Articles Posted in Bad Faith Insurance

Folks in Weatherford, Parker County, Aledo, Azle, Springtown, Poolville, Whitt, Peaster, Hudson Oaks, Brock, Willow Park, Cool, Millsap, and other places in Texas will at one time or another have a claim against their own insurance company. When making this claim against their own insurance company, otherwise known as a first party claim, and the insurance company does not treat you properly in the handling of the claim it is likely that there have been violations of provisions of the Texas Insurance Code. When this happens it is advisable to seek the assistance of an experienced Insurance Law Attorney. Here is what he should tell you.

1) gather all the documents you have related to the claim, such as the policy itself, letters and e-mails and faxes to and from the insurance company, and any documents verifying the value of the loss such as repair bills or estimates;

2) write out what has happened – this should be your version of the sequence of events with all the relevant information to help the attorney understand the case – the writing should start out: My name is …, I have a policy of insurance with …, On such and such date … happened, I then made a claim to my insurance company for benefits. Then write down a sequencial listing of what happened in the claims process.

How does this stuff work?! That is a question someone in Dallas, Fort Worth, Grand Prairie, Weatherford, Arlington, Mansfield, Irving, or anywhere else in Texas might ask when it comes to insurance contracts and bad faith insurance.

“Insurance coverage claims and bad faith claims are by their nature independent. But, in most circumstances, an insured may not prevail on a bad faith claim without first showing that the insurer breached the contract.” This was stated in the Texas Supreme Court case styled, Liberty National Fire Insurance Company v. The Honorable Ted Akin, decided in 1996.

The case is called a mandamus proceeding.

Weatherford, Parker County, Aledo, Azle, Mineral Wells, and other residents through out Texas would wonder what are the different ways of recovering losses that result from an insurance company or insurance company agent doing something wrong in the sale of an insurance policy.

The Texas Department of Insurance has a web-site that provides some information about insurance companies and insurance agents. There is also information at this site about insurance adjusters.

The Texas Supreme Court hears and issues opinions about situations that have happened across the state dealing with insurance related issues. Plus the lower appeals courts and the local courts have to hear and decide on insurance related cases on a fairly regular basis.

People in Grand Prairie, Dallas, Fort Worth, Arlington, Mansfield, Garland, Mesquite, Rowlette, De Soto, Cedar Hill, Duncanville, and other places in Texas would like to think that people are honest with them in their business dealings. The majority of the time, this is true. Rarely does someone intentionally lie about a subject, but occassionly a misrepresentation is made, not on purpose, but accidently. When this is done it is called negligent misrepresentation.

Here is an example of negligent misrepresentation. This is from a 2003 case styled, New York Life Insurance Company, et al v. Phillip M. Miller. This case was decided by the Texas Court of Appeals, Austin.

Here is some background:

Insureds in Dallas, Fort Worth, Grand Prairie, Mansfield, Cedar Hill, De Soto, Duncanville, Red Oak, Lancaster, Arlington, Forest Hills, and other places in Texas do not really understand the different parts of insurance transactions. Let’s try to get an understanding and be more educated about insurance transactions.

To understand the different ways disputes can arise, it is helpful to consider the sequence of events that is likely to occur. At its very simplest, the insurance transaction can be divided into the initial sale of the policy, and subsequent handling of claims. These can be broken down further to include:

(1) The sale of the policy: Initially, the consumer and insurer or insurer’s agent must communicate to establish a contractual relationship. Disputes may arise over what was asked for by the applicant, what was represented by the insurer or agent, or the timeliness of the insurer or agent in providing coverage. Issues may also arise about the truthfulness of the applicant or agent in disclosing information requested by the insurer;

An insured in Dallas, Fort Worth, Grand Prairie, Arlington, Mansfield, Garland, Richardson, Weatherford, or anywhere else in Texas may not know if they are being treated in bad faith by their insurance company when it is happening. Here is something to think about – if it doesn’t seem right it probably isn’t. To be sure, the best thing to do is to consult with an experienced Insurance Law Attorney.

