Dallas Fort Worth Insurance Lawyer Blog

Reservation Of Rights Letter – Get An Attorney

March 1, 2012 | Mark S. Humphreys

If someone in Grand Prairie, Fort Worth, Saginaw, Keller, Roanoke, Haslet, Rhome, Justin, Boyd, or anywhere els gets a “reservation of rights” letter from their insurance company, there is one thing they need to do right away. See an experienced Insurance Law Attorney and have him go over the facts and policy in your situation.

The Texas Court of Appeals, Houston, 1st District, issued an opinion in 1999, that deals with a “reservation of rights” situation. The style of the case is Pecan Grove Association v. John L. Wortham & Sons. Here are some facts.

From 1982 to 1988, Pecan Grove purchased general liability insurance from Lloyds through its agent, Wortham. After June 1988, Pecan Grove purchased its general liability insurance from St. Paul through Wortham, which was also an agent for St. Paul. Wortham was an agent for both carriers. In February, 1988, Pecan Grove was sued by homeowners alleging that the property sold to them was not fit for construction. In October 1990, the Plaintiffs in the underlying suit amended their claims to add more than 70 additional plaintiffs. On December 6, 1990, Pecan Grove sent a letter to St. Paul with a copy to St. Paul through Wortham. On December 13, 1990, St. Paul issued a general reservation of rights letter. On December 17, 1992, St. Paul denied a defense and indemnity based on the policy’s real estate operations exclusion. On December 30, 1993, Pecan Grove settled the underlying lawsuit for $2,500,000.

Interpreting An Insurance Policy / Get A Lawyer To Help

February 28, 2012 | Mark S. Humphreys

Regular people in Weatherford, Aledo, Millsap, Willow Park, Hudson Oaks, Azle, Springtown, Mineral Wells, Brock, and other places in Parker County are going to have a hard time reading and understanding the wording in an insurance policy. It is also safe to say that experienced Insurance Law Attorneys will sometimes differ over the proper interpretation of the words in a policy.

The United States Fifth Circuit issued an opinion in a case in 1999, where the parties were arguing over the correct interpretation of a portion of an insurance policy. The style of the case is, Matador Petroleum Corp. v. St. Paul Surplus Lines Insurance Company. Here are some of the facts.

St. Paul provided Matador with insurance coverage pursuant to an oil and gas commercial general liability policy. The policy contained an absolute pollution exclusion clause. However, an endorsement provided a narrow exception stating that the pollution exclusion would not apply in the event of a “covered pollution incident.” A covered incident was a discharge, release, etc., that begins and ends within 72 hours, does not result from a well out-of-control, is known to you (Matador) or your operating partner within 7 days of its beginning and is reported to the company within 30 days of its beginning. In March 1994, a drilling bit collapsed in a well owned in part by Matador. The collapse caused a discharge of pollutants that fed onto adjacent property and waterways. Matador reported the incident to St. Paul’s agent 38 days after the incident occurred and requested coverage under the policy for damages claimed by landowners. After investigating the claim, St. Paul declined the request for coverage and informed Matador that St. Paul would not provide a defense or indemnity.

Beneficiary Of Life Insurance Policy : Unusual Case

February 26, 2012 | Mark S. Humphreys

People living in Grand Prairie, Arlington, Mansfield, Fort Worth, Hurst, Euless, Bedford, and other places in Texas who are named beneficiaries under a life insurance policy might find this next case unusual. Here is some background.

This is a United States Northern District case decided in 1999. The style of the case is Benbow v. All American Life Insurance Company.

All American Life Insurance Company and General American Life Insurance Company each insured Daniel Benbow under whole life insurance policies that provided coverage of $100,000. Approximately seven months before Daniel’s death, letters were sent to both carriers requesting cancellation of the policies and further requesting that the carriers remit any accumulated cash value of the policies. Both carriers honored the request and issued checks to Daniel for the current value of the policies. After Daniel’s death, Diana Benbow contacted the carriers and notified them that Daniel suffered from a bipolar disorder, and she requested that the carriers deem the cancellation of the policies to be invalid. The carriers contended that the policies had been surrendered, and refused to pay the claim for benefits. Diana then sued both carriers in state court alleging breach of contract, violations of the Texas Insurance Code and violations of the Texas Deceptive Trade Practices Act (DTPA). The carriers removed the case to federal district court. Thereafter, the carriers moved for summary judgment on all causes of action.

