Dallas Fort Worth Insurance Lawyer Blog

Misrepresentation In Insurance Application By Applicant

August 25, 2011 | Mark S. Humphreys

Life insurance policy holders in Weatherford, Mineral Wells, Aledo, Azle, Peaster, Brock, Millsap, Hudson Oaks, Willow Park, Springtown, and other places in Parker County would be interested in this case.

The case was decided by the Texas Supreme Court in 1978. The case is styled, James D. Robinson v. The Reliable Life Insurance Company. The insured beneficiary in this case lost at the trial court level and the first appeals court level and in the Supreme Court.

The question on appeal was whether an insurance company, in order to avoid liability of a policy of life insurance for the reason of false representations in the insurance application, must establish both that (1) the misrepresentation was material to the risk and that (2) the condition about which the misrepresentation was made contributed to the death of the insured.

Insurance Proceeds And Fraud

August 23, 2011 | Mark S. Humphreys

For someone in Grand Prairie, Arlington, Fort Worth, Dallas, Hurst, Euless, Bedford, North Richland Hills, Roanoke, Keller, and other places in North Texas, it is likely to happen. A spouse intentionally burns the house down. Well, what happens to the insurance money? Here is a case that provides some guidance.

The case was decided in 1999, by the Texas Supreme Court. It is styled, Texas Farmers Insurance Company v. Daisy Murphy. The question posed to the court was whether an innocent spouse can recover insurance proceeds when the other co-insured spouse has intentionally destroyed the covered community property.

Here is some background.

Deceptive Trade Practices And Homeowners Policy

August 21, 2011 | Mark S. Humphreys

Here is something that insured people in Grand Prairie, Weatherford, Arlington, Fort Worth, Dallas, Mansfield, and other places in Texas might be curious about. What happens if you have an insurance policy on your house. Next, the house burns down and a claim is made and denied. Next, the homeowner dies! Can the heirs pursue a claim against the insurance company for violations of the Texas Deceptive Trade Practices Act or violations of the Texas Insurance Code?

The Fourth Court of Appeals District of Texas issued an opinion on July 27, 2011, that addressed this question. The style of the case is, Texas Farm Bureau Mutual Insurance Co. v. Shannan Rogers and Cristen Bazan, as legal heirs of Cynthia Bazan, deceased. This case was tried to a jury in the 198th Judicial District Court, Kerr County, Texas, which returned a verdict favorable to the heirs. This appeals court reversed. Here is some background.

In 2008, Cynthia Bazan purchased a house and was required to purchase insurance by the mortgage company. She applied for a policy with Farm Bureau. Farm Bureau initially refused coverage based on a wood-burning stove having inadequate protection. This was remedied and a policy was issued. Later, a fire completely destroyed Bazan’s house and all the contents. Bazan made a claim and Farm Bureau began an investigation which included a background check of Bazan and a “cause and origin” investigation of the fire. Farm Bureau obtained Bazan’s criminal record. Farm Bureau’s fire investigator listed the cause of the fire as “undetermined.”

How Long Does An Insurance Company Have To Pay A Claim

August 20, 2011 | Mark S. Humphreys

Anyone in Grand Prairie, Weatherford, Fort Worth, Dallas, Arlington, Aledo, or anywhere else in Texas may ask the question which is the title of this post. The answer is not as easy as one would hope it to be.

The Texas Insurance Code has a subchapter titled “Prompt Payment of Claims.” This subchapter consists of eleven sections. To answer the question of how long an insurance company has to pay a claim, the section has to be read with the applicable policy and then apply both to the facts of the case.

A 1998, Fourteenth District Court of Appeals case styled, John A Daugherty, Jr. v. American Motorists Insurance Company, deals with the question. The case was decided by the trial judge in favor of the insurance company and then the decision was upheld by this appeals court. Here is the story.

Insurance Payment Delays

August 18, 2011 | Mark S. Humphreys

If you have insurance in Grand Prairie, Arlington, Fort Worth, Mansfield, Dallas, Irving, Mesquite, Garland, or anywhere else in Texas, you would like to think that when you make a claim against your insurance company, that they are going to pay your claim and they are going to pay it promptly. The following is a case where they, first refused to pay then later decided to pay, but by that time it was a late payment.

This is a 1996, Texarkana Court of Appeals case styled, Southland Lloyd’s Insurance Co. and James D. Webb, III v. Charles W. Tomberlain, individually and d/b/a Charles Tomberlain Insurance Agency and Charles M. Tomberlain. The case is somewhat complicated and deals with other issues besides the prompt payment of the claim but the facts are kinda interesting to follow and the law regarding prompt payment is discussed enough to educate.

Southland and Webb were appealing a judgment entered in a lawsuit by Charles M. Tomberlain for delayed payment of an insurance claim. The court reversed the judgment and remanded for a new trial due to errors regarding the jury charge, exclusion of expert testimony, and the granting of a directed verdict.

