Dallas Fort Worth Insurance Lawyer BlogAttorneys in Weatherford, Grand Prairie, Fort Worth, Mineral Wells, or anywhere else in Texas have to have an understanding of insurance law to handle insurance disputes effectively for clients.
There are different ways of recovering when insurance disputes arise. Many of these theories of recovery have common elements.
Insurance transactions tend to resemble one another, so disputes arising from them tend to resemble one another. There are only so many ways that an insurance company and their customer can get crossways. Most situations present recurring problems that can be grouped into categories. Insurance law is even more precedent-driven than other areas of law, as courts try to construe similar policy language consistently. It is not surprising that many cases start to look alike.
The key is to find good authorities that match your facts, or to emphasize the facts that match good authorities. These authorities are found in several places:
1. The Texas Department of Insurance;
2. The Texas Insurance Code;
3. The Texas Administrative Code;
4. Texas Courts such as the Texas Supreme Court, interpreting the laws.
The starting point though is the insurance contract itself. The initial inquiry almost always begins with the language of the contract to determine what is covered and what is not. Other tort and statutory theories may logically depend on the existence of coverage, or may exist independent of coverage. The interplay between recovery for breach of contract and recovery under theories is a broad discussion. Beyond a lawsuit for breach of contract, most insurance cases can be grouped into these categories:
(1) misrepresentations (2) nondisclosures (3) unfair settlement practices; and (4) other misconduct MISREPRESENTATIONS
One of the most common bases for an insurance dispute is the complaint that someone misrepresented something. After a claim arises, the customer may feel that the coverage accepted by the insurer is less than the coverage promised at the time of sale. Depending on the facts of the case, a representation by the insurance company or its agent may lead to liability for breach of contract, unfair insurance practices, deceptive trade practices, negligence, or fraud.
NONDISCLOSURES
Closely related to misrepresentation is the theory that the insurance company, agent, or insured failed to adequately disclose information. For example, if an exclusion is not adequately disclosed, the insurance company may be liable for breach of contract by relying on the exclusion to deny a claim. Failing to adequately disclose limitations or exceptions to coverage may also make the insurance company or agent liable for unfair insurance practices or deceptive trade practices.
UNFAIR SETTLEMENT PRACTICES
Several statutory prohibitions are specifically aimed at settlement practices. Liability may arise from failing to pay benefits that are owed under the policy, for failing to pay benefits that were promised by the agent, for failing to act promptly to settle once liability is reasonably clear, for paying too little, or for paying too slowly. Liability may also arise from the insurance company’s failure to adequately investigate the claim.
OTHER MISCONDUCT
Other disputes may arise that do not fit neatly within the above categories, such as unreasonable cancellation of a policy, unconscionable conduct, or unfair discrimination.
Advice from an experienced Insurance Law Attorney is what is most important when confronted with a situation where an insurance company is not living up to its responsibilities to one of its customers.
Attorneys And Insurance Law
