Claims Denial

Suspicion Of Arson

August 28, 2011 | Mark S. Humphreys

Arson happens in places like Fort Worth, Dallas, Garland, Irving, Mesquite, Richardson, Plano, Duncanville, De Soto, and all other places in Texas at one time or another. But to be accused of arson and have your insurance claim denied because you are suspected by the insurance company is something else. Is there a typical case or situation where this comes about? The answer is no. Every situation has to be scrutinized based on the facts of that particular situation.

The Texarkana Court of Appeals issued an opinion in a 1990 case that discusses the way these arson cases are evaluated. The style of the case is, The St. Paul Guardian Insurance Company v. Teri Lynn Luker and Paul Kimbel Luker. In the case, a jury found in favor of the Lukers and compensated the Lukers for contractual damages of $27,000 and tort damages of $50,000 and mental anguish of $15,000. The court reversed all but the contractual damages of $27,000.

Here are some of the facts of this case.

Insurance Proceeds And Fraud

August 23, 2011 | Mark S. Humphreys

For someone in Grand Prairie, Arlington, Fort Worth, Dallas, Hurst, Euless, Bedford, North Richland Hills, Roanoke, Keller, and other places in North Texas, it is likely to happen. A spouse intentionally burns the house down. Well, what happens to the insurance money? Here is a case that provides some guidance.

The case was decided in 1999, by the Texas Supreme Court. It is styled, Texas Farmers Insurance Company v. Daisy Murphy. The question posed to the court was whether an innocent spouse can recover insurance proceeds when the other co-insured spouse has intentionally destroyed the covered community property.

Here is some background.

Blamed For Arson

August 16, 2011 | Mark S. Humphreys

Arsons happen in Weatherford, Mineral Wells, Aledo, Azle, Millsap, Hudson Oaks, Willow Park, Brock, Peaster, Springtown, and all over Parker County and Texas. But that does not mean the person who owned the property committed the arson. And when the insurance company does an investigation and finds the property owner is having financial problems that does not mean the property owner burned the property either. After all the vast majority of people have financial problems.

Here is a case that deals with arson and the insurance company attempt to blame the arson on the homeowners. The case opinion was issued in 2000, by the Dallas Court of Appeals. The case is styled, Texas Farmers Insurance Company v. Cloteal L. Cameron, et al.

The jury found against Farmers for violations of the Texas Insurance Code, bad faith, violation of the Prompt Payment of Claims Act, mental anguish, violations of the Texas Deceptive Trade Practices Act, knowing and intentional conduct, and attorney fees. This appeals court reversed the finding regarding the mental anguish claim and part of the attorney fees claim and the calculation of interest on the claim.

Arson And Insurance

August 7, 2011 | Mark S. Humphreys

Anyone living in Weatherford, Mineral Wells, Aledo, Azle, Hudson Oaks, Willow Park, Millsap, Brock, Cool, Springtown, or other areas in Parker County, or the State of Texas know what arson means. The question to be wondered about is, what happens if your home burns as the result of an arson fire?

The Waco Court of Appeals issued an opinion in 1998, in the case styled, State Farm Fire and Casualty Insurance Company v. Sandra Sue Vandiver.

In this case Vandiver had sued State Farm seeking to recover damages which resulted from the destruction of her home by a fire. The trial court made many ruling in favor of Vandiver, the result of which, she won her case. One of these ruling was a directed verdict against State Farm on its arson defense. State Farm appealed and this court reversed the verdict and set the case for a new trial. Here is some relevant information.

Fire Loss

July 24, 2011 | Mark S. Humphreys

Whether you live in Weatherford, Aledo, Azle, Willow Park, Hudson Oaks, Mineral Wells, Millsap, Brock, Peaster, Springtown, Poolville, Cool, or anywhere else in Parker County, a fire loss to your home can be a devastating loss. It is compounded when your insurance company refuses to pay for the loss. It is compounded further when they accuse you of arson.

The Texas Supreme Court issued an opinion in a case in 1998, styled “State Farm Fire & Casualty Company v. James and Cynthia Simmons.” The legal issue presented to the court was whether there was sufficient evidence to support a jury finding that State Farm breached its duty of good faith and fair dealing and whether there was some evidence to support a punitive damages award. We will go over the good faith and fair dealing only point due to technicalities surrounding the punitive damages award.

