Claims Denial

Insurance Refusing To Pay In A Car Wreck

August 28, 2010 | Mark S. Humphreys

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.

Life Insurance Denial

August 12, 2010 | Mark S. Humphreys

A terrible thing for someone in Arlington, Grand Prairie, Grapevine, Mansfield, Dallas, Fort Worth, Bedford, Euless, or anywhere else in the metroplex is having a loved one die. Then, when the claim for life insurance benefits is made, the live insurance company denies the claim for benefits.

This happens on a daily basis across the country. The New York Daily News recently published an article about this happening to a Long Island family. The Daily News staff writer is, John Marzulli. The title of the article is, “Lawsuit seeks to prevent Jeffrey Locker’s family from collecting life insurance after bizarre death.”

The article tells us that the family of a Long Island motivational speaker who police say set up his own murder should not collect $4 million in life insurance because he lied about his income. That is the defense in a federal lawsuit filed by the family.

Permissive Driver Coverage In Texas

June 27, 2010 | Mark S. Humphreys

How does someone living in Grand Prairie, Arlington, Mansfield, Fort Worth, Keller, Bedford, Hurst, Euless, Irving, De Soto, Duncanville, Burleson, Granbury, or anywhere else in Texas, know when an unlisted driver on an insurance policy is covered if an accident occurs? This is the third of three posts in a row on this subject. The following is what happened in a third case addressing this topic.

In 1989, the Texas Supreme Court, in the case, United States Fire Insurance Company v. United Service Automobile Association, discussed the issue of permissive driver coverage. This case involved a dispute between insurance companies over which had the duty to defend Anna Milliken, a passenger in an automobile, who allegedly caused an accident by grabbing the steering wheel of a moving vehicle. One policy was issued by United States Fire Insurance Company (Fire) and covered the automobile involved in the accident. The other was issued by United Service Automobile Association and insured the father of the passenger, Anna Milliken. The courts ruled that Fire had responsibility in this case.

The claim arose out of an accident that occurred when Anna was riding back with Douglas Martin from a church sponsored retreat. The car Douglas was driving was owned by his father and was covered by the Fire policy. Douglas testified that there was some swerving and horseplay prior to the accident. Anna testified that Douglas was zigzagging the wheel back and forth prior to the accident and that she grabbed the wheel on two occasions prior to the accident in an effort to play back with him. The first time Douglas did not object, and the second time was immediately prior to the accident. Anna testified that she and Douglas were “just kind of playing around.”

Permission To Use Vehicle And Texas Insurance Law

June 26, 2010 | Mark S. Humphreys

If you are a business owner in Grand Prairie, Arlington, Mansfield, Hurst, Euless, Bedford, Keller, Colleyville, Plano, Fort Worth, Burleson, or anywhere else in Texas and one of your employees is involved in an accident in a company vehicle, will your insurance provide coverage for him? This is the second of three posts on this related subject. Read on to find out what happened in one case.

The Texas Supreme Court, in 1979, issued an opinion in the case, Betty Coronado v. Employers’ National Insurance Company et al.

The issue before the court in this case was whether an employee who was driving a company owned vehicle on a purely personal mission after working hours was operating the vehicle with the permission of the company so as to be insured under the company’s automobile liability policy. The jury said yes. The first appeal court said no and the Texas Supreme Court agreed with the decision of no.

Permission To Use Car And Insurance Law

June 24, 2010 | Mark S. Humphreys

If you live in Grand Prairie, Arlington, Fort Worth, Mansfield, Duncanville, De Soto, Hurst, Euless, Bedford, Aledo, Azle, Weatherford, or anywhere else in Texas and a friend or acquaintance uses your car and has a wreck is there coverage? This posting and the two following will show what has happened in three previous cases.

In 1966, the Texas Supreme Court, in the case, Royal Endemnity Company v. H.E. Abbott & Sons, Inc., had this question before them in a case.

In this case, a 1961 pickup truck owned by Jack Herring and driven by George K. Landers ran into and damaged a building owned by H.E. Abbott & Sons, Inc. The truck was insured by a liability policy issued by Royal Indemnity Company. The insurance policy with Royal had a clause extending coverage to anyone operating the truck with Herring’s implied permission. In the lawsuit, Abbott obtained a judgment against Landers then sued Royal to enforce its judgment.

Compaints Against Insurance Companies In Texas

June 23, 2010 | Mark S. Humphreys

What can someone in Grand Prairie, Arlington, Mansfield, Bedford, Hurst, Euless, De Soto, Duncanville, Fort Worth, or anywhere else in Texas do when they are being “jerked around” by an insurance company? Answer number one – Find an experienced Insurance Law Attorney to consult with. Answer number two – file a complaint.

Seeking the aid of an experienced Insurance Law Attorney is sometimes hard to do. There are a lot of attorneys that help victims of accidents. These attorneys are usually referred to as Personal Injury Attorneys. These types of claims are called third party claims. The other type of claim is called a first party claim. This is a claim against your own insurance company. There are not that many attorneys that have experience in handling these types of claims. These attorneys are usually referred to as Insurance Law Attorneys.

The majority of the time an attorney is going to be able to get you the money you are entitled to plus more depending on how wrong the conduct of the insurance company has been in handling the claim. Consultations are usually free and there is nothing to lose by having an attorney look at your situation.

