Interpreting An Insurance Policy

Life Insurance Exclusions For Pilots

December 21, 2010 | Mark S. Humphreys

Does anybody in Dallas, Fort Worth, Grand Prairie, Arlington, Irving, Mesquite, Garland, Cedar Hill, Duncanville, De Soto, Lancaster, or anywhere in Texas have a pilot’s license? The answer is yes. So the next question is, “Are they covered in their life insurance policy if they die in an airplane crash?” The answer to that is, “It depends.”

All insurance policies are going to have “exclusions”. These exclusions will limit the responsibility of the life insurance company to pay death benefits when these exclusions may apply.

This issue came up in the case, American Home Assurance Company v. Loretta Anne Brandt. This is an older case which was decided in 1989 by the Texarkana Court of Appeals. The exclusion in this case excluded coverage by the following provision: “LIMITED AIR TRAVEL COVERAGE: Insurance provided under the policy includes riding as a passenger, but not as a pilot or crew member in, including boarding or alighting from, or being struck by, any aircraft.”

Disability Insurance Claim

December 14, 2010 | Mark S. Humphreys

Anyone in Dallas, Fort Worth, Grand Prairie, Arlington, Mansfield, De Soto, Richardson, Garland, Mesquite, Burleson, or anywhere else in Texas, who purchases a disability insurance policy may be interested in the reasoning and interpretation of the following case.

On November 29, 2010, the United States Court of Appeals for the Fifth Circuit issued an opinion in the case styled, Bruce Leipzig, M.D. v Principle Life Insurance Company.

From a legal standpoint this case was won by Principle Life Insurance Company (Principle) at the trial court and then was appealed by Dr. Leipzig. He lost on appeal.

Criminal Acts And Automobile First Party Insurance

December 9, 2010 | Mark S. Humphreys

Victims of crime in Dallas, Fort Worth, Arlington, Grand Prairie, Mansfield, Bedford, Hurst, Euless, Burleson, Granbury, or other places in Texas might wonder, What happens if I get injured when I am the victim of a crime? The answer is a lawerly answer: It depends.

The Pittsburg Tribune-Review published an article on December 1, 2010, that gave some insight into a possible answer to the above question. The article was authored by Rich Cholodofsky and is titled, “Firm Denies Benefits To Mt. Pleasant Township Family of Slain Samaritan.”

According to the article, an Erie insurance company asked a Westmoreland County judge for permission to withhold benefits to the family of a Good Samaritan who was shot to death as she tried to assist the wife and daughter of her alleged killer.

Interpreting A Commercial Policy

December 4, 2010 | Mark S. Humphreys

Business people in Dallas, Fort Worth, Arlington, Grand Prairie, Mansfield, Keller, Coppell, Irving, Mesquite, Garland, Richardson, or anywhere else in the State of Texas might want to read the case below. It illustrates why it is important to know what your commercial insurance policy covers and how to interpret it.

The United States Court of Appeals for the Fifth Circuit issued a decision on November 24, 2010, in a case styled, Atlantic Casualty Insurance Company v. Horatio Gonzalez. This is appeal from a district court where the district court had ruled in favor of the insurance company. This appeals court upheld the ruling of the district court.

In this case Atlantic Casualty Insurance Company (Atlantic) insured PV Roofing Corp. (PV). PV was sued by Gonzalez when Gonzalez was injured at a site where PV was performing roofing work.

Delay In Paying Life Insurance Claim In Texas

November 18, 2010 | Mark S. Humphreys

If someone in Dallas, Fort Worth, Grand Prairie, Arlington, Carrollton, Garland, Mesquite, Grapevine, Duncanville, Burleson, or anywhere else in Texas, has a life insurance policy, how long does the life insurance company have before it has to pay the benefits to the beneficiary? The answer is, it depends. But the Texas Prompt Payment of Claims Act still applies.

There is a Waco Court of Appeals case decided in August of 2005, that explains how the Prompt Payment of Claims Act can apply in a life insurance situation. The style of the case is, State Farm Life Insurance Company and Lisa Martinez Paul v. Toni Wasson.

This is a case where the insurance company, State Farm Life Insurance Company, confused itself about who it was suppose to pay policy proceeds to. It is not that unusual for an insurance company to have some doubt about who the rightful beneficiary is under a policy of life insurance. When there is confusion the life insurance company will usually file an “interpleader action” in a local court and then let the court decide who should receive the proceeds of the life insurance policy.