Misrepresentation In Insurance Policy Application

February 25, 2012 | Mark S. Humphreys

People in Weatherford, Aledo, Brock, Millsap, Mineral Wells, Springtown, Willow Park, Hudson Oaks, and other places in Parker County need to understand that the ways they fill out an insurance application can be important.

Here is a case where the insurance company lost the argument that the information in the policy application was incorrect. The style of the case is Fredonia State Bank v. General Life Insurance Company. The opinion in the case was issued in 1994 by the Texas Supreme Court. Here are the facts of the case.

The insured person died as the result of a gunshot wound to the head. Prior to his death, he had purchased two life insurance policies, each in the amount of $250,000 issued by General American Life Insurance Company. General American denied the beneficiary’s claims for benefits. Fredonia State Bank, an assignee of one of the two policies and executor of the insured’s estate, sued to collect the proceeds of the policy.

Life Insurance And Premium Payments – 2 Cases

February 23, 2012 | Mark S. Humphreys

Policy holders in Grand Prairie, Fort Worth, Benbrook, Hurst, Euless, Bedford, Saginaw, Newark, Roanoke, Keller, Grapevine, and other places in Texas might wonder about how premium payments affect coverage. Here are two cases dealing with premium payments and both might seem kind of strange but for these folks they were real and had to be dealt with.

The first case is a Dallas Court of Appeals case decided in 2004. The style of the case is Royal Maccabees Life Insurance Company v. James. Here are some of the facts.

Royal Maccabees Life Insurance Company was sued by the surviving spouse of a police officer seeking an additional $50,000 in life insurance proceeds after the insurer paid the basic $50,000 upon the officer’s death. It was undisputed that the insured applied for the additional $50,000 in coverage. It was also undisputed, however, that the insurer never sent a letter to the insured approving the disputed benefits as required by the insurance policy. The insurer denied the additional $50,000 in coverage and refunded the premiums paid for this coverage. The trial court entered judgment on the jury finding that the insurer breached the contract, committed fraud, and violated the Deceptive Trade Practices Act, the Texas Insurance Code and the duty of good faith and fair dealing. The judgment included mental anguish damages, punitive damages, attorney’s fees and pre-judgment interest. An appeal was filed.

Life Insurance Attorney And Policy Lapse

February 21, 2012 | Mark S. Humphreys

Fort Worth residents and insureds in Grand Prairie, Weatherford, Arlington, Dallas, Saginaw, Grapevine, Aledo, and other places in Texas would want to have some knowledge about what constitutes a “lapse” in their life insurance policy. Here is a case that gives some insight.

This is a 2000, case decided by the San Antonio Court of Appeals. The style of the case is MacIntire v. Armed Forces Benefits Association. Here are some facts.

Linda and Scott MacIntire submitted a joint application for term life insurance to the Armed Forces Benefit Association (AFBA) in April 1996. The payments were to be made automatically via a computerized bank deposit scheme, but for unknown reasons, the payments were never made. The few payments that the MacIntires did make were not enough to keep the policy in force and it lapsed on March 31, 1998 according to AFBA. Scott MacIntire died from a terminal illness in August of 1998 and Linda inquired regarding the policy in September of that year. Upon discovery of the failed automatic deposit setup, Linda tried to pay delinquent payments directly to AFBA, but AFBA denied the payments and coverage, stating that Scott’s policy had already been canceled. Linda sued AFBA, alleging violation of the Texas Insurance Code, violations of the Texas Deceptive Trade Practices Act (DTPA), breach of contract, negligence, breach of duty of good faith and fair dealing, breach of implied warranty, and ambiguity of contract, seeking to recover the death benefits and additional damages. The trial court granted AFBA’s motion for summary judgment on the basis that no genuine issue of material fact existed. Linda appealed, claiming that genuine issue of material fact existed in her claims for breach of contract, breach of implied warrant and ambiguity of contract, DTPA violations, Texas Insurance Code, Section 541.060, breach of duty of good faith and fair dealing, and negligence.

