Dallas Fort Worth Insurance Lawyer Blog

Coverage Under An Auto Policy; Family Member Exclusions

October 25, 2011 | Mark S. Humphreys

Insured’s in Weatherford, Mineral Wells, Aledo, Willow Park, Hudson Oaks, Azle, Brock, Millsap, Springtown, Cool, Peaster, and other places in Parker County would be confused when trying to figure out some aspects of coverage as it relates to auto insurance policy’s. The meaning of “Family Member” in a policy might sound pretty easy at first glance, but looking at individual situations makes it not so easy. What about when people just filed for divorce, are separated, not married but living together, away at college or trade school? Are they a “Family Member?” Here is a different look:

The Houston Court of Appeals, First District, issued an opinion in 1996, that is interesting. The style of the case is, State Farm Mutual Automobile Ins. Co. v. Ms. Hanh Thi Dinh Nguyen, and Dr. Bay Van Nguyen, Individually and as Next Friend of His Deceased Infant Daughter.

This appeal is from a summary judgment hearing wherein the court had to decide whether the child in the case, whose entire six-day life was spent in a hospital, was a “resident” of the insured’s household.

Suing An Insurance Company

October 23, 2011 | Mark S. Humphreys

Someone in Grand Prairie, Weatherford, Arlington, Fort Worth, Dallas, Mineral Wells, Grapevine, Keller, Colleyville, or anywhere else in Texas should know that when it comes to suing an insurance company, there are things to know.

A 2007, San Antonio Court of Appeals case serves as a good example. The style of the case is, In re Terri Ann Garcia.

This is a writ of mandamus case. The person suing, Terri Ann Garcia, sought a writ of mandamus to vacate the trial court’s order quashing the deposition of a State Farm Mutual Automobile Insurance Company representative. State Farm was trying to prevent the taking of the deposition of its representative.

Underinsured / Uninsured Motorist At Work

October 22, 2011 | Mark S. Humphreys

Workers in Grand Prairie, Arlington, Irving, Fort Worth, Dallas, Mesquite, Garland, Richardson, Carrollton, Hurst, Euless, Bedford, or anywhere else in Texas may wonder about this situation. What if you are hurt at work while driving a company vehicle, your employer has workers compensation benefits you seek and obtain, and the vehicle has underinsured / uninsured (UM) benefits purchased by your employer? Can you obtain the UM benefits?

The Amarillo Court of Appeals had this issue come up in a case they issued an opinion in on September 26, 2011. The style of the case is, Robert Smith v. City of Lubbock and St. Paul Fire and Marine Insurance Company.

This case was an appeal from a summary judgment in favor of Lubbock and St. Paul. This court reversed as it relates to St. Paul but affirmed the decision as it relates to the employer, City of Lubbock.

Insurance – Resident Of The Same Household – Divorce

October 20, 2011 | Mark S. Humphreys

Insured’s in Grand Prairie, Irving, Garland, Mesquite, Dallas, Carrollton, Richardson, Duncanville, De Soto, and other places in Dallas County might have a hard time believing some of the reasons an insurance company will use for denying a claim. Here is one they tried but it did not work regarding the child of divorced parents.

The case was decided by the Texarkana Court of Appeals in 1978. The style of the case is, Hartford Casualty Insurance Company v. Barbara Smith Phillips, Individually and as Personal Representative of the Estate of Jerry Glenn Phillips.

This case involves the question of coverage under the uninsured motorist provisions of a policy of automobile liability insurance. Barbara Phillips was the named insured and sought recovery of damages for bodily injuries sustained by her son, Jerry Glenn Phillips, as a result of an accident caused by an uninsured motorist. At trial, the jury found that Jerry was a “resident of the same household” as Barbara. Hartford contended that Jerry was not such a resident as a matter of law; that there is no evidence to support the jury finding; that there was insufficient evidence to support such finding; and that such finding was so against the great weight and preponderance of the evidence as to be manifestly wrong and unjust.

Residents Of The Same Household

October 18, 2011 | Mark S. Humphreys

Insureds in Grand Prairie, Arlington, Fort Worth, North Richland Hills, Hurst, Euless, Bedford, Dalworthington Gardens, Lake Worth, Crowley, or anywhere else in Tarrant County may wonder when a person is determined to be a member of the household for insurance purposes under an insurance policy. Guidance to an answer of that question was provided in a case in 1977.

The style of the case is, Southern Farm Bureau Casualty Insurance Company v. Kenneth C. Kimball et al. The opinion was issued by the Waco Court of Appeals.

Kenneth Kimball was the named insured under a policy issued by Southern Farm Bureau Casualty Insurance Company. Kenneth’s wife, Connie was killed in an automobile accident with an uninsured motorist when the policy was in force. At the time of her death, she and Kenneth were separated, living in separate residences, and a divorce action by her was pending. Farm bureau filed a declaratory judgment as to its responsibilities under the policy for uninsured motorist protection benefits, personal injury benefits, and death indemnity benefits. On the trial, under stipulated facts, the only issue raised by the parties was whether Connie and Kenneth were “residents of the same household,” as that term is used in the policy, at the time of Connie’s death.

