Dallas Fort Worth Insurance Lawyer Blog

Insurance And Appraisal

July 30, 2011 | Mark S. Humphreys

Appraisals are a reality in most insurance policies, regardless if you live in Grand Prairie, Arlington, Fort Worth, Dallas, Mansfield, or anywhere else in the state of Texas.

The United States District Court, Southern District, Houston Division, issued an opinion on July 1, 2011, in the case styled, EDM Office Services, Inc. v. Hartford Lloyds Insurance Company, et al.

This was a lawsuit to recover insurance proceeds and damages under the Texas Insurance Code and common law. Hartford was demanding an appraisal pursuant to the insurance policy and EDM was saying that Hartford had not complied with the conditions precedent identified in the insurance policy for appraisal because it had not conducted a reasonable investigation of the claim as required by Texas Insurance Code, Section 541.060(a)(7). Plus, EDM argued that even if Hartford was entitled to the appraisal, that Hartford had waived its right to the appraisal.

Accidental Death Benefits

July 28, 2011 | Mark S. Humphreys

Accidental deaths would be common in Grand Prairie, Arlington, Fort Worth, Hurst, Euless, Bedford, Keller, Saginaw, Grapevine, and any other place in Texas. It is simply one of those things that is going to happen.

A lot of people have insurance policy’s that provide coverage in the event of an accidental death. These policies are known as “accidental death” policies. The United States District Court, Southern District of Texas, Houston Division, issued an opinion on June 29, 2011, in the case styled, Cheryl Likens v. Hartford Life and Accident Insurance Company. This case made a summary judgment ruling regarding an accidental death policy that people who have these types of policies should understand. Here is some background.

Wesley Vincent fell at his home in February 2008, and suffered injuries to his cervical spine. He died as a result of that injury four days later. The discharge summary from the hospital listed his cause of death as “anoxic brain injury secondary to cardiopulmonary arrest.”

Insurance And Attorney Fees

July 26, 2011 | Mark S. Humphreys

Policy holders in Grand Prairie, Arlington, Fort Worth, Mansfield, Crowley, Burleson, Rendon, Lake Worth, Benbrook, Hulen, and other areas of Texas probably get worried about attorney fees if they find themselves in a position where they need to fight with an insurance company. Some experienced Insurance Law Attorneys will work on a contingency fee basis rather than forcing someone to pay large retainer fees that scare away most people.

The ultimate questions would be: If I win, can I recover my attorney fees? The answer to that question in most all insurance claim lawsuits is “yes.” The District Court for the Western District of Texas, Austin Division, issued an opinion on June 28, 2011, that addresses this question. The style of the case is Berkley Regional Insurance Company, as Subrogee of Venus Rouhani and as Assignee/Subrogee of the Tower of Town Lake Condominium Association v. Philadelphia Indemnity Insurance Company. Here is some background.

In this case, Venus Rouhani is a third party who obtained a judgment against the Towers, the insured under an insurance contract with Philadelphia. Therefore, under Texas law, Rouhani was entitled to enforce the terms of the Philadelphia insurance contract. The court had, in earlier proceedings, held that Berkley obtained Rouhani’s rights under a judgment, either through contractual assignment or statutory subrogation,at which point Berkley became entitled to enforce the contract terms at issue in this case.

Fire Loss

July 24, 2011 | Mark S. Humphreys

Whether you live in Weatherford, Aledo, Azle, Willow Park, Hudson Oaks, Mineral Wells, Millsap, Brock, Peaster, Springtown, Poolville, Cool, or anywhere else in Parker County, a fire loss to your home can be a devastating loss. It is compounded when your insurance company refuses to pay for the loss. It is compounded further when they accuse you of arson.

The Texas Supreme Court issued an opinion in a case in 1998, styled “State Farm Fire & Casualty Company v. James and Cynthia Simmons.” The legal issue presented to the court was whether there was sufficient evidence to support a jury finding that State Farm breached its duty of good faith and fair dealing and whether there was some evidence to support a punitive damages award. We will go over the good faith and fair dealing only point due to technicalities surrounding the punitive damages award.

Background information:

Insurance Company Demanding More Documents

July 23, 2011 | Mark S. Humphreys

Someone in Grand Prairie, Arlington, Dallas, Irving, Carrollton, Farmers Branch, Lewisville, Hurst, Euless, Bedford, or anywhere else in the metroplex area would just get mad and frustrated with an insurance company treating them wrong, by continuing to ask for paperwork and documents that they don’t really need to evaluate and settle a claim. Usually the insurance company is just trying to wear you out. Here is a case where they did not get away with it.

In 2004, the Corpus Christi Court of Appeals issued an opinion in the case styled, Minnesota Life Insurance Company v. Elia L. Vasquez. Elia sued Minnesota Life for knowing violations of the Texas Insurance Code and for mental anguish associated with those violations. We will deal with the knowing violations part of the opinion. Here are some of the allegations and facts.

Elia alleged that Minnesota Life unreasonably delayed payment of the proceeds of an accidental death policy that insured the life of her deceased husband. Minnesota Life contended that the cause of death was not clearly accidental and the delay was caused by its need to obtain additional medical records. The hospital from which the records were sought was unresponsive and did not turn over the requested documents to Minnesota Life for five months. Upon receipt of these records, Minnesota Life paid Elia’s claim.

Policy Interpretation – Residents Of Household

July 21, 2011 | Mark S. Humphreys

Insureds in Grand Prairie, Arlington, Grapevine, Keller, Flower Mound, Rhome, Ponder, Justin, Haslet, Saginaw, Farmers Branch, and other places in Texas might think they know the meaning of household resident. They would be surprised that often times an insurance company is going to fight over what it means when someone makes a claim. Here is an example.

The Texas Court of Appeals, Waco, determined a case in 1977, which is still good law. The case is styled, Southern Farm Bureau Casualty Insurance Company v. Kenneth C. Kimball et al. Here are some facts of the case.

Kenneth Kimball was the named insured in a family automobile policy issued by Southern Farm Bureau. 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 filed by her was pending. Farm Bureau filed a declaratory judgment asking the court to declare that they did not owe any benefits under the policy. The case was heard on stipulated facts. The only issue raised 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.

Interpreting An Insurance Policy

July 19, 2011 | Mark S. Humphreys

It is doubtful anyone in Grand Prairie, Hurst, Euless, Bedford, Arlington, Dalworthington Gardens, Mansfield, North Richland Hills, Fort Worth, or anywhere else in Tarrant County is going to run a cross this particular situation, but it is kinda interesting.

The Texas Supreme Court issued an opinion in June 2011, in the case styled, Lancer Insurance Company v. Garcia Holiday Tours, Et Al. The question for this court to decide in this case was whether the transmission of a communicable disease from the driver of a motor vehicle to a passenger is a covered a loss under a business auto policy, which affords coverage for accidental bodily injuries resulting from the vehicle’s use. This Texas Supreme Court said no. Here is some background information.

Garcia Holiday Tours operates a commercial bus company. It contracted with the Alice ISD to provide a bus and driver for a field trip to Six Flags Fiesta in San Antonio. The trip was for Alice High School band members, several of whom observed the driver coughing during the trip. Upon return, the driver was hospitalized after being diagnosed with an active case of tuberculosis.

Underinsured Motorist

July 17, 2011 | Mark S. Humphreys

Persons with uninsured coverage in Weatherford, Mineral Wells, Aledo, Azle, Newark, Hudson Oaks, Willow Park, Cresson, Peaster, Millsap, Brock, and other places in Parker County need to have a bit of an understanding of the following case. Or they need to know how to get in touch with an experienced Insurance Law Attorney.

The opinion in this case was issued by the Houston Court of Appeals, 14th District. It was issued on June 21, 2011, and the style is, Chezaray Melancon v. State Farm Mutual Automobile Insurance Company.

In this case, Melancon sued State Farm under the underinsured coverage part of her insurance policy. At trial, the jury found the amount of her personal injuries to be an amount that was less than what she had settled for with other parties in the case. This court said that the unambiguous language of the policy showed that State Farm had no further liability.

Duty To Cooperate With Insurance Company

July 16, 2011 | Mark S. Humphreys

If you have insurance in Grand Prairie, Arlington, Mansfield, Garland, Richardson, Mesquite, Rowlett, Fort Worth, Dallas, or anywhere else in the Dallas and Fort Worth metroplex area, you most likely have the same obligation as everyone else in the State of Texas, and that is the duty to cooperate with any investigation your insurance company wants to conduct with respect to any claim you are involved in.

The Dallas Court of Appeals issued an opinion in a case on June 21, 2011, that dealt with this duty to cooperate with your insurance company. The style of the case is quite long and is abbreviated here to, Ann Martinez v. ACCC Insurance Company.

In this case there were three insurance entities sued together and the trial court granted a summary judgment in favor of the three entities. Here is some background:

Insurance Scams?

July 14, 2011 | Mark S. Humphreys

Residents of Grand Prairie, Arlington, Mansfield, Fort Worth, Dallas, Garland, Mesquite, Richardson, Carrollton, and other places in Dallas County and Texas should be concerned about insurance scams. They drive up the cost of insurance and nobody likes the thought of someone profiting from illegal actions. Most of the time when you think of this, what comes to mind is staged car wrecks, intentional fires to collect insurance money, and other similar actions. What you do not normally think of is, the insurance company being who is doing the scamming.

Here is a story worth reading.

The Houston Chronicle published an article on May 13, 2011, written by Patrick Danner. The title of the article is, “USAA sued anew over medical payouts in crashes Plaintiffs say insurer’s reviews are ‘shams’; firm defends pratices.”