Claims Handling Process

Accused Of Arson By Insurance Company

August 9, 2011 | Mark S. Humphreys

Arson cases are the same in Grand Prairie, Arlington, Irving, Fort Worth, Dallas, Mesquite, Garland, Mansfield, Duncanville, Lancaster, De Soto, or anywhere else in Texas. Fires happen by accident and by arson. When a fire occurs the insurance company is going to investigate for reasons of denying coverage for the claim or to find reasons to lower the amount of money they may have to pay on the claim.

In 1992, the San Antonio Court of Appeals, issued an opinion in a case styled, State Farm Lloyds, Inc. v. Robert Polasek and Shirley Polasek.

In this case, arson and bad faith were asserted against State Farm. The Polasek’s prevailed at trial and State Farm appealed. The jury had awarded $40,000 in property damage and $500,000 as exemplary damages against State Farm. The court sustained the verdict for the property damage but overruled the finding of bad faith that allowed the award of exemplary damages. Here is some background.

Co-operating With Insurance Company

July 5, 2011 | Mark S. Humphreys

Here is one for people in Grand Prairie, Arlington, Irving, Mansfield, Fort Worth, Dallas, Mesquite, Garland, Richardson, Farmers Branch, and other places in Texas to think about.

What if you get sued but do not tell your insurance company but the person who sued you does tell the insurance company, does the insurance company have to defend you in the lawsuit?

In 2008, the Texas Supreme Court in the case styled, National Union Fire Insurance Company of Pittsburg, PA. v. Beatrice Crocker, issued an opinion dealing with this issue. Here is some background and a discussion.

How Much Does An Insurance Company Have To Pay On A Claim

June 21, 2011 | Mark S. Humphreys

A natural question for someone in Grand Prairie, Arlington, Mansfield, Fort Worth, Dallas, Hurst, Euless, Bedford, North Richland Hills, and other places in Texas would be – How much does an insurance company have to pay on a claim? The answer is – It depends on many things?

A Fort Worth Court of Appeals case, decided in 2000, gives some insight into how much an insurance company may have to pay on a claim. The style of the case is, Thomas Carter, Mary Carter, and Ed Carter v. State Farm Mutual Automobile Insurance Company. Here is some background.

In April of 1997, Thomas Carter, Kari Brunson, Jeff Goodman, Michelle Keeffe, and Craig Derrick were traveling west on I-30 in an Isuzu. At the same time, Jennifer Puterbaugh was traveling the same direction at a high rate of speed weaving through traffic and struck the Isuzu from behind. The collision caused the death of Kari Brunson and injured the four other occupants of the Isuzu. State Farm insured Michelle Keeffe, the Isuzu’s owner, against loss caused by bodily injury under a $50,000 per person up to $100,000 per incident uninsured/underinsured (UM/UIM) policy.

Homeowners Insurance Policies

May 12, 2011 | Mark S. Humphreys

People who own homes in Weatherford, Aledo, Azle, Poolville, Brock, Hudson Oaks, Willow Park, Peaster, Mineral Wells, Cool, Millsap, and other areas of Parker and Palo Pinto counties might want to pay attention this story.

The Court of Appeals, Beaumont, issued an opinion on March 10, 2011, that gives some insight into how the courts will look at appraisal clauses in homeowners insurance policies. The style of the case is, In Re Southern Insurance Company.

In this case the homeowner, Michelle Neisen, suffered a loss that she alleges was the result of hurricane damage. Southern sought to have an appraisal process to determine the amount of the disputed loss. Neison claimed that Southern waived its right to appraisal because Southern claimed it was not responsible for the loss. The trial court refused to order participation in the appraisal process which Southern was requesting and Southern appealed that decision.

Insurance And Hospital Liens

April 3, 2011 | Mark S. Humphreys

Here is one for people in Weatherford, Grand Prairie, Fort Worth, Dallas, Aledo, Richardson, Garland, Mesquite, Irving, and anywhere else in Texas to know. It regards insurance settlements and hospital liens.

This is an opnion issued on March 17, 2011, by the Texas Court of Appeals, First District, Houston. The style of the case is, Memorial Hermann Hospital System v. Progressive County Mutual Insurance Company.

In this case, Progressive settled a claim brought against one of its insureds arising out of injuries in a car accident. Memorial filed a hospital lien for the cost of medical treatment to the injured person half an hour before Progressive issued the settlement check. Under the Texas Hospital Lien Law, a hospital “has a lien on a cause of action or claim of an individual who receives hospital services for injuries caused by an accident that is attibuted to the negligence of another person.” Texas Property Coce, Section 55.002. To secure the lien, Section 55.005 requires the hospital file notice with the county clerk before payments to the entitled party. The statute also declares that the county clerk “shall index the record in the name of the injured individual.”

