Dallas Fort Worth Insurance Lawyer Blog

Prompt Payment Of Claims Act After Appraisal

August 1, 2020 | Mark S. Humphreys

Recent Texas Supreme Court opinions have been helpful to Texas insureds. The help comes in the form of the Court deciding that an insurer by merely paying an appraisal award is no longer able to wash their hands of the case. The insured can still seek remedy under the Texas Prompt Payment of Claims Act (TPPCA).

The case is from the Texas Supreme Court and is styled, William Marchbanks v. Liberty Insurance Corporation.

At issue in this insurance dispute is whether an insurer’s payment of an appraisal award bars an insured’s claims under the TPPCA, codified as Chapter 542 of the Insurance Code. The court of appeals concluded it did. Because the court of appeals’ opinion is inconsistent with recent decisions on this issue, this Court now reverses.

Suing The Adjuster On Storm Damage Claims

July 29, 2020 | Mark S. Humphreys

Yet another case after the passage of Texas Insurance Code, Section 542A.006, dealing with suing the adjuster in storm damage claims. This is an issue that will eventually be addressed by the 5th Circuit. For now, this case is from the Northern District of Texas, Dallas Division, and is styled, Grant Stowell v. United Property & Casualty Insurance Company and Samantha Jenkins.

Stowell has a policy of insurance with United Property (UPC). Stowell suffered property damage after a hail storm and filed a claim with UPC. UPC assigned the claim to Jenkins. Stowell was not happy with the way the claim was handled in sued UPC and Jenkins in State Court for various violations of the Texas Insurance Code.

After the lawsuit was filed, UPC filed it’s election of responsibility, pursuant to Section 542A.006(c), in the State Court. UPC then removed the case to this Federal Court. Both Stowell and Jenkins are Texas citizens and thus, the joinder of Jenkins in the lawsuit beats diversity jurisdiction and thus, renders a lack of jurisdiction for this Federal Court.

Suing The Adjuster And Texas Insurance Code

July 26, 2020 | Mark S. Humphreys

Texas Insurance Code, Section 542A.006(c), is being a source of frequent litigation in Texas since it was en-acted. The various Federal Courts are treating it differently. Here is a case from the Western District of Texas, Austin Division, dealing with this issue. The case is styled, Shiv Partners LTD and Shiv Host, LLC D/B/A La Quinta Inn & Suites v. The Ohio Casualty Insurance Company and Kevin M. Witt.

La Quinta had suffered a loss as the result of storm damage. The insurer, Ohio, assigned the claim to Witt. Ohio is not a Texas resident but Witt is. La Quinta was displeased with the way the claim was handled and sued Ohio and Witt in State Court. La Quinta removed the case to Federal Court asserting that Witt had been improperly joined in the lawsuit thus, diversity existed between the parties giving the Federal Court jurisdiction of the lawsuit.

La Quinta failed to provide Ohio or Witt with pre-suit notification of 61 days prior to filing as required by Texas Insurance Code, Section 541.154 and 542A.003. The first notice of the lawsuit was when it was received by Ohio and Witt. Ohio then made immediate election of responsibility for Witt as allowed by Section 542A.006(c).

Suing The Adjusting Company

July 25, 2020 | Mark S. Humphreys

Here is another of the cases where the insured is suing the insurance adjuster and the insurance company is arguing the new law found in the Texas Insurance Code, Chapter 542A governs the case. The case is from the Southern District of Texas, Houston Division. It is styled, D.U.R. Properties LLC v. Amrisc LLC et al.

This case arises out of a storm damage claim. DUR had insurance coverage with Certain Underwrites at Lloyd’s London (Lloyd’s). DUR made a claim with Lloyd’s. Amrisc adjusted the claim for Lloyd’s and DUR alleges that Amrisc did a poor job adjusting the claim. DUR sued Lloyd’s and Amrisc in State Court and Lloyd’s had the case removed to Federeal Court based on the assertion that Amrisc, a Texas resident, was improperly joined and thus, diversity jurisdiction exists between Lloyd’s and DUR.

Fraudulent joinder – a heavy burden – requires the moving party to show either: (1) actual fraud in the jurisdictional pleadings of the facts; or (2) the plaintiff is unable to establish a claim against the non-diverse party in state court. Lloyd’s does not assert actual fraud and instead agrees that DUR and Amrisc are Texas citizens. Thus, the Court turns to whether Lloyd’s can show DUR is unable to establish a claim against Amrisc in State Court.

Life Insurance And ERISA

July 22, 2020 | Mark S. Humphreys

Here is a case arising out of the Employee Retirement Income Security Act (ERISA) which involves life insurance. The case is from the Northern District of Texas, Lubbock Division. It is styled, Elizabeth Hernandez v. Unum Group v. Sara Hernandez and Jose Hernandez.

The basic Facts are that Xavier Hernandez had a policy of live insurance with his employer that was part of an ERISA plan. On May 24, 2018, Xavier was killed in an auto accident.