Misrepresentation Clarified, A Little

February 19, 2012 | Mark S. Humphreys

Insured people in Weatherford, Fort Worth, Grand Prairie, Mineral Wells, Springtown, Azle, Aledo, and other places in Tarrant and Parker Counties might understand a little more about misrepresentation after reading about the case here.

The case is styled, Tellez v. Encompass Insurance Company of America.

This opinion was issued by the United States Federal District Court, Eastern District, in 2004. Here are some of the facts.

Lawyers And Home Owners Claim Denial Based On Lateness Of Claim

February 18, 2012 | Mark S. Humphreys

When someone in Grand Prairie, Weatherford, Fort Worth, or anywhere else in the north Texas area suffers an insured loss, how long do they have to report the claim to their insurance company? The answer is a lawyers answer: It Depends.

The Fifth Circuit Court of Appeals dealt with this issue in an opinion it issued in 2005. The style of the case is Ridglea Estate Condominium Association v. Lexington Insurance Company. Here are some of the facts.

In July 2001, after receiving notice from a roofing inspector that its building in Fort Worth, Texas has suffered hail damage, Ridglea filed an insurance claim with its carrier Chubb Custom Insurance. Upon its inspection, however, Chubb informed Ridglea that the damage was not caused by the more recent storm but rather by a storm that occurred on May 5, 1995. Ridglea did so and filed the claim with the 1995 carrier, Lexington Insurance Company. Lexington’s inspection revealed that the damage did not exceed the deductible and that there was not sufficient evidence that the damage occurred in 1995 and denied the claim. After about a year’s worth of negotiations involving Ridglea and all its insurers, Ridglea made a final demand. Lexington again denied the claim and brought a declaratory judgment action seeking a ruling that it was not liable for the damage. Both parties moved for summary judgment and the trial court granted summary judgment in favor of Lexington holding that Ridglea had failed to comply with the notice requirements contained in the policy. Ridglea appealed to the U.S. Court of Appeals for the Fifth Circuit.

Lawyer Getting Knowing Violation Of Insurance Code

February 16, 2012 | Mark S. Humphreys

Insured people in Grand Prairie, Fort Worth, Arlington, Dallas, and other places in the Dallas and Fort Worth metroplex would probably not understand how to hold an insurance company responsible for a knowing violation of the Texas Insurance Code. Here is a case where the lawyer had success in this area of the law.

The style of the case is, State Farm Lloyds v. Johns. The case was decided by the Dallas Court of Appeals in 1998. Here are the facts.

Ms. Johns’ house was built in 1964. Johns moved in to her house in 1972. In the summer of 1990, Johns noticed evidence of extensive foundation problems including door mis-allignment, significant cracks in the interior walls and a slope to the floor. Repairmen later discovered two plumbing leaks under the house. Johns made a claim for foundation damage alleging that the plumbing leaks caused the soil underneath the house to expand resulting in an upheaval of the foundation, thereby damaging the structure. State Farm hired a foundation expert, Mr. Betting, who concluded that Johns’ foundation problems were not caused by the plumbing leaks, but rather asserted that the damage occurred from natural soil movement common to north Texas. State Farm’s homeowners policy excluded damage caused by ordinary settlement. Based on the exclusion State Farm denied the claim.

Lawyer And Bad Faith Insurance

February 14, 2012 | Mark S. Humphreys

Someone in Weatherford, Fort Worth, Aledo, and other places in Tarrant and Parker County might have a hard time understanding what is “bad faith” in most insurance situations. Here is a case that gives some insight into how it works.

The case is State Farm Lloyd’s v. Johns and was decided by the Dallas Court of Appeals in 1998. Here are some of the background facts.

Johns’ house was built in 1964. Johns moved in to her house in 1972. In the summer of 1990, Johns noticed evidence of extensive foundation problems including door misalignment, significant cracks in the interior walls and a slope to the floor. Repairmen later discovered two plumbing leaks under the house. Johns made a claim for foundation damage alleging that the plumbing leaks caused the soil underneath the house to expand resulting in an upheaval of the foundation, thereby damaging the structure. State Farm concluded that Johns’ foundation problems were not caused by the plumbing leaks, but rather asserted that the damage was caused by ordinary settlement. Based on the exclusion, State Farm denied the claim.