This writing gives some insight into how an attorney knows whether not an insurance company can be held responsible for the acts of it’s agents.

Insurance companies, like other entities that exist, can only act through agents. Insurance companies rely on agents to sell their policies, to underwrite potential insureds, and to investigate and adjust claims. The agents will not only sell the policy, but also explain the policy and hopefully, give the customer what they are looking for in a policy.

Insurance companies may be vicariously liable for another’s misconduct if that other person is the insurance company’s agent and if that agent acted within the scope of his or her authority. This has been stated repeatedly in case law by the Texas Supreme Court as well as the Houston Court of Appeals and other Courts throughout the state of Texas.

A 1994, Texas Supreme Court case styled, Celtic Life Insurance Company v. Coats, shows us how the courts look to find the agency relationship between the acts of an agent and an insurance company.

This case presents issues relating to an insurance company’s liability for its agent’s representations: first, whether the company’s liability depends on its authorization of misrepresentations; second, whether reliance on the representations is an element of recovery.

Kenneth Harrell, a duly-appointed agent for Celtic visited Aloha Pools and met with its owner, John Coats, to discuss health insurance for Aloha’s employees and their families. Coats stated that he wanted a policy providing benefits for psychiatric care that would be equal to or better than the $20,000 coverage provided by his current policy. Coats explained that he needed such coverage because his oldest son had previously required psychiatric care, and he was concerned that his younger son might require similar care. Harrell responded that he understood Coats’ needs fully, having experienced similar financial difficulties in providing psychiatric care for his own son.

Dallas insurance lawyers and those in Mesquite, Garland, Richardson, De Soto, Cedar Hill, and other areas need to know when an insurance agent or adjuster can be held responsible for the wrongs they commit.

Just as an insurance company is liable for its own misconduct, so too agents may be personally liable for their misdeeds, even when acting on the company’s behalf. In general, an agent is individually liable for his or her own tort or statutory violation.

Ordinarily, an agent is not liable for breach of contract based on the insurance policy, because the contract of insurance is not between the insured and the agent.

Dallas insurance attorneys and those in Duncanville, Carrollton, Farmers Branch, Garland, and other places in Dallas County need to know the laws regarding the liability of an insurance company.

The law in Texas is very clear, as the contracting party, the insurance company may be liable based on the contract with their insurance customer.

An insurance company may also be statutorily liable. For example, Texas Insurance Code, Section 541.151, tells us;

Fort Worth insurance lawyers and those in Benbrook, Crowley, Burleson, and other parts of Tarrant County need to know the ways insurance companies fight.

The Austin Court of Appeals issued an opinion in December 2012, that illustrates some of this. The case is styled, In re Old American County Mutual Fire Insurance Company.

Old American filed a petition for writ of mandamus complaining of the trial court’s order denying their plea in abatement. This Court denied the writ of mandamus.

Grand Prairie insurance attorneys need to understand the purpose and rules of insurance regulation.

As stated by the Texas Supreme Court in 1951, the insurance business affects the public interest and thus is subject to extensive regulation to prevent abuses. The rationale for this principle bears quoting at length. In an early case, the United States Supreme Court stated:

