A claim being denied doesn’t necessarily mean an expert has to be hired in the case. But when an expert is needed the correct legal process must be followed. This is illustrated in a 2024 opinion from the Southern District of Texas, Houston Division. The opinion is styled, Dora Doss…
Articles Posted in Claims Denial
Insurance Coverage And Willful Acts
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…
Cooperation Requirement With Insurance Company
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,…
Duty To Cooperate With Insurance Company
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…
Homeowner’s Claim And Damage Segregation
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…
Statute Of Limitations On First Party Insurance Claims
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.…
Claims Denial For Failure To Cooperate
An insured under an insurance policy has a duty to cooperate with an insurance company investigation of a claim. This issue is discussed in the 2024 opinion, Henry & Lydia Ansah v. Nationwide Property and Casualty Insurance Company. The opinion is from the Southern District of Texas, Houston Division. The…
Claims Denial Due To Misrepresentation
A misrepresentation in an insurance application is grounds for denial of a claim but it is not necessarily a win for the insurance company. This issue is discussed in a recent opinion from the Texas 14th Court of Appeals. The opinion is styled, Jose Palma v. Allied Trust Insurance Co.…
The Insurance Policy Definitions
Here is a 2024 opinion from the Northern District of Texas, Dallas Division, that deals with an insurance policy. Specifically, the wording of an insurance policy. The opinion is styled, Johnetta Askew Hunt v. Meridian Security Insurance Company State Auto Insurance Companies. This is a summary judgment opinion regarding “residing”…
Insurance Claims And Statute Of Limitations
Insurance lawyers need to read this November 2023, opinion from the Southern District of Texas, McAllen Division. It is styled, Bertha Salinas v. State Farm Lloyds. The relevant facts are undisputed, Bertha sued State Farm for denying her claim against her homeowners policy due to a weather event on July…