Background information:

Accused Of Arson

June 26, 2011 | Mark S. Humphreys

Homeowners in Grand Prairie, Arlington, Irving, Duncanville, De Soto, Cedar Hill, Dalworthington Gardens, Fort Worth, Dallas, and other places in Texas might be interested in this story. It has to do with insurance and arson.

The story is from knoxnews.com and was written by Jamie Satterfield. The article was published on May 27, 2011, and is titled “Vonore couple accused of arson: Insurance firm sues, claiming pair blamed neighbor as cover-up.”

The article tell us that the insurance company, American National Property and Casualty Company, a Missouri based insurance company, is accusing a lesbian couple of being arsonists who burned down their own home to receive the insurance proceeds. The couple say they are victims of hate crime.

Insurance Company Denies Claim

June 23, 2011 | Mark S. Humphreys

Someone in Grand Prairie, Arlington, Grapevine, Colleyville, Hurst, Euless, Bedford, Keller, Flower Mound, Roanoke, Haslet, Saginaw, and other places in the state of Texas would naturally be upset if their claim were denied. But next, they would want to hire an experienced Insurance Law Attorney and pursue a lawsuit against their insurance company to make them pay.

Here is a case where an attorney tried to get the insurance company to pay but most of the lawsuit was almost thrown out of court. The style of the case is, Rosa Garcia and Augustin Garcia v. Nationwide Property and Casualty Insurance Company. The opinion in this case was issued on May 16, 2011, by the United States District Court, S. D. Texas, Houston Division.

Here is what is going on in this situation:

Claim Denied – Policy Interpretation

June 5, 2011 | Mark S. Humphreys

Here is one for residents of Weatherford, Mineral Wells, Aledo, Azle, Springtown, Hudson Oaks, Willow Park, Brock, Millsap, Poolville, and other places in Parker County and Palo Pinto County. This case is unusual.

The Texas Court of Appeals, San Antonio, issued an opinion on May 11, 2011, in a case appealed from the 73rd Judicial District Court. The style of the case is, Dora Gulley v. State Farm Lloyds.

A little legal information first. This is an agreed interlocutory appeal pursuant to Texas Civil Practices & Remedies Code, Section 51.014(d). It is arising out of an insurance case where in both sides in the case filed motions for Summary Judgment asking the court to rule in their favor as a matter of law. The Judge denied both parties motions and allowed them to pursue an appeal pursuant to the above statute. So this case was essentially being given to the appeals court to make a decision / ruling.

Insurance Claim Denied – Experts

June 4, 2011 | Mark S. Humphreys

No matter where you live, Grand Prairie, Arlington, Mansfield, Fort Worth, Dallas, Garland, Mesquite, Richardson, Coppell, Carrollton, or anywhere else in Texas, at some point you are probably going to have an insurance claim denied. To what extent will an insurance company go to prove they do not owe you anything?

The Texas Court of Appeals, Eastland, decided a case in December, 2008, wherein the insurance company appealed the findings of an injured persons own treating experts. The style of the case is, American Casualty Company of Reading, Pa. v. Donna Zachero. Here is some background information.

On March 17, 2003, Zachero was injured at work when she fainted and fell. She hit her chin, shoulder, chest, and elbow during the fall and developed bruises on those areas. She also injured her knee when she fell. On April 17, 2003, Zachero went to the emergency room due to pain and swelling in her knee. She was x-rayed and instructed to see an orthopedic, Dr. Luke, a specialist for the injury.

Uninsured / Underinsured Coverage And Limitations

April 10, 2011 | Mark S. Humphreys

Someone with uninsured and underinsured coverage in Grand Prairie, Arlington, Dallas, Fort Worth, Mansfield, Irving, Pantego, Dalworthington Gardens, or anywhere else in Texas would probably have a hard time understanding when it becomes too late to file a claim for benefits under these coverages. Maybe this will help.

A Texas Supreme Court case decided in 1974, is still good law and a reference point for answering this question. The case is styled, “Raul C. Franco et us. v. Allstate Insurance Company.

In this case, Franco and his wife sought to recover from Allstate Insurance Company, under the uninsured motorist provision of their insurance policy, for the death of their daughter and personal injuries to Franco, arising out of an accident alleged to have been caused by the negligence of an uninsured motorist. Their suit was filed approximately three years after the date of the accident and death. The question is whether the two or four year statute of limitations is applicable to either or both of the claims asserted.