Dallas Fort Worth Insurance Lawyer Blog

How Not To Handle A Hail Claim

January 4, 2015 | Mark S. Humphreys

Dallas area attorneys handling hail damage claims have a case to review as an example of how NOT to handle a claim. This is a United States Northern District Court case. It is a 2014 opinion and is styled, Stevenson v. Nationwide Property and Casualty Insurance Company.

Beatrrice Stevenson filed suit against Nationwide. Her claims include: (1) breach of contract; (2) violation of Section 542 of the Texas Insurance Code; (3) violation of the Deceptive Trade Practices Act; (4) violation of Section 541 of the Texas Insurance Code; (5) breach of duty of good faith and fair dealing; (6) fraud; and (7) conspiracy to commit fraud. She also states that Nationwide has waived and is estopped from asserting any coverage defenses, conditions, exclusions, or exceptions to coverage not contained in any reservation of rights letters to her. She seeks damages, plus prejudgment interest, attorney’s fees, additional damages, and exemplary damages. The case was removed to Federal Court.

Stevenson submitted a claim to Nationwide for damage, water damage, hail damage, windstorm damage, and mold damage to the Property as a result of the storm. She states that she asked Nationwide to cover the cost of repair to the Property pursuant to the Policy and any other available coverages under the Policy. She contends that the adjuster failed to properly adjust the claim made by her. Additionally, she contends that Nationwide has denied at least a portion of the claim without an adequate investigation. She asserts that Nationwide has failed to compensate her adequately under the terms of the Policy.

Homeowners Insurance And Foreclosure

January 3, 2015 | Mark S. Humphreys

Lawyers who deal with homeowners insurance policies might face the following situation at some point in their legal career. It is an interesting case and is from the 5th Circuit Court of Appeals. It is a 2014 opinion styled, Nationwide Mutual Insurance Company v.Baptist. here is some relevant information from the case.

The district court held that the Baptists initially purchased a valid homeowner’s insurance policy from Nationwide, but that subsequent renewals of that policy were void ab initio because they occurred after the Baptists lost ownership of their home to foreclosure.

The parties do not dispute the relevant facts. The Baptists purchased the Nationwide policy in October 2006. Just over two years later, in November 2008, they lost their home to foreclosure. They did not inform Nationwide of the foreclosure sale, however, and they continued to occupy in the home. The Bank of New York, which had purchased the home at the foreclosure sale, sought and obtained a judgment evicting the Baptists on December 9, 2011. That should have caused the Baptists to vacate the home by January 13, 2012, but it was seriously damaged by a fire or fires on December 27 and 28, 2011. It was in conducting a post-loss investigation of the Baptists’ claims arising from these fires that Nationwide first discovered that they no longer held title to the property.

Abilene Texas Hailstorm Damage – 2014

January 1, 2015 | Mark S. Humphreys

Attorneys handling Texas hailstorm claims need to keep up with events happening throughout the state related to hailstorms. Insurancenewsnet.com ran an article in June of 2014, that talks about some of the recent hailstorm events in Texas. Abilene, Texas got hit particularly hard. Here is some of the information from that article.

As reports of damage from the recent hail storms continue to pour in, people wait for insurance adjusters to estimate repair costs.

Three Abilene Independent School District elementary schools received roof damage. Repairs will cost the district at least $250,000, the amount of the district’s deductible, said Phil Ashby, communications director. This is a high deductible which essentially means the School District was self-insured up to that amount.

Abilene Hail Claims

December 30, 2014 | Mark S. Humphreys

An Abilene insurance lawyer is probably keeping up with hail storm events in Abilene. The Insurance Council of Texas released a small article in July that has some general information in it about some hail storms in Abilene.

Abilene is by many standards a small town. In a small town such as Abilene it is often times hard for a person to find an attorney who focuses in an area of law such as insurance law. There is a lot of need for attorneys handling family law cases as well as cases related to criminal matters, probate, debt collection, bankruptcy, energy, and property. But niche areas such as insurance law are not as common an issue. Plus, when there is an issue, often times the person who a claim may be involved in a claim may be a friend or good acquaintance such as a local insurance agent or a local insurance adjuster whom local attorneys have business and social contacts relationships. Often times it is best to seek the advice of an out of town attorney to help an individual or small business person to peruse a claim that is being denied for some reason or another.

Here is a little of what the article tells us.

Who does the attorney work for, the insured or the insurer?

December 28, 2014 | Mark S. Humphreys

Insurance Law Lawyers all know that in many instances an insurance company hires the attorney who represents a person or entity being sued. The issue comes up, “who does the attorney work for, the insured or the insurer?” A 1973, Texas Supreme Court case discusses this issue and is still good law. The style of the case is, Employers Casualty Company v. Tilley.

This is a declaratory judgment action.

Prior to filing the instant suit, Employers, secured a standard non-waiver agreement from Tilley and engaged an attorney to represent Tilley as his attorney in the Starky personal injury suit. For a period of nearly 18 months, the attorney not only performed such services for Tilley in defending against Starky, but he also performed services for Employers which were adverse to Tilley on the question of coverage. Tilley claimed that he had no knowledge of the Starky accident which occurred on November 25, 1967, until he was sued on September 19, 1969. This was his excuse for not notifying Employers before the suit was filed.

Consent To Settle Provision In Insurance Policy

December 27, 2014 | Mark S. Humphreys

Most Garland insurance law lawyers can tell you how important the “consent to settle” provision is in an insurance policy. This provision is addressed in a 2006, 5th Circuit Court of Appeals opinion. It is styled, Motiva Enterprises, LLC v. St. Paul and Marine Insurance Company. Here is what it says.

