Claims Refusal

Auto Coverage In Texas And Gun Racks

May 5, 2010 | Mark S. Humphreys

What if you are a “good ole boy” in Weatherford, Texas? Or for that matter, in Arlington, Grand Prairie, Fort Worth, or Dallas, and you have a gun rack in your vehicle. In the gun rack you have a loaded firearm. Next, the firearm is accidently discharged. Will your insurance company cover the resulting damages to others? The answer is a lawyerly answer for you: It depends.

Here is an interesting case issued by the Texas Supreme Court. This case discusses how the facts should be analysed to see if coverge will exist. The case, decided in 1999, is styled, Mid-Century Insurance Company of Texas, a division of The Farmers Insurance Group of Companies, v. Richard Tanner. The cite is, 997 S.W.2d 153.

The question for the court to decide in this case was whether the underinsured motorist provision of a standard Texas personal auto policy covers the insured’s bodily injuries resulting from the unintentional discharge of a shotgun on a gun rack in a pickup truck parked nearby. The answer, in this case, depended on whether, within the meaning of the policy, the injuries resulted from “an accident” “arising out of” the “use” of the truck.

In Texas – Who Do You Sue?

April 6, 2010 | Mark S. Humphreys

You live in Grand Prairie, Fort Worth, Arlington, Dallas, Weatherford, or anywhere else in Texas and you get treated wrong with your insurance policy – Who do you sue? The answer is not very hard.

First of all …. seek the advice of an experienced Insurance Law Attorney. Then …

The Texas Insurance Code, Section 541.151, provides that a person who has sustained damages caused by another’s engaging in unfair or deceptive insurance practices may sue the person engaging in those acts or practices. Texas Insurance Code Statute, 541.002(2) defines “person” to mean “an individual, corporation, association, partnership, reciprocal or interinsurance exchange, Lloyd’s plan, fraternal benefit society, or any other legal entity engaged in the business of insurance, including an agent, broker, adjuster or life insurance counselor.”

Who Can Sue? … A “Person” Or A “Consumer”

April 5, 2010 | Mark S. Humphreys

Is a Grand Prairie resident who purchases an auto policy a person or a consumer for purposes of Texas law? What about residents of Arlington, Fort Worth, Weatherford, or Dallas? Why does it matter?

The Texas Insurance Code allows “persons” to bring claims against insurance companies and their agents. The Deceptive Trade Practices Act (DTPA) gives this power to “consumers”. The DTPA, Section 17.45(4) defines consumer as one who seeks or acquires goods or services.

Someone suing under the Insurance Code does not have to prove he is a consumer. This is told to us in the 1987, Texas Supreme Court case, Aetna Casualty & Sur. Co. v. Marshall.

Excess Insurance Case Law In Texas

April 3, 2010 | Mark S. Humphreys

If a resident of Grand Prairie or Arlington or other cities such as Dallas, Fort Worth, Weatherford, and others in Texas has a policy of insurance with a limit and another policy that covers claims that go over the limit of the first insurance policy, what happens if the primary policy does not cooperate in settling the case? The Texas Supreme Court answered this question in a 1992 case.

The style of this case is long, American Centennial Insurance Company and First State Insurance v. Canal Insurance Company, Talbert, Biessel, Stone & Lyman, Giessel, Stone, Barker & Lyman, Henry P. Giessel and Richard S. Joseph. Canal Insurance Company (Canal) was the primary insurance company with coverage of $100,000. American Centennial Insurance Company (American) had coverage from $1 million to $4 million and First State Insurance (First State) had insurance from $100,000 for $1 million and were the excess insurance companies. In this case, the insured company was General Rent-A-Car International, Inc., who was sued for injuries and death allegedly resulting from a blowout of a defective tire on one its rental cars.

In the lawsuit against General, there was a $3.7 million settlement based on the claim itself and the alleged mishandling by trial counsel in the litigation. Trial counsel are the other parties named in the style of the lawsuit.

Texas Unfair Insurance Practices

March 23, 2010 | Mark S. Humphreys

Regardless of what kind of insurance you have purchased or where in Texas the purchase occurred, the same law applies. So residents of Grand Prairie, Arlington, Mansfield, Dallas, Fort Worth, or Weatherford, all get treated the same.

This will be the first part of a several part writing on “unfair insurance practices”.

Chapter 541 if the Texas Insurance Code, is where the definition and prohibition for unfair and deceptive insurance practices is found. These sections of the Insurance Code are Sections 541.001 thru 541.061, Section 541.151 thru 541.162, and 541.453.

Texas Case With Lots Of Insurance Law

March 11, 2010 | Mark S. Humphreys

Grand Prairie residents beware; Weatherford residents beware; Arlington, Mansfield, Dallas, Fort Worth residents beware. Here is a case that makes you angry at the insurance company when you get into the details of how this person was treated by her insurance company and those associated with them.