A contract for fire insurance is one for indemnity against loss, and is personal. The admission, however, does not take us far in the solution of the question presented. Its personal character certainly does not of itself preclude regulation, for there are many examples of government regulation in personal contracts, and in the statutes of every state in the Union superintendence and control over the business of insurance are exercised, varying in details and extent. We need not particularize in detail. We need only say that there was quite early state provision for what is known as the unearned premium fund or reserve; then came the limitation of dividends, the publishing of accounts, valued policies, standards of policies, prescribing investment, requiring deposits in money or bonds, confining the business to corporations, preventing discrimination in rates, limitations of risks, and other regulations equally restrictive. In other words, the state has stepped in and imposed conditions upon the companies, restraining the absolute liberty which businesses strictly private are permitted to exercise. Those regulations exhibit it to be the conception of the lawmaking bodies of the country without exception that the business of insurance so far affects the public welfare as to invoke and require governmental regulation. A conception so general cannot be without cause. The universal sense of a people cannot be accidental; its persistence saves it from the charge of unconsidered impulse, and its estimate of insurance certainly has substantial impulse, and its estimate of insurance certainly has substantial basis. Accidental fires are inevitable, and the extent of loss very great. The effect of insurance – indeed, it has been said to be its fundamental object – is to distribute the loss over as wide an area as possible. In other words, the loss is spread over the country, the disaster to an individual is shared by many, the disaster to a community shared by other communities; great catastrophes are thereby lessened, and, it may be, repaired. In assimilation of insurance to a tax, the companies have been said to be mere machinery by which the inevitable losses by fire are distributed so as to fall as lightly as possible on the public at large, the body of the insured, not the companies, paying the tax. Their efficiency, therefore, and solvency, are of great concern. The other objects, direct and indirect, of insurance, we need not mention. Indeed, it may be enough to say, without stating other effects of insurance, that a large part of the countries wealth, subject to uncertainty of loss through fire, is protected by insurance. This demonstrates the interest of the public in it, and we need not dispute with the economists that this is the result of the “substitution of certain for uncertain loss,’ or the diffusion of positive loss over a large group of persons, as we have already said to be considered a matter of public concern to regulate it, and, governmental insurance has its advocates and even examples. Contracts of insurance, therefore, have greater public consequence than contracts between individuals to do or not to do a particular thing whose effect stops with the individuals. We may say in passing that when the effect goes beyond that, there are many examples of regulation.

Fort Worth insurance lawyers and those in North Richland Hills, Roanoke, Keller, Saginaw, and other places in the Tarrant County area need to keep up with opinions issued by the courts in Texas.

The United States District Court, Southern District, Houston Division, issued an opinion December 12, 2012, that is worth reading. This is an appeal from a summary judgment.

American General is in the business of issuing policies of life insurance. David Mickelson entered into an Agent Contract with American General to solicit applications for insurance plans. Mickelson’s Agent Contract requires agents to “repay to American General, on demand, any unearned commissions or service fees received by agents for, or with respect to, premiums or payments returned to policy or contract owners by American General for any reason.”

Fort Worth insurance lawyers and those in Arlington, Hurst, Euless, Bedford, and other places in Tarrant County need to know about this.

ABC News ran a story on January 7th that makes you angry. Here is what the story tells us:

A Staten Island couple said their insurance company short-changed them after superstorm Sandy destroyed their home, and then used their house in a commercial.

Mineral Wells attorneys and those in Graford, Weatherford, Cool, Millsap, Garner, and other places in Parker and Palo Pinto Counties need to understand how insurance policies work and are interpreted.

There is a Texas Supreme Court opinion issued in 1999, that is worth reading. The case is styled Urrutia v. Decker.

This case required the Court to determine the validity of liability insurance a truck leasing company provided to its customer as part of a rental transaction. Based on representations that $20,000 was all the insurance available, the claimant settled his bodily injury claim for that amount. When he later discovered the nature of the leasing company’s insurance arrangement, he sued the leasing company and its customer, seeking to set aside the previous settlement. The claimant urged that the settlement was obtained by fraud or resulted from the parties’ mutual mistake about the insurance available to pay his claims.

Grand Prairie insurance lawyers and those in Garland, Mesquite, Richardson and other places in Dallas County need to know the insurance laws in Texas. But they also need to know what is going on in other states.

The Detroit Free Press published an article on January 2, 2013, that an insurance attorney should find interesting. The article tells us that a judge has ruled that the Michigan Catastrophic Claims Association is subject to the Freedom of Information Act and must disclose how it calculates the annual fee assessed to each Michigan vehicle under the state’s no-fault auto insurance system.

Ingham County Circuit Judge Clinton Canady III issued the ruling late last week in a lawsuit brought by the Coalition Protecting Auto No-Fault and the Brain Injury Association of Michigan.

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