General

Do Texas Laws Govern All Texas Policies

March 9, 2010 | Mark S. Humphreys

An important issue for any resident of Grand Prairie, Arlington, Dallas, Fort Worth, or even a resident of a smaller community such as Weatherford is: What happens if I get into an insurance dispute with my insurance company? What laws apply in fighting with the insurance company?

This question is atleast partially answered by a section of the Texas Insurance Code. Article 21.42 of the Texas Insurance Code is titled, Texas Laws Govern Policies. It says, “Any contract of insurance payable to any citizen or inhabitant of this State by any insurance company or corporation doing business within this State shall be held to be a contract made and entered into under and by virtue of the laws of this State relating to insurance, and governed therby, notwithstanding such policy or contract of insurance may provide that the contract was executed and the premiums and policy (in case it becomes a demand) should be payable without this State, or at the home office of the company or corporation issuing the same”.

Wow, no wonder attorneys are needed to decipher the law!

Rate Hikes Result In Lawsuit

March 8, 2010 | Mark S. Humphreys

It does not matter where in the State of Texas that you live. Whether you are in a small community like Weatherford or in the middle of the Dallas, Fort Worth, area, in cities like Arlington or Grand Prairie, you will see rate increases in your health insurance.

In the state of California, a consumer group filed a lawsuit on March 1, 2010. This was reported by the San Francisco Chronicle. The article is found in the health care section of the paper and is titled “Anthem Blue Cross Sued Over Rate Increases”. The lawsuit alleges that Anthem Blue Cross, by raising rates, was forcing policy holders to move into other policies with higher deductibles and lower benefits.

The consumer group, called Consumer Watchdog, accuses Anthem of violating state law by failing to offer policy holders comparable coverage and minimized rate hikes after the company directs customers to alternative plans when closing existing plans. One lady in the lawsuit, said the company offered her the option of switching to a policy with a higher deductible and skimpier benefits by a specific deadline, but also told her she could stay in her current policy. The company then notified her of the enormous premium increases in her plan after the deadline for switching had passed.

Health Insurance Exclusions

March 7, 2010 | Mark S. Humphreys

All over the Dallas, Fort Worth, Arlington, Grand Prairie areas and even out in Weatherford in Parker County, are immigrants. What many people fail to understand because of all the media coverage on illegal immigration in the United States, is that there is a large and growing number of legal immigrants in our country.

A newspaper in Massachusetts recently ran an article about health insurance and legal immigrants. The newspaper was The Boston Globe. The title of the article is “Immigrants Sue State Over Exclusion From Health Care”.

The State of Massachusetts, prior to 2006 provided health care to legal immigrants. According to the article, in an effort to save money, the legislature voted to eliminate coverage to about 26,000 immigrants. About a third of the money cuts were restored and the immigrants were given a stripped down health care plan with significantly higher copayments for medications and other treatments.

How To Beat Appraisal Clause In Insurance Contract

February 22, 2010 | Mark S. Humphreys

A lot of homeowners insurance policies in Texas have “appraisal” clauses written into them. So whether you live in Weatherford, Texas, or in Grand Prairie, Arlington, Fort Worth or Dallas, if you have homeowners insurance you need to be aware of these appraisal paragraphs.

An appraisal paragraph is of benefit to the insurance company. That is why they put it into the insurance policy. When the homeowner and the insurance company cannot reach an agreement on the amount of money that should be paid on a claim, the insurance company will try to invoke the appraisal clause in the insurance contract. Appraisal happens when the insurance company knows they owe the homeowner money, but there is a dispute as to how much money is owed.

The United States District Court, Southern Division, recently handled a case where the issue was whether the homeowner properly defeated the insurance company trying to invoke the appraisal process. The style of the case is, Hector Sanchez v. Property and Casualty Insurance Company of Hartford and Irene Bernardo. The courts’ opinion was handed down on January 27, 2010.

Where Will An Insurance Company Lawsuit Be Fought?

February 18, 2010 | Mark S. Humphreys

Most insurance company’s have their main offices located outside of Texas. If you live in Weatherford, Texas, Arlington, Grand Prairie, or the Dallas – Fort Worth area, and you sue an insurance company, how do you know you won’t have to travel to Delaware or some other state to fight the lawsuit?

The United State District Court, Southern District, Houston Division, recently had a case dealing with this issue. The case decision was handed down on January 26, 2010, and was styled, Houston Baptist University, v. Ace American Insurance Company and York Claims Service, Inc.

Houston Baptist University (HBU) had a policy of insurance with Ace American Insurance Company (Ace). HBU suffered losses as the result of Hurricane Ike hitting the Houston area and made a claim against Ace. Ace assigned York Claims Service, Inc. (York) to adjust and inspect the claim. HBU and Ace could not reach an agreement on the value of the claim and HBU filed a lawsuit against Ace and York. The insurance policy had a policy provision that read: Any dispute arising under this policy shall be exclusively subject to the jurisdiction of the federal and state courts located in the Commonwealth of Pennsylvania.

