Dallas Fort Worth Insurance Lawyer Blog

Insurance Coverage And Willful Acts

December 14, 2024 | Mark S. Humphreys

Insurance usually covers accident that happen or acts of God, negligence, etc., things that are Unintentional. Policies will rarely cover willful or intentional conduct that causes harm.

The above is illustrated in a 2024 opinion from the Eastern District of Texas, Sherman Division. The opinion is styled, Jacksonville, Realty, LLC v. Certain Underwriters At Lloyds.

The Plaintiff, Jacksonville, filed a summary judgement seeks the Court to rule that the policy contract had been broken by the Defendant. The policy at issue is an errors and omissions policy. Miller Title acted as the escrow agent for a real estate transaction between Jacksonville and IBF Retail I, LLC. As part of the transaction, IBF deposited $2,750,000 in earnest money with Miller Title.

Late Payment Claims And Death

December 7, 2024 | Mark S. Humphreys

Insurance claims that are not timely paid and in violation of the Texas Prompt Payment of Claims Act, do those claims survive the death of the insured? This topic is discussed in a 2024 opinion from the Eastern District of Texas, Beaumont Division. The opinion is styled, Brenda barron, Temporary Administratrix Of The Estate Of Larry Barron, Deceased v. Century Surety Company, d/b/a Century Insurance Group.

The issue here is whether an insured’s claim for statutory interest and attorney fees under chapter 542 of the Texas Insurance Code survives their death. In February 2021, Larry Barron’s commercial building was damaged by a winter storm. The building was insured by Century. After Century refused to pay all of Barron’s claim, he sued Century for breach of contract, statutory bad faith, and statutory interest and attorney fees under chapter 542. Following the parties’ motions for summary judgment, the court dismissed his claim for bad faith.

Sadly, Larry Barron passed away on December 17, 2023. Brenda Barron replaced him in this lawsuit as the administratrix of his estate. In Century’s present motion for summary judgment, it argues that none of the insured’s extra-contractual claims survive his death. In response, Barron says that at least the claim for statutory bad faith should survive. But because that claim has already been dismissed, the undersigned only needs to address the remaining extra-contractual claims for statutory damages and attorney fees under chapter 542.

Cooperation Requirement With Insurance Company

November 30, 2024 | Mark S. Humphreys

Cooperating with the your own insurance company when making a claim for policy benefits is almost always a requirement in the policy. An opinion discussing this was issued by the Tyler Court of Appeals in 2024. The opinion is styled, Kenneth R. Cade v. State Farm Lloyds.

On April 18, 2019, a windstorm blew a large tree onto a portion of Cade’s house that was insured by State Farm. Cade eventually made a claim for damage to the structure and contents. Several inspections were made and payment was made totaling approximately $30,000. The personal property claim was not made until about 18 months later, claiming several items of personal property were damaged or destroyed. A lawsuit resulted after State Farm denied paying further damages citing a lack of cooperation by Cade with the claim. State Farm filed a motion for summary judgement which was granted.

The opinion details many more of the facts and testimony in the case which should be read. This article will cite the law related to this type of claim.

Insurance Agents And Lawsuits

November 23, 2024 | Mark S. Humphreys

Insurance agents who make mistakes in selling an insurance policy will sometimes end up being sued along with the insurance company issuing the policy. From a strategy point of view it is often times desirable to sue the agent to keep the lawsuit from being litigated in Federal Court. Here is a 2024 opinion dealing with how to sue the agent correctly. The opinion is from the Eastern District of Texas, Judge Campbell Barker. The opinion is styled, William McCalister v. United States Liability Insurance Company et al.

At issue in this insurance-coverage dispute is plaintiff ’s motion to remand the case back to state court for lack of subject-matter jurisdiction. This hinges on whether plaintiff improperly joined defendant Amanda DeShazo, the insurance agent who sold the policy to plaintiff. The petition asserted claims under the Texas Insurance Code, Section 541.061(1), the Texas Deceptive Trade Practices Act, Section 17.46(b)(5), and common-law breach of contract. Mostly these claims fit into two categories: misrepresentation and denial. The former pertains to front-end misrepresentations about the scope of the policy.

The statutory basis for removal is 28 U.S.C. § 1441(a), which provides that defendants may remove from state court “any civil action brought in a State court of which the district courts of the United States have original jurisdiction.” The relevant limitation is found in the next subsection: “A civil action otherwise removable solely on the basis of the jurisdiction under section 1332(a) of this title may not be removed if any of the parties in interest properly joined and served as defendants is a citizen of the State in which such action is brought.” As alluded to above, the basis for subject-matter jurisdiction in this case is diversity of citizenship under § 1332(a). Thus, if DeShazo was properly joined, then this court lacks jurisdiction and must remand.

Duty To Cooperate With Insurance Company

November 16, 2024 | Mark S. Humphreys

The duty to cooperate with the insurance company investigation of a claim is something a lot of people don’t realize. When it is your own insurance company, the insurance contract requires the insured to cooperate with the insurance company investigation of the claim.

This issue was the point of contention in a 2024 opinion from the Southern District of Texas, Houston Division. The opinion is styled, Raymond Funes v. Allstate Vehicle And Property Insurance Company.

