Dallas Fort Worth Insurance Lawyer Blog

Exclusions In Insurance Policies

May 3, 2011 | Mark S. Humphreys

Insureds in Weatherford, Mineral Wells, Millsap, Hudson Oaks, Aledo, Azle, Peaster, Cresson, Cool, Brock, Poolville, Springtown, and other places in Texas would have a very hard time reading and understanding what an insurance policy says. That is the main reason why an experienced Insurance Lawyer needs to be consulted whenever a claim is denied.

The Texas Court of Appeals in Amarillo decided a case on April 18, 2011, that dealt with policy interpretation. The style of the case is, Evanston Insurance Company v. D&L Masonry of Lubbock, Inc. In this case the court of appeals granted a summary judgment in favor of D&L Masonry. Here is some background.

Evanston issued a commercial general liability policy to D&L. The policy periods are not in dispute. D&L was engaged in the masonry business and contracted to install masonry and renovations to public schools in Muleshoe, Texas. Because of difficulties and weather concerns, D&L did not do the masonry work until after the window frames and windows had been installed. Because the windows and frames were already in place, D&L had to attempt to seal the area between the frames and brick with mortar. In an effort to prevent masonry mortar from damaging the windows and frames, D&L used masking tape around the window frames and soap and water to soap the windows. After D&L had completed the masonry work, the schools were examined and mortar stains were found on many of the window frames. Additionally, some of the frames were scratched when D&L attempted to remove some of the excess mortar that had fallen on the frames during the masonry work. D&L was eventually charged and they paid to have the windows replaced at a cost of $58,113. D&L paid the amount and submitted a claim to Evanston for reinbursement. Evanston denied the claim stating the policy exclusions applied because the window frame damage was damage to property upon which D&L performed its work. D&L then sued Evanston.

Examination Under Oath Compliance

May 1, 2011 | Mark S. Humphreys

Most insureds living in Grand Prairie, Fort Worth, Dallas, Arlington, Pantego, Hurst, Euless, Bedford, Keller, Colleyville, Saginaw, and other places in Texas would not be sure what it means to submit to an “examination under oath” (EUO).

An EUO is where a person is asked questions, usually by an attorney or insurance investigator, after the person has taken an oath to tell the truth, and the testimony is taken by a certified court reporter.

The United States District Court, Southern District, Houston Division, issued an opinion on April 11, 2011, where part of the case dealt with the requirements of an EUO. The style of the case is, Rossco Holdings, Inc. v. Lexington Insurance Company.

Life Insurance – ERISA And Misrepresentation

April 30, 2011 | Mark S. Humphreys

Here is a case for insureds in Grand Prairie, Weatherford, Mineral Wells, Arlington, Dallas, Fort Worth, and other places in Texas to think about.

This case was decided by the United States Court of Appeals for the Fifth Circuit, on April 13, 2011. The style of the case is, Araceli Medina Garcia v. American United Life Insurance Company. Here is some background.

In January 2006, Salvador DeReza Garcia died in a car accident. At the time of this death, Salvador was covered under a group life and accidental death insurance policy issued by American United Life Insurance Company (AUL) and subject to the Employee Retirement Income Security Act (ERISA), 29 U.S.C. Sections 1001-46. Salvador’s wife, Araceli Medina Garcia, submitted a claim under this policy following his death. AUL denied her claim because Salvador was living illegally in the United States and made material misrepresentations regarding his identity during the application process. A lawsuit was filed, the district court ruled in AUL’s favor. This appeal followed. This appeals court affirmed the ruling of the trial court.

Long Term Disability Benefits

April 28, 2011 | Mark S. Humphreys

Anyone in Grand Prairie, Arlington, Irving, Mansfield, Dallas, Fort Worth, Cockrell Hill, Oak Cliff, De Soto, Duncanville, Lancaster, or any other place in Texas, who has disability insurance to help in a time of need, would be interested in the following case.

The case was decided by the The United States Court of Appeals for the Fifth Circuit. It is an appeal from a summary judgment in the district court in favor of the insurance company. The case is styled, Gwendolyn Byrd v. Unum Life Insurance Company of America. The opinion was issued on April 7, 2011.

The plaintiff, Gwendolyn Byrd, filed suit challenging Unim Life Insurance Company’s decision to terminate her long term disability benefits. The job of this appeals court was to review the case for an abuse of discretion by the district court. Here is some background.

Pre-existing Claims? Fortuity

April 26, 2011 | Mark S. Humphreys

Insurance purchasers in Grand Prairie, Arlington, Dallas, Fort Worth, Mansfield, Irving, Mesquite, Cockrell Hill, Oak Cliff, Richardson, or any other place in Texas need to know about the “known-loss” exclusion in an insurance policy.