Insurance Policy Appraisal Clause

November 14, 2010 | Mark S. Humphreys

If you have an insurance policy in Dallas, Fort Worth, Grand Prairie, Arlington, Mansfield, or anywhere else in Texas, you should look at it closely. It probably has an “appraisal clause” in it.

The United States Western District of Texas, Austin Division, decided a case on October 27, 2010. The style of the case is Orleans Harbor Homeowners Association, Inc. v. Public Service Mutual Insurance Company. The main issue in the case dealt with the appraisal clause in the insurance policy between Orleans Harbor Homeowners Association, Inc. (Orleans) and Public Service Mutual Insurance Company (Public).

Here is some background:

Interpreting A Policy Exclusion

November 11, 2010 | Mark S. Humphreys

A business man in Dallas, Fort Worth, Grand Praire, Arlington, Mansfield, Duncanville, Mesquite, Garland, or anywhere else is Texas, will usually have a hard time understanding exclusions in their commercial insurance policies. Here is a case where policy interpretation and exclusions were the issue.

On October 8, 2020, the United States District Court, S. D. Texas, Houston Division, issued an opinion in the case styled, Associated Marine & Industrial Staffing, Inc. v. Liberty Surplus Insurance Corporation. In the case the court ruled in favor of the insurance company.

Here are some facts:

Exclusion In Liability Policy

November 11, 2010 | Mark S. Humphreys

Someone in Dallas, Fort Worth, Grand Prairie, Keller, Colleyville, Roanoke, Springtown, Azle, Weatherford, or anywhere else in Texas who has a commercial liability policy would assume they have coverge if someone gets hurt. Well, depending on the policy and the exclusions contained in the policy, there may not be any coverage.

On October 5, 2010, the United States District Court, Northern District of Texas, Dallas Division, decided a case styled, Essex Insurance Company v. Michael Clark, d/b/a Ace Construction Company and Augustin Delrazo.

Here is some background: Essex Insurance Company (Essex) had issued a policy of insurance to Michael Clark (Clark), d/b/a Ace Construction Company (ACC). While the policy of insurance was in force, Delrazo cut his left hand on a table saw while doing work for ACC. Delrazo’s lawsuit alleged atleast eleven things ACC did to cause or contribute to his injuries.

Interpreting Homeowners Policy

November 9, 2010 | Mark S. Humphreys

Homeowners in Grand Prairie, Dallas, Fort Worth, Arlington, Mansfield, Irving, De Soto, Duncanville, Carrollton, Coppell, and other cities throughout Texas, probably have very little understanding about their homeowners insurance policy except that it is suppose to help them rebuild their house if it burns down. In addition to that, it is also suppose to provide coverage for you as a homeowner if someone is injured on your property and then sues you for their injuries.

The United States District Court for the Western District of Texas, Austin Division, issued an opinion on September 7, 2010. The style of the case is, Liberty Mutual Fire Insurance Company v. John Trovato and O’Delle Annette Hall. This case deals with the duty of an insurance company to protect its insured under a homeowners policy when they are sued and the interpretation of the insurance contract in that regard.

Here are some facts. On August 2, 2007, Hall came from a home she owned to help Trovato clean boxes out of Trovato’s attic. While moving boxes from the attic, Hall fell through the ceiling. The fall resulted in serious injuries to Hall. Hall sued Trovato. Trovato asked Liberty Mutual Fire Insurance Company to protect him in the lawsuit filed by Trovato. Liberty refused and this lawsuit resulted when Liberty filed this declaratory judgment action to have the court determine whether or not Liberty had any duties under the homeowners policy.

Insurance Policy And Appraisals

November 7, 2010 | Mark S. Humphreys

If you live in Grand Prairie, Arlington, Irving, Dallas, Fort Worth, Burleson, Keller, or anywhere else in the state of Texas and you have a homeowners insurance policy the policy is likely to contain an “appraisal” provision. So what does that mean?

The Texas Court of Appeals, Houston 14th District, issued an opinion on a case

September, 23, 2010, wherein the main issue dealt with an appraisal clause in an insurance policy. The policy at issue was a commercial policy but is essentially the same as those found in homeowners policies. The style of the case is, In re Continental Casualty Company.