A frequent phone call to insurance law lawyers is someone asking about participating in an examination under oath (EUO). Most people understand what taking the 5th means. It refers to our right to not be compelled to say anything that may be self-incriminating. It usually is discussed in the context…
Are spouses entitled to life insurance benefits? That is a normal question in a lot of life insurance cases. Here is some law in that regard. One spouse can designate his or her estate as the beneficiary of the policy, at the expense of the other spouse, absent any showing…
Many situations involving insurance claims also involve issues dealing with subrogation and liens. Here is a little information for insurance lawyers who might have to deal with subrogation. Subrogation is an element of insurance law. In 1944, the United States Supreme Court in the case styled, United States v. South-Eastern…
This may come as a surprise to many but here goes, — There is no such thing as “negligent claims handling” recognized by Texas courts. This is re-stated by the U.S. District Court, Western District, Austin Division, in the case styled, Thomas G. Kezar and Sylvia Kezar v. State Farm…
The 5th Circuit Court of Appeals issued an opinion regarding commercial policies that would be of interest to some businesses. The case is styled, Sierra Equipment, Incorporated v. Lexington Insurance Company. Lexington insured LWL Management for construction equipment leased from Sierra. Sierra argues that, even though it was not a…
Insurance cases involving umpire’s are a little different. The Amarillo Court of Appeals issued an opinion on May 14, 2018, styled, Mahmoud Abdalla v. Farmers Insurance Exchange. The case deals with, among other issues, when an umpire’s appraisal award can be challenged. This case is an appeal by Abdalla from…
Here are a few articles for insurance lawyers handling commercial policy cases. Commercial auto policies often contain business use exclusions that exclude coverage when a scheduled auto is used “in the business” of a lessee. A policy containing such a provision is effectively know as a “bobtail” or “non-trucking use”…
Lawyers who handle Employee Retirement Income Security Act (ERISA) claims will tell that insurance claims made on an individual policy and claims made on an ERISA plan are remarkably different. ERISA requires that the insurer or third-party claims administrator engage in a dialogue with the claimant about the claim and…
Discretionary Clauses in Employee Retirement Income Security Act (ERISA) policies — In protecting deference in the face of substantial claims procedure violations, the United States 5th Circuit’s position not only conflict with other United States Circuits but with the Texas Department of Insurance and other state insurance commissioners regarding what…
The United States 5th Circuit Court of Appeals has never found sufficient claims procedure abuse to warrant a change in the standard of review from abuse of discretion to a preponderance of the evidence in an Employee Retirement Income Security Act (ERISA) case. In that regard, the court has noted…