Articles Posted in Life Insurance

Weatherford insurance attorneys see all kinds of gimmicks by insurance companies in their attempts to not pay claims. One of these is to try and cause a beneficiary under a life insurance policy to believe they are not a proper party to make the claim. The U.S. District Court, Tyler Division issued an opinion dealing with this issue. The style of the case is, Marcia Slack v. The Prudential Insurance Company of America.

Marcia sued Prudential for violations of the Texas Insurance Code, among other things, for their refusal to pay benefits on a life insurance policy her deceased husband had purchased wherein she was the named beneficiary. The fact pattern is a little complicated but one of the challenges to her lawsuit made by Prudential was that she did not have standing to under the Texas Insurance Code.

Prudential filed for Motion for Judgment on the Pleadings and argued that Marcia does not have standing to assert a claim under the Texas Insurance Code because she is merely a third party to the Policy. Prudential also contended that “claims under the Texas Insurance Code do not survive following the insured’s death.” Prudential attempted to bolster its argument by stating that (1) Plaintiff does not assert that any of Defendant’s representations reached Plaintiff (and instead were only made to Mr. Slack), (2) Plaintiff only asserts that Mr. Slack paid the Policy premiums, (3) Plaintiff was not designated as the beneficiary until after Mr. Slack took out the Policy, and (4) Plaintiff did not allege any reliance on Defendant’s representations.

Life Insurance lawyers need to know the relevant issues regarding the Texas Deceptive Trade Practices Act (DTPA) and how they interact with life insurance policy issues. This is discussed to a certain extent in a recent U.S. District Court, Tyler Division opinion. It is styled, Marcia Slack v. The Prudential Insurance Company of America.

Tom Slack, purchased a life insurance policy from Prudential in 2001. Mr. Slack named Marcia as the beneficiary of the Policy. After Mr. Slack died on December 2, 2012, Marcia filed a claim for death benefits under the Policy, and Prudential paid Mrcia $274,391.56.

Marcia contends that after purchase of the Policy, Pruential represented to the Slacks that Ronnie William Shaffer was the “representative with whom they should and could communicate regarding the Policy, including any questions concerning payment of premiums.” Marcia contends that the Slacks used community funds to pay the annual premium payment of $10,580.00 plus an additional payment of $6,720.00 from 2001 to 2010 because Prudential represented to them that if they made the additional payment, the premium due under the Policy would vanish after ten years.

Insurance Companies doing wrong again is a constant theme with Texas insurance lawyers. Day in and day out, claims get processed properly, but too many times they are not. The Texas Tribune published an article in September 2015, that illustrates one of the times an insurance company does wrong. The title of the article is, “Workers’ Comp Insurer Fined $250,000.00.”

The article tells us that for years, Crystal Davis battled an insurance company for workers’ compensation benefits after her husband, Wayne, was killed on the job in 2012.

As a result of her struggles, the Texas Department of Insurance has slapped that insurer with what is believed to be the largest fine ever issued for workers’ compensation violations in the state — $250,000. None of the money goes to Davis — a stay-at-home Tyler mom with two children — but the state is requiring that a large chunk of it be used to help children of injured or killed workers.

Dallas life insurance lawyers keep up with court decisions related to life insurance claims. The most recent from the date of the post is from the U.S. 5th Circuit Court of Appeals. It is styled, Lila McWhirter v. AAA Life Insurance Company.

Eugene McWhirter purchased a life-insurance policy from AAA covering accidents that occurred while “exiting from any private passenger automobile . . . .” In December, McWhirter attended a party with his daughter Karen and wife Lila. After the party, Karen drove the family home and backed into the driveway. Shortly thereafter, McWhirter fell. Neither Lila nor Karen witnessed the incident. They discovered McWhirter lying in the grass near the car. McWhirter died as a result of the head injury he sustained during the fall.

Lila filed a claim with AAA seeking death benefits. In the claim forms, she described the accident as follows: “While exiting the vehicle and entering the home hit the entry step and fell backwards into the yard hitting the back of his head to the ground.” She also submitted McWhirter’s death certificate, an EMS report, an affidavit from a neighbor who observed the scene, and a drawing and photograph in which the neighbor showed that McWhirter was found lying parallel to the car on his back. AAA concluded that these documents, as well as Lila’s description of the accident and statements made by Karen in letters to the company, indicated that McWhirter fell after exiting the car. As a result, it determined that the fall was not covered under McWhirter’s policy and denied Lila’s claim.

Life insurance lawyers in Dallas already know what was published in the Washington Post. It is an article about the death of a loved one being the beginning of a hard fight with the life insurance company.

The article tells us of an experience by a Jane Pierce. Jane spent nine years struggling beside her husband, Todd, as he fought cancer in his sinus cavity. The treatments were working. Then in July 2009, Todd died in a fiery car crash at the age of 46. Todd’s death ended a fight with cancer but began a long fight with Todd’s insurance company, MetLife, for life insurance benefits.

A state medical examiner and a sheriff investigating the case concluded that Todd’s death was an accident. The accident was caused when Todd lost control of his silver GMC pickup after passing a car on a two-lane road. Sounds simple enough, right!?