Title Insurance In Texas

February 15, 2010 | Mark S. Humphreys

If a Grand Prairie resident buys a new home, 95% of the time he is also going to be required to purchase a title insurance policy. This would be the same for a resident of Arlington, Dallas, Fort Worth, or Weatherford.

The Texas Supreme Court decided a case in 1994 that is relavent to home buyers and purchasers of title insurance policies. The case is styled, Chicago Title Insurance Company v. Jerry E. McDaniel and Christina W. McDaniel.

This case involves a claim against Chicago Title Insurance Company for violations of the Texas Deceptive Trade Practices Act (DTPA). The McDaniels purchased a title insurance policy issued by Chicago Title. The policy guaranteed the McDaniels had good and indefeasible title to the estate or interest in land described in the policy, which was the home they had purchased. This was in 1983.

Understand The Insurance You Are Buying

February 12, 2010 | Mark S. Humphreys

Good words of advice for any person buying insurance anywhere is: Know what you are buying. At the least, get it explained to you when purchasing some sort of insurance or warranty. This applies to the good people in the Dallas, Fort Worth, Arlington, Grand Prairie, and Weatherford areas of Texas.

The Pittsburgh Post Gazette recently published a news story where-in people were buying a pipe warranty. The title of the story is “Lawsuit Filed Over Opt-Out Waterline Insurance”. The charge for this warranty was only five dollars a month, but it was worthless to the people to whom it was being sold.

The pipe warranty was sold by the Pittsburgh Water and Sewer Authority. The warranty provider is Utility Line Security, or ULS, a new, Wilkinsburg-based business that shares most of their officers with Resource Development and Management. RDM is a politically connected firm that worked closely with the water authority Executive Director.

Insurance Company Fights Hard To Have Case Fought In Federal Court

February 4, 2010 | Mark S. Humphreys

Insurance companies prefer to have lawsuits litigated and fought in Federal Court. Attorneys who represent individuals and companies in Dallas, Fort Worth, Arlington, Grand Prairie, Weatherford, or any other community in Texas, prefer to be in the local State and County Courts. There are several reasons an insurance company prefers to be in Federal Court, but the bottom line is, it is better for them to be in Federal Court.

One fight an insurance company recently lost was in the case, Rosario Mayorga, v. Government Employees Insurance Company. The opinion on this case was issued on January 20, 2010.

The Mayorga case was originally filed in the 79th District Court of Jim Wells County. Mayorga sued Government Employees Insurance Company (GEICO) and the adjuster, Sean Hicks. GEICO is an insurance company with its headquarters located outside of Texas, which is a condition that would allow for the case to be removed to Federal Court. However, the adjuster, Hicks, was a Texas resident which would prevent removal. GEICO claimed that Hicks was improperly sued and because he was improperly sued the case should be allowed into Federal Court.

Excess Insurance Case In Texas

February 3, 2010 | Mark S. Humphreys

The United States Court of Appeals for the Fifth Circuit recently decided a case wherein the insured argued that he had an excess insurance policy. The court decided that his policy was not an excess insurance policy.

The case is styled “Danny Kirk, v. Universal Underwriters of Texas Insurance Co.” In this case, Universal Underwriters of Texas Insurance Co. (“UUT”), issued to Olympic International Trucks, Inc. d/b/a Olympic Ideal Lease (“Olympic”) an insurance policy. Kirk, who was injured by a tractor-trailer unit leased to Gulf Coast Building Supply (“Gulf Coast”), asserted that the policy issued to UUT was an excess policy.

The court analysed the policy. Reading Part 500 of the UUT Policy, it provided liability insurance to Olympic for injuries arising out of “garage operations” or “auto hazard.” Auto hazard included coverage of “anyone else required by law to be an insured while using an auto under a lease or rental agreement, within the scope of Olympic’s permission.” The UUT Policy provided that it only covered Olympic’s lessees if “at the time of the accident, the insurance required by the lease or rental agreement is not collectable.”

A Case Of Insurance Fraud

February 2, 2010 | Mark S. Humphreys

Most of the time when someone thinks of insurance fraud, they think about a staged accident, arson, or something else along these lines, where a person or company is trying to get money out of an insurance company that is not legitamate. Another example is lying on the insurance application. Here is a short story about a company making a false workers compensation report to the State. This case is a California incident but could just as easily have been an incident that happened with a business in the Dallas – Fort Worth area, like Arlington or Grand Prairie, or even out in Weatherford, in Parker County.

This article was found in the Los Angeles Times, in the Business Section. The title of the article is “Staffing Firm Pays $20 Million to Settle Fraud Allegation” and was reported on January 25.

The company, Staffing Services, Inc., was in the business of providing temporary workers to other businesses. They were accused of underpaying premiums to the State Compensation Insurance Fund, the state’s workers’ compensation carrier of last resort. Regulators filed charges against the company on November 26, 2008, accusing it of misrepresenting the number of employees and their job descriptions so it would pay smaller insurance premiums.