Motiva settled an action brought against it for damages without notice to National Union, its insurer, and without obtaining National Union’s consent. Motiva sued National Union to recover the amount Motiva paid in settlement, contending that it had no obligation to comply with the condition in the policy to obtain its insurer’s consent to settle because National Union refused to tender an unqualified defense to Motiva. This Court agreed with the district court that National Union’s tender of a defense with a reservation of rights to later deny coverage did not excuse Motiva’s breach of the consent-to-settle clause. The Court also conclude that National Union suffered prejudice as a matter of law and had no obligation to reimburse Motiva for the settlement.

A sulfuric acid storage tank exploded at Motiva’s Delaware refinery, killing one employee and injuring several others. Motiva had approximately $250 million in liability insurance which Motiva contended covered its liability for injuries and litigation costs related to the explosion. The policy contained standard “consent-to-settle” and “cooperation” clauses. The consent-to-settle clause required National Union’s advance consent to any settlements that it would be funding, and the cooperation clause required Motiva to cooperate with National Union in the investigation, settlement, and defense of claims.

Consent To Settle

December 25, 2014 | Mark S. Humphreys

North Richland Hills insurance attorneys should be aware of the “consent to settle” provision in most insurance policies. This is discussed in a 2006, United States 5th Circuit Court of Appeals opinion. The style of the case is, Motiva Enterprises, LLC v. St. Paul Fire and Marine Insurance Company. Here is what the case tells us.

In July 2001, a sulfuric acid storage tank exploded at Motiva’s Delaware refinery, killing one employee and injuring several others. A number of civil suits ensued, including a lawsuit by John and Pamela Beaver for injuries John sustained in the explosion (the “Beaver” suit).

Motiva had approximately $250 million in liability insurance which Motiva contended covered its liability for injuries and litigation costs related to the explosion. The coverage was divided into two “towers,” referred to as the Continental Tower and the St. Paul Tower, and consisted of seven insurance policies in all. National Union supplied $25 million of umbrella coverage, providing for both the duty to defend and the duty to indemnify once the underlying insurance was exhausted. The policy contained standard “consent-to-settle” and “cooperation” clauses. The consent-to-settle clause required National Union’s advance consent to any settlements that it would be funding, and the cooperation clause required Motiva to cooperate with National Union in the investigation, settlement, and defense of claims.

Exclusions Effecting Coverage In An Insurance Policy

December 23, 2014 | Mark S. Humphreys

Irving insurance lawyers should be able discuss with clients how exclusions in an insurance policy effect coverage. A 1994, Fort Worth Court of Appeals case is worth knowing about on this issue. The style of the case is, Union Pacific Resources Co. v. Aetna Casualty & Surety Co. Here is relevant information from that case.

Over a three year period Union Pacific (UP) disposed of potentially polluting waste in an industrial landfill. Even though dumping of such waste was legal and an accepted form of disposal at the time the EPA subsequently sued UP and others to recover clean up costs at the landfill site. UP entered into a partial consent degree agreeing to participate in limiting pollution hazards at the landfill. UP alleged that it had received third-party claims regarding the landfill and anticipated further claims.

Aetna denied coverage on the basis that the depositing of the waste in the landfill violated the various policies’ pollution exclusion clauses. Some of the policies contained a “sudden and accidental” exclusion which excluded liability for property damage arising out of the discharge, disbursal, release, or escape of waste materials or other irritants, contaminants, or pollutants into or upon the land, the atmosphere, or any water, course, or body of water.

Exclusions In Insurance Policy’s

December 21, 2014 | Mark S. Humphreys

Arlington insurance attorneys will tell their clients they need to be aware of exclusions in insurance policies and how they are interpreted. Just reading the declarations page is not enough. The entire policy needs to be including the exclusions. A 1998, Texarkana Court of Appeals case serves as an example. The style of the case is, Allen V. St. Paul Fire & Marine Insurance Company. Here is some of the relevant information from that case.

This suit alleged damages arising out of Tawakoni Water System’s failure to provide “potable” water, “good quality” water, water “reasonably fit for family residential use,” or water “approved and/or certified by the appropriate State of Texas and federal authorities.” The Allens also alleged that the water received was of “unpalatable quality,” “unfit for human consumption and/or use,” and that the water was contaminated.

St. Paul denied coverage and refused to provide a defense for Tawakoni. St. Paul based its denial of coverage on pollution exclusions allegedly included in the five policies upon which the Allens sued. Following a bench trial, a judgment of $17,326,174 was rendered in favor of the Allens. Tawakoni then assigned to the Allens its claim against St. Paul for wrongful refusal to defend in return for a covenant not to execute.

Hail Damage And Appraisals

December 20, 2014 | Mark S. Humphreys

Fort Worth insurance lawyers who handle hail damage claims need to be know how courts interpret appraisal clauses in insurance policies. A 2009, Texas Supreme Court case is a must read for helping to understand the appraisal process. The style of the case is, State Farm Lloyds v. Johnson. Here is some of the relevant facts and information to be taken from the case.

A hailstorm moved through Plano, Texas in April of 2003, damaging the roof of Johnson’s home. She filed a claim under her homeowners insurance policy with State Farm Lloyds. State Farm’s inspector concluded that hail had damaged only the ridgeline of her roof, and estimated repair costs at $499.50 (less than the policy’s $1,477 deductible). By contrast, Johnson’s roofing contractor concluded the entire roof needed to be replaced at a cost of more than $13,000.

To settle this difference, Johnson demanded appraisal of the ” amount of loss” under the following provision in her standard-form policy: