Articles Posted in Bad Faith Insurance

The general rule in first party insurance cases is that in order to recover for bad faith insurance causes of action and insured must first prove a breach of the insurance contract.  There is an exception to this rule.  The exception is discussed in this July, 2018, opinion from the United States 5th Circuit.  The opinion is styled, Glen Moore v. Allstate Texas Lloyd’s.

This case is an appeal from a summary judgment granted in favor of Allstate.  The case resulted from a lawsuit filed in State Court and the removed to Federal Court by Allstate.  This court sustained the ruling in favor of Allstate.

Moore alleged his property “suffered incredible damage due to storm related conditions.”  Moore alleged there were a “laundry list of perils, which Allstate would not cover under the claim.”

The United States District Court, Eastern District, Marshall Division, issued an opinion on June 27, 2018, that discusses the law regarding the above title.  The opinion is styled, Medallion Transport & Logistics, LLC v. AIG Claims, Inc., Granite State Insurance Co., and Jay Carman.

The facts of the case will not be discussed here but can be read in the opinion.  It deals with the refusal of an insurer to pay a Stowers demand.  The opinion is a good read for it’s discussion of Texas Insurance Code, Section 541.060(a).  The allegation was that the defendants in the case failed to effectuate a prompt, fair, and equitable settlement of a claim for which the insurer’s liability had become reasonably clear.  Also, part of the claim dealt with Texas Insurance Code, Section 541.060(a)(7) wherein the defendants were accused of refusing to pay a claim without conducting a reasonable investigation of the claim.

The Texas Supreme Court has held that liability under the language of Section 541.060(a)(2)(A) requires the insured the show “that (1) the policy covers the claim, (2) the insured’s liability is reasonably clear, (3) the claimant has made a proper settlement demand within policy limits, and (4) the demand’s terms are such that an ordinary prudent insurer would accept it.”  Unlike a Stowers claim, the statute requires a bad-faith component.  The statute defines the foregoing failure to act in good faith as an unfair or deceptive act.  That means in the context of resisting a “no evidence” motion for summary judgment, the plaintiff must show some evidence that the insurer had no reasonable basis for denying or delaying payment or settlement of a claim.

Bad faith is hard to prove in Texas.  The standards for getting a bad faith judgment are high standards.  But it can be done.  It just depends on the circumstances of the case.

The Telegraph, a Macon Georgia, newspaper published the results of a bad faith case involving Geico insurance.  The article is titled, Federal Jury Finds Geico Acted In Bad Faith, Awards Smiths Station Cyclist $2.763 Million.

Here is what the article tells us.

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 Lloyds.

The Kezars home was damaged in a fire and they made a claim with their insurer, State Farm.  A lawsuit was eventually filed as a result of the claim.

Texas insurance lawyers are always asking the above question when someone comes to see them about an insurance company doing them wrong.

To start with, as the contracting party, the insurance company can be liable based on the contract that exists between them and their customer.

There are also several statues, under which, the insurance company can be held liable.  For example, under Texas Insurance Code, Section 541.151, the statute states “any person” engaged in the business of insurance may be liable for unfair insurance practices.  Reading further, the Texas Insurance Code, Section 541.002(2), defines the term “person” to include various insuring entities.

Insurance lawyers need to know about this 2017 case from the Eastern District, Sherman Division.  It is styled, Hidden Cove Park and Marina et al v. Lexington Insurance Company, et al.  The case concerns the discovery of an insurance company’s loss reserves.

The Court held a telephonic conference regarding a discovery dispute a regarding redacted records.  The Court ordered Lexington to produce the un-redacted clam notes and to allow Hidden Cove to depose Lexington’s 30(b)(6) deponent, limited to the information included in the previously redacted claim notes.

After severe storms caused damage to properties insured under a policy issued by Lexington, Hidden Cove sued Lexington alleging failure to properly conduct an investigation into the cause of the loss, failure to issue timely payments, and wrongfully delaying or denying the claim, all pursuant to Chapter 542 of the Texas Insurance Code, and breach of contract and breach of common law duty of good faith and fair dealing.  The central issue is the parties’ interpretation of the “Flood” exclusion contained in the policy and its effect on the claim.

Bad Faith insurance lawyers got a favorable ruling in the Texas Supreme Court recently.  This is discussed in an article published by the Claims Journal.  It is titled, Texas High Court Establishes Clear Rules For Breach Of Contract, Bad Faith Suits Against Insurers.

In an effort to clear up confusion as a result of past decisions, the Texas Supreme Court announced five rules that “address the relationship between contract claims under an insurance policy and tort claims under the Insurance Code.”

The clarification was part of an opinion issued earlier this month.  The case is styled USAA Texas Lloyd’s Company v. Gail Menchaca.

For Texas insurance lawyers, here is a new opinion from the Texas Supreme Court.  It is styled, Menchaca v. Texas Lloyds.

This claim arises from an insured’s claim for losses sustained during Hurricane Ike.  The insured sued USAA for (1) breach of contract and for (2) Unfair Settlement Practices under the Texas Insurance Code.  As damages for both claims, the insured sought only policy benefits plus court costs and attorney’s fees.  In evaluating the bad faith claims brought by the insured against USAA, the Supreme Court acknowledges that some of its previous decisions have created uncertainty in the law.  As a result, this opinion is designed to put that uncertainty to rest as nearly as possible.

The primary issue is whether the insured can recover policy benefits based on jury findings that the insurer violation the Texas Insurance Code and that the violation resulted in the insured’s loss of benefits the insurer “should have paid” under the policy, even the jury also failed to find that the insurer failed to comply with its obligation under the policy.  USAA argued that because the jury found there was no breach of contract, Menchaca could not recover for “bad faith” or extra-contractual liability as a matter of law.  The Court disagreed with USAA and re-affirmed its holding in Vail v. Texas Farm Bureau Mut. Ins. Co., where the Court held that an insurer’s “unfair refusal to pay the insured’s claim causes damages as a matter of law in at least the amount of the policy benefits wrongfully withheld.”

Palo Pinto insurance lawyers know the above question can be difficult to answer.  Each situation is different.  The Stowers doctrine in the law is an example to look toward for some understanding.

The heart of a Stowers claims is the 1929 decision in G. A. Stowers Furniture Co. v. American Indemnity.

In Stowers, the insurance company refused to accept a third party’s offer to settle the asserted claim within policy limits and a judgment in excess of the policy limits resulted.  The court imposed a duty for an insurance company to handle settlement demands reasonably.