One of the first cases from the Texas Supreme Court making clear that an insured has a cause of action against his insurance company for bad faith insurance was decided in 1987. The style of the case is, Glen Arnold v. National County Mutual Fire Insurance Company.

Here are some of the facts in this case:

What if someone in Dallas, Fort Worth, Grand Prairie, Arlington, Irving, Richardson, Hurst, Euless, Bedford, or somewhere else in Texas, thinks the insurance company is denying their claim for insurance benefits for the wrong reason? Can anything be done? As with so many legal answers – it depends.

The Texas Supreme Court issued an opinion in 1993, in the case styled, Golda A. Lyons v. The Millers Casualty Insurance Company of Texas, that helps with the above question. As the court stated, “This case presents us with the opportunity to clarify the method by which Texas courts should conduct legal sufficiency review of factfindings of bad faith against an insurer.”

Here are the facts:

Someone in Dallas, Fort Worth, Grand Prairie, Arlington, Mansfield, Mesquite, Garland, Plano, Weatherford, or anywhere else in Texas, may experience a delay in being paid when making a claim against their insurance company. Is that ok? The answer is no, according to the Texas Prompt Payment of Claims Act.

The Texas Supreme Court decided a case in 2004, wherein the topic had to do with how the Texas Prompt Payment of Claims Act impacted the decision in the case. The style of the case is, Republic Underwriters Insurance Company v. Mex-Tex, Inc. The court phrased the issue this way: We must decide whether the commercial property insurer in this case breached its policy obligation to replace a damaged roof with one of “like kind and quality”, and if so, whether the insurer’s tender of partial payment of the claim avoided, on that amount, the 18% per annum delay penalty imposed by the Prompt Payment of Claims Act of the Texas Insurance Code.

Following a May 25, 1999 hail storm in Amarillo declared by the Texas Department of Insurance to be a weather-related “catastrophe for the purposes of claims processing”, Mex-Tex, Inc. notified its property insurer, Republic Underwriters Insurance Co., of damage to the roof of Signature Mall, a retail shopping center that Mex-Tex owned. Mex-Tex claimed that the roof had been destroyed and should be replaced. Republic immediately investigated the claim but disputed the amount of damage attibutable to hail.

Insured persons in Grand Prairie, Frisco, Arlington, Aledo, Fort Worth, Dallas, Mesquite, Garland, and other places in the state may be adversely affected when an insurance company cancels a policy. If no claim is being made, or in the process of being made, then it may be a case of “no harm, no foul.” But what if the cancellation is first brought up when a claim is made?

This is what happened in a 2001, case styled, Lois Jones v. Ray Insurance Gency a/k/a Azteca Insurance and / or Alamo Insurance, and Collision Clinic, Inc., State & County Mutual Fire Insurance Company and Harbor Insurance Managers. This is a Corpus Christi, Court of Appeals case that was affirmed in 2002 by the Texas Supreme Court.

Here are the facts:

It will probably happen to most people at one time or another. Including residents of Dallas, Arlington, Grand Prairie, Mansfield, Burleson, Crowley, De Soto, Mesquite, Weatherford, and lots of other towns and cities in North Texas. An insurance company will refuse a reasonable offer from you or your attorney to settle a claim you have against the insured of an insurance company. If it happens – what can be done?

This article will focus on one aspect of the above. That aspect is when a third party claimant has his demand for a settlement refused by the other person’s insurance company. This happens in lots of scenarios but the most common is a car wreck. The most common situation is where the third party causes a wreck wherein the claimant has damages that exceed the insurance policy limits of the third party who caused the damages. Example – The third party has insurance coverage for the state’s required minimum as of this date, $25,000. The person injured has medical bills exceeding $40,000 plus another $10,000 in lost wages, plus he is entitled to compensation for his impairment, and pain and suffering.

Next, the injured person through his attorney demands that the insurance company for the person who caused the wreck to pay $120,000 to settle the claim or policy limits, which ever is less. The insurance company refuses to pay. The injured person sues the person who caused the wreck and gets a judgment for $120,000. The insurance pays only the $25,000 that they insured and now the injured person has a judgment against the responsible person for the balance. Of course, most of the time the only money this person has is the money he is insured for.

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