Interpreting An Insurance Policy

Insurance Policy Interpretation

January 8, 2012 | Mark S. Humphreys

Customers in Grand Prairie, Arlington, Mansfield, Fort Worth, Hurst, Euless, Bedford, Saginaw, Haslet, Rhome, and other places in Texas would have a hard time trying to read and interpret an insurance policy. This is when the advice of an experienced Insurance Law Attorney is most helpful.

The United States District Court, Southern District of Texas, Houston Division, issued an opinion on October 5, 2011. This opinion deals with policy interpretation. The case arises from a declaratory judgement lawsuit filed by the insurance company, RLI Insurance Company, and the partial motion for summary judgment filed by the insured, Willbros Construction (U.S.) LLC, et al.

The court ruled in favor of the insureds. Her is some factual background.

Attorney And Disability Policy And Renunciation

December 29, 2011 | Mark S. Humphreys

A lot of people in Grand Prairie, Arlington, Irving, Fort worth, Dallas, and other areas in Texas will have a disability policy. Sometimes these policies are from work and other times a person will purchase one for themselves. But what happens if the insurance company refuses to pay benefits under one of these policies when a person becomes eligible for benefits.

What happened in one case is discussed by the Houston Court of Appeals, in a 1976 case styled, Republic Bankers Life Insurance Company v. B.L. Jaeger.

This lawsuit concerned a disability insurance contract. B.L. Jaeger sued Republic Bankers Life Insurance Company to recover accrued and unaccrued disability benefits for an accidental injury.

Uninsured Motorists And Consent To Settle

December 22, 2011 | Mark S. Humphreys

Most insureds in Grand Prairie, Fort Worth, Dallas, Mansfield, Arlington, and other areas in the Dallas – Fort Worth metroplex have no idea how the uninsured motorist protection coverage on their automobile policies works. All they know is that their insurance agent told them that they should have it in case they have a wreck with someone who does not have insurance.

The Texas Insurance Code, Section 1952.101 requires that all automobile policies issued in the State of Texas contain uninsured motorist UM protection unless the UM protection is rejected in writing. Section 1952.108, allows for the insurance carrier to pursue the uninsured driver for any amounts paid out by the insurance company. As a result of Section 1952.108, allowing the insurance company to pursue the uninsured driver, almost all insurance policies require that their insured obtain written permission from their insurance company before reaching a settlement with the uninsured driver. Most people do not realize this. As a result, what happens if permission to settle is not obtained before settlement with the uninsured driver?

The answer to the above question is partially answered in the 1977, Texas Supreme Court case, Robert William Ford, Jr., et al. v State Farm Mutual Automobile Insurance Company. The principle question in this case was whether State Farm’s unconditional denial of liability constituted a waiver of its right to consent before its insured subsequently settled with another insurance carrier.

Making an Underinsured Motorist Claim

December 20, 2011 | Mark S. Humphreys

People in Grand Prairie, Fort Worth, Arlington, Irving, Dallas, and other places in Texas, who have underinsured motorist (UIM) coverage will hope they never have to use that coverage. But what if they do have to use it? What are the rules?

One rule focused on here, is that in order to make the UIM claim, the claimant must first get written permission from their UIM insurance carrier to settle the case with the underinsured driver who caused injuries. If there is a settlement with the underinsured driver without getting written permission from the UIM carrier, the UIM carrier can refuse benefits. Here is a case where this played out.

The case is a Texas Supreme Court case decided in 1994. The style of the case is Ruben and Anita Hernandez v. Gulf Group Lloyd’s.

Permission To Settle Claim

December 18, 2011 | Mark S. Humphreys

People in Grand Prairie, Arlington, Mansfield, Fort Worth, Dallas, or anywhere else in Texas will often times try to settle a claim they have without the assistance of an experienced Insurance Law Attorney. The problem with doing this is that there are multiple ways a person can be making a big mistake. Here is just one of them.

The Dallas Court of Appeals, decided a case in 1992, styled, “Rochelle Traylor v. Cascade Insurance Company, Formerly Known as Bonneville Texas Insurance Company, Successor in Interest to Victoria Lloyds Insurance Company.”

