Employee Retirement Income Security Act (ERISA) issues can be more onerous than most people can imagine. Most people who get their insurance from work do not think about it except the the extent of how much it costs, the extent of coverage, and which providers are in the network. Rarely…
The Employee Retirement Income Security Act, otherwise known as ERISA provides for insurance benefits that are vital to claimants and their families. An ERISA claim denial means that the claimant did not receive the medical treatment, disability income, life insurance or retirement benefits that the claimant expected under the plan. …
Who is entitled to life insurance benefits is not always an easy answer. The designated beneficiary of a life insurance policy generally is entitled to the proceeds upon the death of the insured. Absent an adverse claim, the insurer may pay the benefits to the designated beneficiary. This is not…
Pinning down the exact date coverage begins can sometimes be a tricky proposition. If an insured dies before a policy becomes effective, there is no coverage. This was discussed in the 1950, Texas Supreme Court opinion, Republic National Life Insurance Company v. Hall. and the 1980, Eastland Court of Appeals…
Life insurance lawyers will see many reasons for denial of life insurance benefits. Occasionally, one of the reasons is that the policy had not become effective at the time of death. Most policies state the “effective date” of coverage. This date may be earlier than, or later than, the date…
Almost all auto policies will have a form to fill out called a 515A. This form when filled out and signed excludes named drivers from any coverage while they are operating the otherwise insured vehicle. This topic was discussed in a declaratory judgement opinion from the Dallas Court of Appeals…
The U.S. District Court, Eastern District, Sherman Division, issued an opinion in May 2018, styled, James Cunningham and Tabatha Cunningham v. Allstate Vehicle and Property Insurance Company. The Cunningham’s allegedly suffered damages during a hail and windstorm. The claim was reported to Allstate and five days later Allstate inspected the…
ERISA cases are complicated, as any attorney handling ERISA cases can tell you. This is exemplified in an April 2018, opinion from the U.S. District Court, Western Division, Austin Texas. The opinion is styled, Kimberley Phillips v. Charter Communications, Inc. Welfare Benefit Plan. Charter filed a motion to transfer the…
The United States District Court, Northern District, Dallas Division, issued an opinion in April 2018, titled, Grand Hotel Hospitality LLC d/b/a Grand Hotel Dallas v. Certain Underwriters at Lloyd’s of London et al. This is a breach of contract case where Grand Hotel suffered a fire damage and sued Lloyd’s…
Life insurance policies are required to have certain provisions. To begin with, all life insurance policy forms have to be approved by the Texas Department of Insurance. Texas Insurance Code, Section 1101.004 requires that all policies allow a grace period of at least a month. Section 1101.003 requires that the…