All insurance lawyers understand that there are time limits within which an insurance company must accept and pay the claim or else deny the claim. And it is also understood that the insured making the claim has an absolute duty to cooperate with the claims investigation. But what about a…
Here is an insurance case that was appealed to the Fort Worth Court of Appeals. The case is styled, Joseph Lambert and Susan Lambert v. State Farm Lloyds and Tevin Senne. The appeal involved a few issues but the one focused on here deals with the Texas Prompt Payment of…
Just saying the claim was paid is not enough. In Court, the insurance company needs to prove the claim was paid and paid timely in order to prevail on a Motion For Summary Judgment. Here is a case from the Northern District of Texas, Dallas Division. It is styled, Carolyn…
Insurance lawyers need to know the time lines for an insurance company to pay claims under the Texas Prompt Payment of Claims Act and they need to know the legal reasons for those time lines being extended. Pursuant to Texas Insurance Code, Section 542.056(d), if the insurance company cannot accept…
The next question in this series related to violations of the Texas Prompt Payment of Claims Act is, what are some of the defenses the insurance company has for not making prompt payment on a claim. The statute contains several provisions by which insurance companies may extend the deadlines. While,…
Additional remedies under the Texas Prompt Payment of Claims include attorney fees. Attorney fees under the statute are governed by the 1997, Texas Supreme Court opinion, Arthur Andersen & Co. v. Perry Equipment Corp. In that case, the court held that a reasonable fee must be based on eight factors…
Under the 18% penalty imposed by Texas Insurance Code, Section 542.060, what is the effect if there is a finding of multiple violations? Does the result of result of multiple violations result in multiple penalties? In applying the Texas Prompt Payment of Claims Act and Section 542.060, the 1999, Tyler…
How to label the 18% penalty in the Texas Prompt Payment of Claims Act is a topic of much discussion in Insurance Law circles. How is Section 542.060 to be labeled? Maybe the damages awarded under the prompt payment statute are awarded simply for a failure to comply with a…
Opinions related to the Texas Prompt Payment of Claims Act and in particular the 18% penalty found in Section 542.060, have differed as to whether or not the 18% damages must be exemplary damages and not actual damage. In that regard; First, it is not clear at all that the…
Respected writers, Robert E. Keeton and Alan I. Widiss, argue that damages under the Texas Prompt Payment of Claims Act, Section 542.060(a), have a purpose of providing compensation to the insured. They write: The statutory provisions establishing remedies for the late payment or nonpayment of insurance claims are often regarded,…