Articles Posted in General

Weatherford insurance attorneys need to be aware of this recent United States District Court, Dallas Division, opinion. The style is DeCluette v. State Farm Lloyds and Ruben Gallegos.

Here is some relevant information:

According to DeCluette, he purchased a homeowner’s insurance policy from State Farm to protect their residence in the event of damage. Storms struck Dallas County and damaged his residential property. He filed a claim with State Farm against the insurance policy for various damages to the residential property resulting from the storm. Ruben Gallegos was an employee of State Farm, serving as an insurance adjuster for the claim. Gallegos allegedly failed to thoroughly investigate and properly adjust DeCluettes’ property damage claims. As a result of Gallegos’ allegedly improper adjustment of the claim, State Farm denied a portion of the insurance claim.

Weatherford attorneys need to know the difference between “first party” insurance and “third party” insurance. So do attorneys in Willow Park, Aledo, Springtown, Milsap, Brock, Hudson Oaks, and all places in Parker County.

A “first party” insurance policy usually involves insurance that provides policy benefits directly to the insured or beneficiary. The Texas Insurance Code, Section 541.051(2) defines “first party claim” as a claim “by an insured or a policyholder under an insurance policy or contract or by a beneficiary named in the policy or contract that must be paid by the insurer directly to the insured or beneficiary.” These types of policies generally include health insurance, life insurance, disability insurance, homeowner’s property insurance, and commercial property insurance.

By contrast, “third party insurance” is usually liability insurance. This type of insurance is designed to insure against loss to third parties caused by the insured or another person covered by the policy. These types of policies include commercial general liability, homeowner’s liability, auto liability, and professional liability coverages.

Weatherford lawyers and those in Graford, Garner, Mineral Wells, Palo Pinto, and other places in Texas would need to understand how insurance companies work when a claim is made.

The New York Daily News published an article in January that gives some insight into what the companies are looking for. The article is titled, “Fraud is driving car insurance rates through the roof in New York City: Brooklyn prosecutor.” It tells us drivers in New York City pay among the highest automobile insurance rates in the nation because of fraudulent or inflated claims.

City drivers are faced with some of the highest car insurance premiums in the nation because of massive insurance fraud, district attorneys say.

Fort Worth insurance law attorneys and those in other parts of Texas should be consulted when a person has his insurance rates get increased without any apparent good reason. An article from the Boston Globe illustrates one of the games that insurance companies play when it comes to premium payments.

The title of the article is, MetLife Settles With Mass. Over Surcharges.” The article tell us MetLife will pay at least $50,000 in penalties and refund an undetermined amount of money to customers to settle allegations it imposed costly surcharges on Massachusetts drivers who were found not at fault in auto accidents.

State Attorney General Martha Coakley said Tuesday that some customers of Metropolitan Property & ­Casualty Insurance Co. — a unit of MetLife — who filed accident claims with the company were improperly ­penalized even after a state appeals board ruled they were not responsible for causing the crashes.

Fort Worth insurance lawyers and those in Benbrook, Crowley, Burleson, and other parts of Tarrant County need to know the ways insurance companies fight.

The Austin Court of Appeals issued an opinion in December 2012, that illustrates some of this. The case is styled, In re Old American County Mutual Fire Insurance Company.

Old American filed a petition for writ of mandamus complaining of the trial court’s order denying their plea in abatement. This Court denied the writ of mandamus.

Grand Prairie insurance attorneys need to understand the purpose and rules of insurance regulation.

As stated by the Texas Supreme Court in 1951, the insurance business affects the public interest and thus is subject to extensive regulation to prevent abuses. The rationale for this principle bears quoting at length. In an early case, the United States Supreme Court stated:

A contract for fire insurance is one for indemnity against loss, and is personal. The admission, however, does not take us far in the solution of the question presented. Its personal character certainly does not of itself preclude regulation, for there are many examples of government regulation in personal contracts, and in the statutes of every state in the Union superintendence and control over the business of insurance are exercised, varying in details and extent. We need not particularize in detail. We need only say that there was quite early state provision for what is known as the unearned premium fund or reserve; then came the limitation of dividends, the publishing of accounts, valued policies, standards of policies, prescribing investment, requiring deposits in money or bonds, confining the business to corporations, preventing discrimination in rates, limitations of risks, and other regulations equally restrictive. In other words, the state has stepped in and imposed conditions upon the companies, restraining the absolute liberty which businesses strictly private are permitted to exercise. Those regulations exhibit it to be the conception of the lawmaking bodies of the country without exception that the business of insurance so far affects the public welfare as to invoke and require governmental regulation. A conception so general cannot be without cause. The universal sense of a people cannot be accidental; its persistence saves it from the charge of unconsidered impulse, and its estimate of insurance certainly has substantial impulse, and its estimate of insurance certainly has substantial basis. Accidental fires are inevitable, and the extent of loss very great. The effect of insurance – indeed, it has been said to be its fundamental object – is to distribute the loss over as wide an area as possible. In other words, the loss is spread over the country, the disaster to an individual is shared by many, the disaster to a community shared by other communities; great catastrophes are thereby lessened, and, it may be, repaired. In assimilation of insurance to a tax, the companies have been said to be mere machinery by which the inevitable losses by fire are distributed so as to fall as lightly as possible on the public at large, the body of the insured, not the companies, paying the tax. Their efficiency, therefore, and solvency, are of great concern. The other objects, direct and indirect, of insurance, we need not mention. Indeed, it may be enough to say, without stating other effects of insurance, that a large part of the countries wealth, subject to uncertainty of loss through fire, is protected by insurance. This demonstrates the interest of the public in it, and we need not dispute with the economists that this is the result of the “substitution of certain for uncertain loss,’ or the diffusion of positive loss over a large group of persons, as we have already said to be considered a matter of public concern to regulate it, and, governmental insurance has its advocates and even examples. Contracts of insurance, therefore, have greater public consequence than contracts between individuals to do or not to do a particular thing whose effect stops with the individuals. We may say in passing that when the effect goes beyond that, there are many examples of regulation.

Fort Worth insurance lawyers and those in Arlington, Hurst, Euless, Bedford, and other places in Tarrant County need to know about this.

ABC News ran a story on January 7th that makes you angry. Here is what the story tells us:

A Staten Island couple said their insurance company short-changed them after superstorm Sandy destroyed their home, and then used their house in a commercial.

Grand Prairie insurance lawyers and those in Garland, Mesquite, Richardson and other places in Dallas County need to know the insurance laws in Texas. But they also need to know what is going on in other states.

The Detroit Free Press published an article on January 2, 2013, that an insurance attorney should find interesting. The article tells us that a judge has ruled that the Michigan Catastrophic Claims Association is subject to the Freedom of Information Act and must disclose how it calculates the annual fee assessed to each Michigan vehicle under the state’s no-fault auto insurance system.

Ingham County Circuit Judge Clinton Canady III issued the ruling late last week in a lawsuit brought by the Coalition Protecting Auto No-Fault and the Brain Injury Association of Michigan.

Dallas insurance lawyers and those in Mesquite, Garland, Richardson, and other places in Dallas need to know the different ways insurance companies operate. One of those is rescinding a policy.

As a general principle, prior to a loss an insurance company has the right to rescind the policy procured through mutual mistake or fraud. This is old law from the Amarillo Court of Appeals in 1931.

An insurance company may rescind a policy based on the insured’s misrepresentation, if the insurance company pleads and proves the following elements:

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