The case is kinda old, decided in 2001. The style of the case is long, Lois Jones v. Ray Insurance Agency a/k/a Azteca Insurance and / or Alamo Insurance, and Collision Clinic, Inc., State & County Mutual Fire Insurance Company and Harbor Insurance Managers. It was decided by the Court of Appeals of Texas, Corpus Christi.

The facts of the case are long, but not really complicated. Lois Jones purchased a new 1998 Pontiac and purchased a State & County Mutual Fire Insurance Company insurance policy (State & County). This policy was purchased from the agent, Ray Insurance Agency a/k/a Azteca Insurance and / or Alamo Insurance (Ray). The policy administrator was Harbor Insurance Managers (Harbor). When purchasing the policy, Jones informed the agent that her sister lived with her, and was advised by the agent, that would not be a problem, and that as long as she paid her premiums on time she would have insurance. The policy with State & County excludes coverage for anyone residing with Jones age fourteen or over unless listed. Ms. Jones paid the November and December premium payments. The policy was to be effective from November 7, 1997 (the date of purchase) thru May 7, 1998.

Permission? To Operate The Vehicle

February 25, 2010 | Mark S. Humphreys

A Dallas Appeals Court upheld a lower Court ruling in an interesting case. The ruling applies to the same facts anywhere in Texas, including, Fort Worth, Arlington, Grand Prairie, or Weatherford.

This case is valid law today but was decided in 1989. The fact pattern is unique. The style of the case is United States Fire Insurance Company v. United Service Automobile Association.

The underlying liability lawsuit arose out of an accident that occurred when an Anna Milliken was riding as a passenger, with a Douglas Martin, being the driver. The car Douglas was driving was owned by his father and was covered by the United States Fire Insurance Company (U.S. Fire) policy. Anna’s insurance was United Service Automobile Association. Douglas testified about some swerving and horseplay prior to the accident. Anna testified that Douglas was zigzagging the wheel back and forth and that she grabbed the wheel on two occasions prior to the accident. She was doing this to play back with Douglas. The first time she did this, Douglas did not object, and the second time was when the accident occurred causing serious injury to Douglas. Douglas sued Anna for his injuries.

Attorney’s Fees In Insurance Lawsuits

January 25, 2010 | Mark S. Humphreys

Almost all insurance disputes are going to have situations where an attorney is involved. Too many times these disputes end up in lawsuits. Prior posts on this blog have shown how most situations are going to require the insurance company to pay or reimburse attorneys fees where the policy holder prevails in their claim.

In 2007 a case, Lamar Homes, Inc. v. Mid-Continent Casualty Company, the Texas Supreme Court ruled that Section 542.060, Texas Insurance Code, applied to not just the underlying claim at issue in a lawsuit but to also attorneys fees in situations where the insurance company did not pay for attorneys on behalf of the insured persons or business.

Section 542.060 assesses an 18% annual penalty on the attorneys fees that the insurance company did not pay for.

Does My Texas Insurance Company Have To Defend Me If I Get Sued?

November 25, 2009 | Mark S. Humphreys

An Appeals Court in San Antonio, Texas, has recently handed down a decison that discusses the above question. The case is, Lancer Insurance Company v. Oscar Perez, et al, and was decided on November 4, 2009.

The Lancer case involved members of a high school band going on an overnight field trip. The driver of a bus transporting the band was infected with active turberculosis. This disease was discovered by the passengers and subsequent tests proved positive for some of the band members. The bus driver and bus company were sued for negligently exposing the band members to the disease.

Upon being sued, the bus company made a written demand to Lancer to defend the lawsuit pursuant to the business automobile insurance policy Lancer had issued covering the bus. Lancer refused to defend and the case went to trial wherein the passengers were awarded $5.25 million in total damages.

Excluded Drivers In Texas Automobile Policies

November 24, 2009 | Mark S. Humphreys

Let’s say you are a Grand Prairie or Arlington resident. You purchased an auto policy from an agent in Fort Worth. The price quoted seemed way too high and you asked the agent if there was anything that could be done to get the premium lower. The agent says, “Yes, we can take your teenage son off the policy.” You say okay. The agent sells you a policy that excludes coverage if your teenage son is driving the car.

You can guess what happens next – the son drives the car and gets involved in a wreck. Now what? Numerous lawsuits have been filed in these situations and outcomes will sometimes be different depending on the facts of the accident and more importantly, the wording in the insurance policy that excludes the son.

Courts will look closely at the wording in the policy at issue but as a general rule, these exclusions are found by the Courts to be valid. It has been held that public policy dictates the allowance of such exclusions to enable insured motorists with children having bad driving records to secure insurance they can afford, rather than being relegated to securing coverage from an assigned risk pool at a much higher cost. This issue was discussed at length in the case, Wright v. Rodney D. Young Ins. Agcy. Wright was a 1995, Fort Worth Court of Appeals case.