Hail damages claims can be tough and this 2023 opinion doesn’t help.  The opinion is from the Northern District of Texas, Amarillo Division.  It is styled, Phouthasith Amphay v. Allstate Vehicle and Property Insurance Company.

Plaintiff alleges hail damage to his dwelling and made a claim against his insurer, Allstate.  Allstate filed a motion for partial summary judgement because “Plaintiff’s alleged damage to the metal roofs is cosmetic damage and not covered by the express terms of his Homeowner’s Policy.

Summary Judgment is proper if the movant shows there is no genuine dispute of material fact.  A fact is “material” if resolving it one way or another would change the outcome of the lawsuit.  A genuine dispute over that fact exists if the evidence is such that a reasonable jury could return a verdict for the non-moving party.  Courts must view the evidence in the light most favorable to the non-movant and resolve factual controversies in the non-movant’s favor.

Making a claim against the adjuster handling the claim is an advantage in lawsuits, or at least that is what many attorneys believe.  A proper analysis of making a claim against an adjuster is discussed in this 2023 opinion from the Eastern District of Texas, Sherman Division.  The opinion is styled, Lawrence Family Fund, LLC v. Westchester Surplus Lines Insurance Company, et al.

This is a property damage claim alleged to have occurred when Lawrence incurred a theft.  A claim was made against Westchester and the adjuster Westchester hired to adjust the claim, Frederick Achala.  The lawsuit filed in State Court and Westchester removed the case to Federal Court asserting that Achala was improperly joined in the lawsuit in an effort to defeat diversity jurisdiction under 28 U.S.C. Section 1441 and 28 U.S.C. Section 1332.  Lawrence then filed this motion to remand claiming that Achala had not been improperly joined.

The statute permits the removal of any civil action brought in a State court of which the district courts of the United States have original jurisdiction.

Life insurance lawyers will tell you that the answer to the titled question is dependent on the wording of the insurance policy and the facts of the case.

This issue was discussed in the 1979, Fort Worth Court of Appeals opinion styled, Leach v. Eureka Life Insurance Company of America.

This case involved a credit life insurance policy.  The deceased in Tommy Leach and the executrix of the estate is Mary Leach, the Plaintiff here.

The designated beneficiary of a life insurance policy generally is entitled to the proceeds upon the death of the insured.  Absent an adverse claim, the insurer may pay the benefits to the designated beneficiary.
This is discussed in the 1967, Texas Supreme Court opinion styled, McFarland v. Franklin Life Ins. Co.
In 1950 respondent issued a policy of insurance on the life of John V. McFarland, who was about nine years of age at the time.  The policy was taken out by his parents, Bernard and Gwendolyn McFarland, the latter of whom is petitioner here.  Bernard was named in the policy as primary beneficiary, and petitioner was designated as contingent beneficiary.  John married in 1962 and died the following year.  His father predeceased him; he was survived by his widow and petitioner.

Here is a life insurance case that went to trial in 2023.  The case is styled, Mirna Guzman v. Allstate Assurance Company.  The case was tried in the Northern District of Texas, Amarillo Division.

Allstate filed a declaratory judgment action against Guzman to have the life insurance policy she had applied for, rescinded due to misrepresentations in the policy application.

This was a lawsuit originally filed by Guzman and Allstate had countered with the declaratory judgment action.

Hail damage claims result in lots of lawsuits.  Here is a 2023 opinion from the Western District of Texas, El Paso Division.  The opinion is styled, John Kazanjian and Patricia Kazanjian v. State Farm Lloyds.

State Farm had made a settlement offer that was substantially less than what Plaintiff’s felt was fair.  A lawsuit resulted and after much discovery and testimony of experts on both sides, State Farm filed this partial motion for summary judgement.

Defendant argues that it is entitled to summary judgment on Plaintiffs’ Unfair Settlement Claims because there is no evidence that it acted in bad faith during the course of investigating
Plaintiffs’ insurance claim.  Plaintiffs’ Unfair Settlement Claims, if successful, would permit recovery under section 541.060 of the Texas Insurance Code.  And to recover under section 541.060, the insured must prove that the insurer acted in bad faith.  The bad faith requirement for claims under section 541.060 is the same as the Texas common law standard for bad faith.

Bad Faith Law Firms will have a frequent question asked of them.  That question is, “Can I Recover My Attorney Fees.”

One segment of the attorney fees question is addressed in a 2023 opinion from the Southern District of Texas, Houston Division.  The opinion is styled, Gilbane Building Company, Inc. v. Swiss Re Corporate Solutions Elite Insurance Company d/b/a North American Elite Insurance Company and Everest National Insurance Company.

Gilbane brought this lawsuit against Swiss asserting causes of action under the Texas Insurance Code and as part of the claim, sought recovery of attorney fees.  Swiss filed a motion to exclude attorney fees based on the assertion that Gilbane had not complied with Section 542.003(a) of the Texas Insurance Code, in that the presuit notice requirement had not been satisfied as required by that statute.

Bad Faith lawyers who handle commercial policy claims will want to read this 2023 case.  This case is from the Southern District of Texas, Corpus Christi Division.  It is styled, Laguna Enterprises, LLC v. Westchester Surplus Lines Insurance Company, et al.

A big difference between commercial policies and the policies covering a normal person who has a homeowners or auto is that the commercial policies will have a greater number of exclusions and limitations to coverage and conditions that have to be satisfied for coverage to apply.  That is the situation in this case.

Plaintiff’s proper was insured through Westchester.  Plaintiff suffered a fire loss and Plaintiff made a claim for benefits.  Westchester denied the claim because the property lacked smoke detectors as required by the policy.  Plaintiff sued for violations of the Texas Insurance Code and breach of contract.  Westchester filed a motion for summary judgement based on the facts of the case and the policy language.

Bad Faith Insurance Attorneys need to read this 1988, opinion from the Texas Supreme Court.  The opinion is styled, Vail v. Texas Farm Bureau Mut. Ins. Co.

This case involves a house burning down.  A claim was made for the homeowner insurance benefits and the insurance company denied the claim.  Here is how the court ruled on the recovery of money beyond the policy benefits:

The court of appeals did not make specific holdings on the Vails’ other points of error but generally agreed with the contentions of Texas Farm. Because we reversed the court of appeals and hold that the Vails stated a cause of action for unfair claims settlement practices and are entitled to treble damages under the DTPA, we will also address the parties’ points of error on which the court of appeals did not specifically rule.

Imagine this.  A life insurance claim is denied.  The beneficiary goes to an attorney who makes sends a demand letter to the life insurance company demanding payment and monies for their bad faith actions.  In response to the demand letter the life insurance company sends the policy proceeds, plus interest.  Does that end the matter?

This was answered as far back in Texas as 1908, in the Texas Supreme Court opinion styled, Penn Mutual Life Ins. Co. v. Manor.

For the full facts the opinion, which is kinda long, needs to be read.

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