In this case, the facts are generally undisputed. Plaintiff filed a claim in or around February 2021 for broken pipes at his property that was insured by Defendant. He withdrew the claim in March 2021, but then retained an attorney and pursued the claim with Defendant in February 2023. Defendant inspected the property and found that the home had been re-piped. It requested the plumbing report and or invoice for the re-piping, but Plaintiff failed to oblige. As such, Defendant denied the request for appraisal for “lack of cooperation by the insured.” Subsequently, Plaintiff brought this suit.

Bad Faith Claims And The Statute Of Limitations

November 9, 2024 | Mark S. Humphreys

Bad Faith claims have a statute of limitations and that limitations period must be strictly followed. This issue is discussed in a 2024 opinion from the Northern District of Texas, Fort Worth Division. The opinion is styled, Shalport, Inc. d/b/a Chevron #36316 v. Amguard Insurance Company.

Shalport, Inc. (“Plaintiff”) is the business owner of a Chevron gas station and convenience store (the “property”), which includes a car wash on its premises. Plaintiff owns commercial property insurance, which was issued by AmGUARD Insurance Company (“Defendant”). On or around December 1, 2021, the car wash on the property sustained severe damage. The damage to the carwash rendered it inoperative. Plaintiff submitted a claim for coverage to AmGUARD. AmGUARD acknowledged the claim and assigned it to a third-party administrator, Raphael & Associates. On April 20, 2022, Raphael & Associates sent Plaintiff a letter stating that no coverage existed under the policy and as such, no payment would be issued for the claim.

Plaintiff retained G.T.O. Car Wash to inspect the car wash and determine the monetary cost of restoring it to its pre-damaged condition. Plaintiff again asked AmGUARD to cover the cost of repairs pursuant to the policy.

Homeowner’s Claim And Damage Segregation

November 2, 2024 | Mark S. Humphreys

Here is a 2024 opinion from the Western District of Texas, Austin Division, that deals with segregating damages in a homeowners claim. The opinion is styled, David Espinoza v. State Farm Lloyds.

Espinoza had a State Farm homeowners policy in force when a storm caused damage to his home. The claim was partially paid but State Farm but denied as to the full claim with State Farm alleging some of the damages were caused by matters not covered by the policy. State Farm filed a motion for summary judgment based on Plaintiff being unable to segregate the covered damages from the uncovered damages.

For an insurance company to be liable for a breach of its duty to satisfy a claim presented by its insured, the insured must prove that its claim falls within the insuring agreement of the policy.

Life Insurance – State Law Versus Federal Law

October 26, 2024 | Mark S. Humphreys

Most life insurance policies are regulated by State Law. But, what if the life insurance policy at issue is governed by Federal Law? It’s simple, Federal Law pre-empts State Law. This is illustrated in the 2001, United States Supreme Court opinion styled, Egelhoff v. Egelhoff.

The Egelhoff opinion, the Supreme Court held that the Employee Retirement Income Security Act (ERISA) preempts a state law that revokes a life insurance policy beneficiary designation when spouses divorce. The state statute as issue in the Egelhoff opinion provided that if the life insurance beneficiary designation of an ex-spouse was made before the divorce, that designation was considered revoked. Because the insurance was part of an employee benefit plan, the Supreme Court held that ERISA preempted state law so that the benefits would be paid in accordance with the plan documents. The insured had not changed the beneficiary designation according to the plan, so his ex-wife received the benefits. Texas has a statute which would be prevented, that statute being Texas Family Code, section 9.301.

Homeowners Claim Where Insurance Company Says It’s Arson

October 19, 2024 | Mark S. Humphreys

Here is a 2024 opinion from the Southern District of Texas, Houston Division, wherein the insurance company, State Farm Lloyd’s, is refusing to pay the claim because State Farm believes the insured cause the fire on purpose in an effort to collect insurance monies. The opinion is styled, Raynelle King v. State Farm Lloyds.

On November 18, 2018, a late-night fire broke out in King’s home, and King filed a claim with State Farm. Arson investigators later found gasoline residue in debris samples from the room where the fire started. King was apparently in considerable financial distress at the time. As a result, State Farm denied King’s claim alleging that she had set fire to her own home. King sued, arguing that State Farm wrongfully denied her claim. State Farm has now filed a Motion for Summary Judgment. State Farm asks the Court to find that King committed arson and therefore cannot recover under the policy. After careful review, the Court finds that there is a genuine dispute of material fact, and State Farm is not entitled to judgment as a matter of law. The Court, therefore, DENIES the Motion.

On the night of November 18, 2018, Plaintiff King’s house caught fire, which caused extensive damage. At the time, King held a homeowner’s insurance policy from State Farm that covered fire loss, among other things. King submitted a claim for damages under her policy, which State Farm denied. King sued State Farm for failing to pay out her insurance policy. She asserts various causes of action under

Statute Of Limitations On First Party Insurance Claims

October 12, 2024 | Mark S. Humphreys

It is important to understand the time frame under which lawsuits must be filed. As part of that, reading the insurance policy is vital. A 2024 opinion from the Western District of Texas, Del Rio Division, discusses limitation periods written into insurance policies. The opinion is styled, Antonio Caballero v. Allstate Vehicle And Property Insurance Company .

This case was decided on the summary judgment motion filed by Allstate.

This matter arises from an insurance claim. The Plaintiff alleges hail storm property damage in excess of $20o,000. The Plaintiff filed a claim with the Defendant on December 13, 2018. The Defendant denied the Plaintiff’s claim on October 11, 2019. The Plaintiff filed suit in Texas state court on August 21, 2023, asserting: violations of the Texas Insurance Code and breach of contract among other causes of action.