Here is some factual background:

Appraisal And Insurance

December 11, 2011 | Mark S. Humphreys

Appraisal – People in Grand Prairie, Arlington, Fort Worth, Dallas, Keller, Coppell, Farmers Branch, Hurst, Euless, Bedford, and other places in the DFW area are probably not familiar with the way appraisal works in an insurance policy.

The Texas Supreme Court issued an opinion in 2009 that deals with appraisals. The style of the case is State Farm Lloyds v. Becky Ann Johnson. Here is some background.

A hailstorm moved through Plano, Texas in 2003, damaging the roof of Becky Ann Johnson’s home. She filed a claim under her homeowners insurance policy with State Farm. The inspector concluded that hail had damaged only the ridgeline of her roof, and estimated repair costs at $499.50, which was less than her deductible. Johnson’s roofing contractor concluded the entire roof needed to be repaired at a cost of more than $13,000.

Temporary Substitute In Insurance Policy

November 1, 2011 | Mark S. Humphreys

If someone in Grand Prairie, Fort Worth, Saginaw, Roanoke, North Richland Hills, Lake Worth, Colleyville, or anywhere else in Tarrant County uses someone else’s car when their own car is unavailable, does the insurance on that other car protect them?

This issue was discussed in a 2003, Texas Supreme Court case styled, Progressive County Mutual Insurance Company v. Paul Sink. The case concerned coverage for a “temporary substitute” vehicle under the standard Texas Personal Auto Policy.

The issue was whether the policy provided liability coverage when the insured, whose own vehicle was disabled, takes and drives an automobile owned by someone who is not a family member without permission or the reasonable belief that he has permission and is involved in an auto accident with a third party. The trial court ruled as a matter of law that there was no coverage. The appeals court reversed the trial court. This Supreme Court reversed the appeals courts. Here is some background.

Insurance And Which Car Is Insured?

October 30, 2011 | Mark S. Humphreys

Here is a situation for someone in Grand Prairie, Arlington, Fort Worth, Dallas, Irving, or anywhere else in the DFW area to think about. If a car has insurance and it gets sold, is the insurance on the car still valid?

This case was decided by the Houston Court of Appeals, First District, in 1986. The style of the case is Douglas W. Black v. BLC Insurance Company.

Black was appealing from a summary judgment that BLC had no duty to defend against his claim because BLC had no liability to him under its insurance policy.

Insurance Claim Denial

October 29, 2011 | Mark S. Humphreys

Insureds in Weatherford, Mineral Wells, Aledo, Azle, Hudson Oaks, Willow Park, Brock, Millsap, Cool, Springtown, and other places in Parker County and Texas do not always understand what is covered by their policy and what is not. Here is a case that helps understand a little bit about coverage as it relates to auto policies.

In 2003, the Houston Court of Appeals, 14th Dist. issued an opinion in the case, Alejandro Armendariz and Alma Armendairz v. Progressive County Mutual Insurance Company. This case is an appeal from a Declaratory Judgment lawsuit where in Progressive won after filing a motion for Summary Judgment. Here is some background.

The Progressive automobile insurance policy in the case covered two cars, one owed by Alejandro and the other owned by his sister, Alma. Alejandro was the named insured on the policy. Additionally, Alejandro’s parents, who lived with him, and Alma were named as “listed drivers” on the policy. When Alejandro first purchased insurance from Progressive, the policy covered his parents’ van. However, Alejandro deleted the van from the policy because his parents wanted to sell it. Four months later, while driving her parents’ then uninsured van, Alma, by accident, backed over and killed her father. Alma’s mother then sued Alma for the father’s wrongful death.

Who Is Insured Under The Policy

October 27, 2011 | Mark S. Humphreys

Policy purchasers in Grand Prairie, Arlington, Irving, Fort Worth, Crowley, Hurst, Euless, Bedford, Mansfield, Dallas, and other places in Texas would like to think they know who is covered under a policy they purchase. What is surprising is the difference between what the policy purchaser thinks and what the insurance company thinks.

A 1972, Texas Supreme Court case styled, Robert Snyder, et al. v. Allstate Insurance Company, is an interesting case. Here is a little bit about it.

The controversy is between Allstate, which issued an auto policy to J.B. Rhodes about whether or not they should pay damages arising out of a claim in the possession of and used by Darla Rhodes (minor daughter of J.B.) while being driven by Robert Snyder with Darla Rhodes as a passenger.