From August 2015, until May 2018, Xavier was married to Sara Hemandez. In January 2018, Xavier designated Sara as the beneficiary of his life insurance policy. Weeks before Xavier’s death, he and Sara divorced. The divorce decree indicates that both Sara and Xavier were present at the proceeding and does not mention Xavier’s life insurance policy. Sara represents that, at the time of the divorce, she was unaware that she was the beneficiary under Xavier,s policy and only became aware once Xavier’s employer advised her of her status. She maintains that she did not waive her rights as a beneficiary under the policy in the divorce decree or elsewhere.

Non-Renewal Of Policy

July 19, 2020 | Mark S. Humphreys

Here is a homeowners claim from the Northern District of Texas, Amarillo Division, that is interesting. The case is styled, Valerie Smith v. State Farm Lloyds.

This is a summary judgment opinion wherein State Farm asserts that it is entitled to summary judgment because it notified Smith two months before a fire destroyed her home that her homeowners policy had not been renewed.

Smith asserts she never received notice that the policy had expired.

Life Insurance And Additional Recovery

July 18, 2020 | Mark S. Humphreys

Life insurance claims which are denied, often end up being litigated in Federal Court and thus, have to be analyzed differently than when in State Court. Here is a case from the Northern District of Texas, Dallas Division, which illustrates why an experienced insurance law attorney is needed. The opinion is styled, State Farm Life Insurance Company v. Mae Katheryn Bryant and Amy Cannon.

This is an interpleader case. The ruling is the result of State Farm filing a Rule 12(b)(6) Motion to Dismiss and a Rule 12(b)(1) Motion to Dismiss.

Bryant and Cannon both claimed to be entitled to the insurance proceeds after the death of Cannon’s deceased ex-husband. The Court eventually ruled that Bryant was entitled to the money. As a result of that ruling, State Farm requested that the Court dismiss Cannon’s claim against State Farm.

Interpreting An Insurance Policy When The Policy Establishes Limits

July 15, 2020 | Mark S. Humphreys

Here is a case that is seen frequently. It will be interesting to see if this is what all Federal Courts faced with this situation decide. This opinion is from the Northern District of Texas, Dallas Division, and is styled, Sharon Wihlenmaier v. Allstate Indemnity Company.

Plaintiff filed her Original Petition in State District Court against Allstate alleging that Allstate improperly denied her uninsured/underinsured motorist benefits (UIM) arising out of a vehicle accident. The Original Petition states that Plaintiff seeks monetary relief over $200,000.00 but not more than $1,000,000.00. Allstate’s policy limits for UIM benefits in the policy at issue are $30,000.00. Allstate timely removed the case from the State Court to this Federal Court and Plaintiff filed her Motion to Remand.

Stating the law, the Court said that pursuant to 28 U.S.C., Section 1441(a), it has jurisdiction over the matter if the amount in controversy exceeds $75,000.00 and the parties are diverse. Here, Allstate is a citizen of another state, so diversity exists. The next issue to decide is whether the amount in controversy exceeds $75,000.00.

Life Insurance Claims And Federal Court

July 12, 2020 | Mark S. Humphreys

Life insurance claims which are denied, often end up being litigated in Federal Court. Here is a case from the Northern District of Texas, Dallas Division, which illustrates why an experienced insurance law attorney is needed, particularly when the case is going to be litigated in Federal Court. The opinion discusses more than will be discussed here and is a must read for lawyers handling a case in Federal Court. The opinion is styled, State Farm Life Insurance Company v. Mae Katheryn Bryant and Amy Cannon.

This is an interpleader case. The ruling is the result of State Farm filing a Rule 12(b)(6) Motion to Dismiss and a Rule 12(b)(1) Motion to Dismiss.

Factually, Cannon and Bryant both submitted claims to recover Policy proceeds of $300,000.00 after the insured’s death. Cannon contends that she is entitled to the policy proceeds as the primary beneficiary under the Policy. Bryant maintains that she is entitled to the Policy proceeds as the successor beneficiary under the Policy and as the mother and heir of her son because the Insured’s and Cannon’s divorce decree did not designate Cannon as a beneficiary under the Policy,and the Insured did not re-designate Cannon as his beneficiary under the Policy after their divorce as required by Texas law. The Court eventually ruled against Cannon being entitled to any policy proceeds.

Life Insurance Through Employer

July 11, 2020 | Mark S. Humphreys

Insurance lawyers will get frequent phone calls from a life insurance beneficiary wherein the beneficiary had a spouse who has died and that spouse had life insurance that had been obtained through their employer/work. This was the case in a recent opinion from the Western District of Texas, El Paso Division. The style of the case is Vanessa St. Pierre v. Dearborn National Life Insurance Company.

The facts of this case a somewhat confusing the opinion needs to be read to get what the exact facts were in this case. However, the law related to insurance coverage when it is purchased through employment is discussed and knowing about this law is important when it comes to being able to properly discuss with clients the possible outcome in a case.

Quoting from the case: