Division.

This is an insurance coverage dispute related to whether Campmed is obligated to defend Specialists on Call (SOC) in the underlying litigation.  On December 19, 2016, Campmed filed its motion for leave to amend its complaint.  On December 28, 2016, SOC filed a response.  On January 2, 2017, Another Defendant, Dr. Leonard DaSilva filed a response that adopted and incorporated the entirety of SCO’s response.

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