Flood Insurance Coverage

October 16, 2011 | Mark S. Humphreys

Whether you live in Weatherford, Mineral Wells, Aledo, Willow Park, Hudson Oaks, Peaster, Millsap, Brock, Springtown, Azle, Cool, or anywhere else in Parker County, there are odds that you may be subject to suffering a loss from flood damage. A natural question would be, “How does flood insurance work?”

Because most property insurance policies covering property at fixed locations exclude flooding, flood insurance must be purchased separately. In 1969, Congress created the National Flood Insurance Program to administer the sale of flood insurance. National flood insurance is available directly from the Federal Insurance Administration or through hundreds of private insurers who participate in federal flood insurance programs. The Federal Emergency Management Agency (FEMA) reinsures private companies against flood losses.

Flood insurance premiums are calculated based upon geographic maps setting forth the boundaries for various flood zones.

Replacement Cost In Insurance Policy

October 15, 2011 | Mark S. Humphreys

People in Grand Prairie, Arlington, Mansfield, Fort Worth, North Richland Hills, Saginaw, Keller, Roanoke, and other places in the Tarrant County area and Texas would want to know how their insurance policy pays for their property that is damaged in a loss that is covered by the policy.

A 1998, Austin Court of Appeals case helps us understand how some losses are calculated and paid. The case is styled, Great Texas County Mutual Insurance Co. v. Emmett C. Lewis. This is an appeal from the trial court finding in favor of Lewis.

The facts are undisputed. While covered by a policy issued by Great Texas, Lewis’s 1989 Dodge Caravan car sustained damage to the engine. The car had 110,000 miles on it. Great Texas inspected the car and calculated the cost of repairs to be $3,608.27. which included the cost of a re-manufactured engine, replacement parts, and labor. From the $3,608.27, Great Texas subtracted the policy deductible of $527 and $2,031.72 for betterment or depreciation, leaving a net sum of $1,049.55. Great Texas offered Lewis that sum to discharge the obligation under the policy.

Insurable Interest

October 13, 2011 | Mark S. Humphreys

What if someone in Weatherford, Mineral Wells, Aledo, Willow Park, Azle, Hudson Oaks, Millsap, Brock, Springtown, Cool, or anywhere else in Parker County has insurance on a house and the house burns down – do they automatically get paid the insurance on the house? The answer is – It depends.

To be able to recover on an insurance policy, the person suffering the loss must have an insurable interest in the property that is insured. The Dallas Court of Appeals issued an opinion in 1993, that is still good law. The style of the case is, William T. & Elaine Jones v. Texas Pacific Indemnity Company.

It is a summary judgment case. The Jones sued Texas Pacific on an insurance policy. The summary judgment was granted in favor of Texas Pacific because the court said the Joneses could not recover insurance proceeds on property which they did not have an insurable interest to.

Suing The Insurance Adjuster

October 11, 2011 | Mark S. Humphreys

Insurance Law Attorneys in Grand Prairie, Irving, Duncanville, De Soto, Lancaster, Mesquite, Garland, Richardson, Farmers Branch, or anywhere else in the state of Texas will usually want to sue the adjuster who handled the claim in addition to suing the insurance company when a claim is denied. There are reasons for this. But the insurance company will fight the issue.

The United States District Court, Southern District, Galveston Division, issued an opinion in a case on August 10, 2011, wherein the court allowed the adjuster to be sued over the objections of the insurance company. The style of the case is, Juan Jose Cruz, Lidia Cruz and Griselda Cruz v. Allstate Lloyds and Pilot Catastrophe Services, Inc. It is property damage claim following Hurricane Ike.

In this Federal Court case, the Cruz’s filed a “Motion for Leave to File Amended Complaint” for the purpose of adding to the lawsuit the individual adjuster who handled the investigation of the claim. Of relevance to the court was that by adding the adjuster the case still remained in Federal Court whereas often times the addition of the adjuster causes the case to be remanded to State Court.

Suing Insurance Adjusters

October 9, 2011 | Mark S. Humphreys

Adjusters in Grand Prairie, Dallas, Irving, Richardson, Garland, Mesquite, Carrollton, Farmers Branch, Duncanville, or anywhere else in Texas, who make a mistake in their job that costs an insurance customer money, can be sued for what he cost the insurance customer. The tricky thing is doing it in the most advantageous manner.

Usually the individual adjuster does not have to be sued. Suing his employer, the insurance company, is often times just as good. But sometimes there is a legal advantage to suing the adjuster and the company. Often times, if just the company is sued, the case can be removed from the State Court in which it was filed, to a Federal Court. There are advantages to the insurance company for doing a removal. That is why they do it.

One way of defeating the attempt at removal is by suing the insurance adjuster and not just the insurance company. However, doing it this way must be done correctly.