The United States Court of Appeals for the Fifth Circuit is a federal court located outside of Texas. Cases that originate in Texas, including the Dallas, Fort Worth, Arlington, and Grand Prairie areas will end up in this Fifth Circuit Court when it is on an appeal.

A case decided in late December of 2009 discusses “notice” provisions in insurance policies. These provisions are important for the people or businesses who have these policies to understand.

The case is styled, “East Texas Medical Center Regional Healthcare System v. Lexington Insurance Co”.

Very few people doubt that the face of America is changing in that more and more companies are changing the way benefits are provided to employees. The automotive industry is probably the biggest example of this change. Along with the automotive companies themselves, the changes effect all the companies that are intertwined with the big auto companies.

But it is not just the automotive companies. The same is happening in the airline industry, other transportation companies, and all phases of manufacturing. These changes include changes to wages, health care, retirement, and other benefits.

NewPage Corporation is a company that makes paper products. The Dayton Daily News recently ran an article wherein it reports on a change being made by NewPage in the way it handles health-care benfits for its premiums as it relates to their retirees.

Residents of Dallas, Fort Worth, Arlington, Grand Prairie, and surrounding areas are fortunate in that they are not having to deal with the difficulties being faced by homeowners in the Gulf Coast areas of Texas, Louisiana, Mississippi, Alabama, and Florida. The damages following hurricanes Ike, Katrina, and others are causing nightmares for homeowners who are trying to get their insurance companies to properly and promptly pay the claims for damages to their homes.

The Sun Herald ran an article on December 21, 2009, that addresses more of the continueing problems these Gulf Coast residents are having with their insurance companies. The title of the article, “State Farm pays up, but argues award was in error”, doesn’t tell the whole story.

State Farm Fire & Casualty Company, recently paid a couple $179,100.31 for Katrina damage, but the check came to late to save the home of Henry and June Kuehn. The now years old claim of the Kuehn’s, was ordered to be paid by a U.S. District Judge, back in August of 2009. This ordered payment was based on an appraisal award reached by an appraiser for each side, State Farm and the Kuehn’s, and an umpire, who said the amount they considered was only for damage above the second-story water line in the house.

The Supreme Court of Texas issued an opinion on a case on December 11, 2009, that will make insurance companies who have issued commercial policies, to take a second look before denying a claim in certain situations.

The case involved here is titled, D.R. Horton-Texas, LTD. v. Markel International Insurance Company, LTD. This case came out of the Texas Court of Appeals in Houston. It could have been a case arising out of the Dallas or Fort Worth or surrounding areas like Arlington, Grand Praire, or Irving.

In this case, a couple, the Holmes, purchased a home from the builder, D.R. Horton-Texas, LTD. Defects in construction were discovered and as a result of these defects, mold had infested the home. The Holmes sued Horton, saying Horton was responsible for the problems Holmes was experiencing. It appeared ,a sub-contractor, Ramirez, was the person who caused the problems. Ramirez had an insurance policy from Markel International Insurance Company, LTD. Horton sought coverage from Markel, based on the Ramirez policy wherein Horton was an additional insured. Markel refused to get involved and Horton eventually settled the case, then sought reimbursement of defense costs and the settlement payment from Horton, the result of which was this lawsuit.

For those of us living in the Dallas, Fort Worth, Arlington, and Grand Prairie areas of Texas, National Flood Insurance programs are not usually an issue. But this type of insurance is available and sold in Dallas, Tarrant, Parker, and other counties throughout the State of Texas. Knowing a little bit about these programs is helpful and will put you more in the drivers seat when talking with your insurance agent when considering buying this type of insurance.

As with a lot of Federally controlled programs, the consumer is limited in his available remedies when he is mis-treated by the companies administering these programs. The Houston Chronicle ran a story recently giving an example of how these Federal Flood Insurance programs can be nightmares for the consumers involved. The article is titled “Ike Case HIts A New Obstacle”, and illustrates some of the problems homeowners experience when making a claim for coverage.