One way of understanding this exclusion is by reading the case, Colony National Insurance Company v. Unique Industrial Product Company, L.P. This case was decided by the United States District Court, Southern District, Judge Lynn N. Hughes, on April 7, 2011. This is a summary judgment ruling.

Here is some background.

Insurance Company Doing Wrong

April 24, 2011 | Mark S. Humphreys

From Grand Prairie, Arlington, Fort Worth, Dallas, Hurst, Euless, Bedford, Pantego, Dalworthington Gardens, Mansfield, Crowley, to all over Texas, people who have their insurance with State Farm Insurance should find this interesting.

The Houston Chronicle ran a story on April 11, 2011, by writer Terrence Stutz. The title of the article is, “State Farm Is Told To Pay $350 Million.”

The article tells us that State District Judge Tim Sulak found that state Commissioner Mike Geeslin acted properly when he ordered State Farm Lloyd’s to reimburse an estimated 1.2 million customers for overcharges as well as penalty interest going back to 2003. The amount owed is nearly $350 million.

Insurance Company Denys Claim

April 23, 2011 | Mark S. Humphreys

No one in Weatherford, Mineral Wells, Aledo, Azle, Hudson Oaks, Peaster, Poolville, Millsap, Brock, Cresson, Lipan, Willow Park, or anywhere else in Texas wants to hear their insurance company deny a claim they make.

The newspaper, Boulder Daily Camera, ran a story on April 13, 2011, authored by staff writer, Vanessa Miller. The title of the story is, Fourmile Fire Victom Sues Insurance Company For Denying Coverage. It is a story where the insurance company denied a claim and placed the reason for the denial back on the shoulders of the insured.

It it certain that anyone who faces a similar story should do as the person in this story did; that is to seek the advice of an experienced Insurance Law Attorney. Here is much of the story.

Vacant Homes And Insurance

April 21, 2011 | Mark S. Humphreys

When someone in Grand Prairie, Fort Worth, Arlington, Dallas, Irving, Mesquite, Garland, Richardson, Carrollton, De Soto, or anywhere else in Texas leaves their house – is it vacant? What if you moved out to renovate it? What if you moved out while it was up for sale? What if you moved out while you had a temporary job out of town? What if you moved out to take care of a sick relative or friend?

When a house seems to be vacant and a loss occurs, the insurance company that insures the house will probably deny the claim under the “vacancy exclusion” in the insurance contract. Of course when this happens, an experienced Insurance Law Attorney needs to be consulted immediately. Whether the house is vacant, as that term is defined in the insurance contract and Texas courts, will determine whether or not there is coverage.

A case decided by the Court of Appeals, Waco, in 1971, is a good place to look for some guidance. The style of the case is, Germania Farm Mutual Aid Association v. Bobby D. Anderson and Lavern Anderson.

Vacant Buildings And Homes And Insurance

April 19, 2011 | Mark S. Humphreys

Structures owners in Weatherford, Aledo, Azle, Peaster, Hudson Oaks, Willow Park, Cresson, Mineral Wells, Millsap, Brock, Peaster, Springtown, and other places in Texas should know how insurance works when it comes to structures that are not “always” occupied.

The Houston Court of Appeals [1 Dist], decided a case in 1992, styled, Balram R. Jerry v. Kentucky Central Insurance Company. This case dealt with the trial court’s ruling in favor of the Kentucky Central Insurance Company (Kentucky). Here is some background.

In November 1985, Jerry and his wife, Valerie, moved to Utah for employment reasons. They retained ownership of their house in Harris County (the property). In April 1986, Valerie returned to the property and discovered it broken into and vandalized. Most of their property was taken or damaged. Six months later, Valerie’s parents visited the property and discovered it destroyed by fire. On November 11, 1986, Jerry reported the fire to Kentucky.

Vacancy Clause In Homeowners Policy

April 17, 2011 | Mark S. Humphreys

Property owners in Grand Prairie, Arlington, Pantego, Dalworthington Gardens, Crowley, Burleson, Lake Worth, Fort Worth, Weatherford, and other places in Texas who own homes and other building should know about the “vancancy clause” in their insurance policy.

Here is a 1969, case dealing with the vacancy clause in a homeowners insurance policy. It was decided by the Houston Court of Appeals and is styled, John J. Knoff et al. v. United States Fidelity and Guaranty Co.

Here are some facts of the case. Knoff and others sued United States Fidelity and Guaranty Co. (Fidelity) for money under a fire insurance policy. The policy excluded coverage when the house had been vacant beyond a period of thirty consecutive days. A fire occurred May 19, 1966, destroying the home. Here is some of the trial testimony.