Insurance Company Denying Or Refusing Claim

June 22, 2010 | Mark S. Humphreys

It would be fair to say that most residents of Grand Prairie, Arlington, Mansfield, Coppell, De Soto, Duncanville, Fort Worth, Weatherford, and all other places in Texas, are responsible and conduct themselves in fair and proper ways in their dealings with others. Unfortunately that is not the way insurance companies always conduct their affairs.

The Dallas Morning News recently ran an article showing misconduct by two insurance companies doing business in Texas. The article is titled, “2 Texas auto insurers top complaints list, face investigation.” This article ran on June 5, 2010, and was authored by Terrence Stutz. Almost any experienced Insurance Law Attorney could tell you the names of the insurance companies that treat people right most of the time and the ones that treat people wrong most of the time. Further, even the “good” companies will do people wrong too many times.

In the article, Terrence Stutz gives some examples that are typical problems with the two companies named. The insurance companies are Loya Insurance and Old American County Mutual. These two companies were at the top of the list after an analysis of the Texas Department of Insurance figures showed that 10 of the 25 largest auto insurers in the state had worse than average customer service records. The above companies were at the top of the list.

Underinsured Motorist Coverage In Texas Commercial Policies

June 2, 2010 | Mark S. Humphreys

What if someone in Grand Prairie, Arlington, Duncanville, Mansfield, Burleson, Weatherford, Fort Worth, or some other city in Texas is involved in an accident, as an employee, with an underinsured driver? Does the employers underinsured portion of their insurance policy provide coverage?

This was the issue in a May 12, 2010 case decided by District Judge, T. John Ward, of the United States District Court, E.D. Texas, Marshall Division. The style of the case is, Dean and Parwana Amanzoui, Individually and as next friends of Fahim Amanzoui and Sabrina Amanzoui v. Universal Underwriters Insurance Company.

In this case, Parwana Amanzoui (Parwana) was riding in an automobile driven by her husband, Dean Amanzoui, and owned by her husband’s employer, the Huffines Automotive Group (Huffines). At the time of the accident, Huffines carried its insurance with Universal Underwriters Insurance Group (Universal) pursuant to a multiple coverage policy. Coverage under the policy for underinsured motorist (UIM) was limited. “Insureds” for purposes of UIM coverage was expressly limited to three categories of persons: (1) persons designated on the declarations as subject to the UIM policy, (2) family members of persons designated in the UIM policy, and (3) persons occupying vehicles driven by someone falling within category no. 1 or no. 2. It was uncontested that Parwana was not included in this list.

Named Driver Exclusions In Automobile Policies In Texas

May 24, 2010 | Mark S. Humphreys

Auto policy holders in Grand Prairie, Arlington, Fort Worth, Mansfield, Azle, Dallas, Weatherford, or any other city in Texas would want to know what all that “stuff” in their auto policy means. One part that is pretty easy to explain is the “Named Driver Exclusion.” This is other times called the “515-A Exclusion” or “515-A Endorsement”.

The normal automobile insurance policy is going to have a part that reads, “You agree that none of the insurance coverage afforded by this policy shall apply while ______________ is operating your covered auto or any other motor vehicle. These exclusions and endorsements are legal in insurance contracts. The language used is partly governed by laws published in the Texas Insurance Code. See Sections 1952.051 et al and Sections 2301.001 et al. As for the “Named Driver Exclusion”, it is legal and is intended to give policy holders the option to exclude from coverage drivers who, by virtue of their driving history or other factors, are deemed high risk drivers. This category of drivers would include drivers who have been convicted of violating the Driving While Intoxicated laws found in the Texas Penal Code, drivers with too many moving violations, too many wrecks, and other high risk drivers such as teenagers who have just got their license. It is important to realize that almost all of these drivers can get insurance but the cost of the insurance is much higher than what other drivers must pay.

The Texas Corpus Christ Court of Appeals decided a case in 1996 that is often cited for the validity of the Named Driver Exclusion. The style of the case is, Janie Zamora, Pete Zamora, Jesus Toc, and Gracie Vela v. Dairyland County Mutual Insurance Company. In this case the excluded driver was Gracie Vela, who was driving Jesus Toc’s vehicle. She had a wreck with the Zamoras causing them injury. In this case, the court upheld the validity of the exclusion and discussed the reasons for its validity.

Bad Faith Insurance And Fire Claims

May 15, 2010 | Mark S. Humphreys

When a house burns in Grand Prairie, Arlington, Colleyville, Keller, Mansfield, Fort Worth, Azle, Aledo, or Weatherford, or anywhere else in Texas; What happens when the house catches on fire? Will the insurance company pay for the damages?

In, State Farm Fire & Casualty Insurance Company v. Simmons, the answer was no until the case went to court. At that point, State Farm Fire & Casualty Company (State Farm) was eventually ordered to pay the damages. This is a 1998, Texas Supreme Court case. In this case, the Simmons had moved into a new home and spent monies improving the property and buying items for the inside of the house. Their house had been burglarized in the middle of the day and later those responsible were located.

Mr. Simmons, a construction supervisor, had experienced down time from work and the Simmons had missed house payments. They later refinanced the house. They continued to experience problems with vandalism and other strange occurrances around the house.