Blamed For Arson

August 16, 2011 | Mark S. Humphreys

Arsons happen in Weatherford, Mineral Wells, Aledo, Azle, Millsap, Hudson Oaks, Willow Park, Brock, Peaster, Springtown, and all over Parker County and Texas. But that does not mean the person who owned the property committed the arson. And when the insurance company does an investigation and finds the property owner is having financial problems that does not mean the property owner burned the property either. After all the vast majority of people have financial problems.

Here is a case that deals with arson and the insurance company attempt to blame the arson on the homeowners. The case opinion was issued in 2000, by the Dallas Court of Appeals. The case is styled, Texas Farmers Insurance Company v. Cloteal L. Cameron, et al.

The jury found against Farmers for violations of the Texas Insurance Code, bad faith, violation of the Prompt Payment of Claims Act, mental anguish, violations of the Texas Deceptive Trade Practices Act, knowing and intentional conduct, and attorney fees. This appeals court reversed the finding regarding the mental anguish claim and part of the attorney fees claim and the calculation of interest on the claim.

Insurable Interest

August 14, 2011 | Mark S. Humphreys

Insured’s in Weatherford, Mineral Wells, Aledo, Azle, Hudson Oaks, Springtown, Willow Park, Brock, Millsap, Peaster, and other places in Parker County might wonder, what does “insurable interest” mean. Here is a case that talks about it.

The opinion in this case was issued in 2000, by the Corpus Christi Court of Appeals. The style of the case is, Colonial County Mutual Insurance Company v. Hector Valdez. Here is some background.

Colonial County Mutual Insurance Company (Colonial) appealed a judgment against them by Valdez, wherein Valdez was awarded damages. This court affirmed the judgment with some reformation. Early on, Colonial had filed a declaratory judgment action asking the court to rule there was no coverage in the case due to Valdez not having an “insurable interest.” Factually here is what happened.

Fire Insurance Claims

August 13, 2011 | Mark S. Humphreys

No one in Grand Prairie, Weatherford, Arlington, Aledo, Fort Worth, Mansfield, Dallas, Irving, Garland, Mesquite, or any other place in Texas likes the though that they will be involved in a fire claim. But for some people it happens. So, what should you expect from the insurance company if it does happen? Here is one example of what can happen when a fire claim is made.

This case was decided in 1991, by the Corpus Christ Court of Appeals. The style of the case is, Automobile Insurance Company of Hartford Connecticut v. David Davila and Donna Davila. David and Donna sued Automobile Insurance Company of Hartford Connecticut (Hartford) for bad faith after a denial of insurance benefits following a fire loss. A jury found in David and Donna’s favor and Hartford appealed. This court modified the judgment in favor of David and Donna. Here is some background.

The Davilla’s house burned in November, 1985. The police were at the house at the time the fire was discovered. Hartford conducted an investigation and denied the claim.

Insurance Coverage – Do You Have It?

August 11, 2011 | Mark S. Humphreys

Residents of Grand Prairie, Arlington, Fort Worth, Dallas, Irving, Richardson, Hurst, Euless, Bedford, Grapevine, Mansfield, and other places all over the metroplex area of North Texas may wonder if the insurance coverage they have bought for themselves is good. Or is the insurance company going to find a reason to not honor their end of the bargain. The following case is an example of how these cases get examined.

The case is styled, Provident American Insurance Company v. Denise Castaneda. The opinion was issued in 1998, by the Texas Supreme Court. Here is some background information.

Denise Castaneda’s father, Guillermo, applied for medical insurance with Provident American Insurance Company in May 1991. He sought a policy that would cover the entire family including Denise., who was twenty-one at the time, her sister, and their brother Guillermo, Jr. During the application process, Guillermo failed to disclose that just two days before he applied for the policy, Jr. had received medical attention from a physician for jaundice, anemia, and suspected hepatitis. Denise had received treatment for jaundice and hepatitis several years prior to the date the insurance was applied for.

Accused Of Arson By Insurance Company

August 9, 2011 | Mark S. Humphreys

Arson cases are the same in Grand Prairie, Arlington, Irving, Fort Worth, Dallas, Mesquite, Garland, Mansfield, Duncanville, Lancaster, De Soto, or anywhere else in Texas. Fires happen by accident and by arson. When a fire occurs the insurance company is going to investigate for reasons of denying coverage for the claim or to find reasons to lower the amount of money they may have to pay on the claim.

In 1992, the San Antonio Court of Appeals, issued an opinion in a case styled, State Farm Lloyds, Inc. v. Robert Polasek and Shirley Polasek.

In this case, arson and bad faith were asserted against State Farm. The Polasek’s prevailed at trial and State Farm appealed. The jury had awarded $40,000 in property damage and $500,000 as exemplary damages against State Farm. The court sustained the verdict for the property damage but overruled the finding of bad faith that allowed the award of exemplary damages. Here is some background.