When there is a dispute, the insurance adjuster will try to get the homeowner to agree to going to arbitration as a way to settle the insurance dispute. Most people will jump at this option thinking to themselves that this will result in a quick settlement and save time and money, including attorneys fees. It turns out that the arbitration process is not necessarily quick nor cheap.

The following is a short discussion of a case trying to interpret Missouri law, in part. The relevance to people in Dallas, Fort Worth, Arlington, or Grand Prairie areas is that the case was heard in a Texas Court in the Southern District of Texas and that the appeal was to the United States Court of Appeals for the Fifth Circuit, which is a Court that makes decisions regarding lots of Texas cases.

The case is Westchester Surplus Lines Insurance Company v. Maverick Tube Corporation. The opinion of the Court was issued on December 10, 2009.

The dispute involved the application of Missouri state law in determining if an insurance “occurrence” and the duty of the insurance company to indemnify existed.

The Chinese drywall cases that have been in the news the last year or so, are primarily affecting home owners along the Gulf Coast. If you live in Texas you are not likely to be affected by the claims resulting from these defective drywalls. Especially if you live in the crowded Dallas and Fort Worth areas. However if you live in areas such as Louisiana and Mississippi, these cases are attracting a lot of attention.

The Times-Picayune recently ran a story that addressed the drywall cases that have been causing problems since the hurricanes in recent years. This story informs its readers that New Orleans Saints coach Sean Payton is the lead plaintiff in a 591-page class action Chinese drywall suit. The company being sued is Knauf Plasterboard Tainjin Co. Ltd., a Chinese company manufacturing company producing the drywall.

The drywall at issue in this case is supposedly causing homes to corrode and making people sick. In the context of homeowners insurance, a lot of insurance companies are refusing coverage for the losses caused by this drywall being installed in the homes.

The Texas Department of Insurance has recently released the Commissioners Order regarding State Farm Homeowners rate reduction and refund fight.

This order is the result of a re-hearing . The original reduction order was first issued in 2003, but was remanded by the Third Court of Appeals in Texas in 2008 to the Texas Department of Insurance for further proceedings due to their finding that a portion of the underlying law enacted in 2003 was unconstitutional.

The total amount of the refund, including interest, is estimated to be about $310 million. Individual amounts will vary among policyholders, with differences based, in large part, on the length of time with the company and the amount of premium paid to State Farm. Further information regarding refunds or premium credits to policyholders, both current and former, will be made available pending any appeal of the order.

Most people do not understand that there are two main kinds of law. The first, most people are familiar with, and we will call statutory law. This is the law that is written down by the legislative branch of government. For purposes of Insurance Law, it is the Sections, Chapters, and Subchapters of the Insurance Code.

The other kind of law, which most people are not aware of, is called the “common law”. The common law is the law that applies to situations even though the law is not specifically written down in a book somewhere.

Under Texas law, there is a “common law” duty for an insurance company to deal with one of its insureds in certain ways. This is called the the duty of good faith and fair dealing. When an insurance company does not honor its common law duty of dealing with one of its insureds in good faith, it is called “bad faith”. This concept was discussed by the Texas Supreme Court in 1987, in the case Arnold v. Nat. County Mut. Fire Ins. Co.

This blog does not try to spend time on the health care debate occurring on the National scene. Rather the focus here is to make people aware of their rights as they relate to their dealings with insurance companies and why they need an experience Insurance Law Attorney when faced with a problem when dealing with an insurance company. The occassional news item is thrown in when it relates to a large number of people, some of whom may be in Texas.

Recent articles on the Chinese drywall, sold by Knauf Plasterboard Tianjin, affecting many residents along the Gulf Coast pointed out that new construction and remodeling done after hurricanes hit the areas on the Gulf Coast have left many homeowners in rough financial situations. This is because many insurance companies refuse to cover the losses resulting from using this drywall.

One recent article points out that the deadline for involvement in a national class action lawsuit against Knauf Plasterboard Tianjin expired on December 2. This lawsuit involves about 35,000 Florida homes where about 30 percent of the installations of this drywall are believed to have occurred.

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