Insurance Lawsuits

March 22, 2011 | Mark S. Humphreys

When someone in Weatherford, Aledo, Hudson Oaks, Peaster, Springtown, Azle, Millsap, Cool, Poolville, Whitt, or out in Mineral Wells, finds themselves in a situation where they have to hire a lawyer and file a lawsuit against an insurance company, they want to win the case. The best chance of doing that is making sure the lawsuit is in a State Court rather than a Federal Court. There are many reasons why a State Court is preferable to Federal Court. All someone really needs to know is that every time an insurance company lawyer can get a case removed from State Court into a Federal Court, they are going to do so. The other thing they need to know is to seek the advice of an experienced Insurance Law Attorney. He will know the best strategies for keeping a case in a State Court.

On January 24, 2011, the United States District Court, Southern District of Texas, Houston Division, issued an opinion in a case where the issue was discussing, in which court the lawsuit should be litigated. The style of the case is, Scott Browning v. Sentinel Insurance Company and Cavalry Construction Co.

Browning had filed the lawsuit in the 11th Judicial District Court of Harris County, Texas, alleging that Calvary, violated provisions of the Texas Insurance Code.

Insurance Coverage For Someone Sued

March 12, 2011 | Mark S. Humphreys

Here is good information for someone sued in Grand Prairie, Arlington, Fort Worth, Dallas, Weatherford, Lake Worth, Roanoke, Newark, Saginaw, and all other places in Texas.

What happens when you are sued? Does the insurance company automatically protect you?

Here is a partial answer to the above.

Insurance Company Referrals

March 8, 2011 | Mark S. Humphreys

It happens in Grand Prairie, Weatherford, Arlington, Dallas, Fort Worth, Roanoke, Keller, Colleyville, North Richland Hills, Grapevine, and all over the state. Someone has some property damage. They call their insurance company. The insurance company suggests they call XYZ company. The insured calls XYZ company. XYZ company does something wrong in their dealings with the insured. The question becomes: Is the insurance company responsible for any wrong committed by XYZ company?

The most common situations where the above happens is car wrecks. After a car wreck the insurance company often suggests a repair shop to take the car to for repairs. The second most common situation is home repairs. A home owner has hail damage, flood, or fire and the insurance company suggests a company to make the repairs.

The Texas Court of Appeals in Dallas recently had a case that involved a theft. The opinion was issued on February 8, 2011, and the case is styled, J. Howard Jaster, Individually and as Assignee of the Edinberg Trust v. Shelter Mutual Insurance Company. In this case Jaster alleged that Shelter Mutual Insurance Company (Shelter) was an agent of Michael Hanna d/b/a Cornerstone Replacement Services (Cornerstone).

Appraisal In Insurance Policies

February 20, 2011 | Mark S. Humphreys

Policy holders in Grand Prairie, Arlington, Dallas, Fort Worth, Flower Mound, Haslet, Saginaw, Newark, Benbrook, Crowley, Cedar Hill, Hutchins, and other places in Texas will wonder what an “appraisal clause” in their insurance policy means. Insurance companies put these in policies because it is a good thing for them. There are ways of getting around these clauses, but an experienced Insurance Law Attorney needs to be consulted.

Many property insurance policies contain appraisal clauses. These clauses define a process for appraising the value of the damaged property, if the parties cannot agree. Common provisions call for each party to choose an appraiser. Those appraisers then choose a neutral third appraiser, called an umpire. If the parties or their appraisers cannot agree on an umpire, either party may petition a court to appoint one. Once the appraisers and umpire are chosen, they value the loss. If all do not agree on the value, the decision of any two will control. The intent is to give the insurance company and the insured a simple, speedy, and fair means of deciding disputed values. This was stated in the Texas Appeals Court in Waco, as far back as 1938. The reality however is that this is not always the case.

When two appraisers do not agree, the umpire does not simply choose between them. It is the duty of the umpire to ascertain and determine, in the exercise of his own judgment and as the result of his own investigation, the values of the disputed items. This is what a San Antonio Appeals Court said in 1994.

Insurance Fraud Article

February 15, 2011 | Mark S. Humphreys

There are many things insured people in Cleburne, Granbury, Aledo, Burleson, Keene, Joshua, Wylie, Roanoke, Keller, Colleyville, and the major cities, like Dallas, Fort Worth, and others need to be aware of as it relates to applying for, or receiving benefits from an insurance policy. A good example of this is found in an article written by Shan Li in the Los Angeles Times.

The article was published on January 25, 2011, and is titled, “Insurers Are Scouring Social Media For Evidence Of Fraud.” Much of the content of the article is included here and is a good read for “one of those things consumers need to be aware of.”

The internet social network sites such as Facebook and Twitter are great sources of information and fun and communication between relatives and friends. One downside to these sites is that other people can find out things that you may not want being public. But as the article tells us, now there’s another reason to be careful about what you post on Facebook and Twitter: “Your insurance company may be watching.”