Home Owners Policies

Segregating Losses On Insurance Claim

May 13, 2014 | Mark S. Humphreys

Saginaw insurance lawyers need to know about this insurance case. The case is a 1999, San Antonio Court of Appeals case styled, Wallis v. United Services Automobile Association. Here is the relevant information.

In the spring of 1993, the Wallises noticed evidence of foundation damage in their home. Suspecting such damage was caused by a plumbing leak, the Wallises filed a claim under their homeowner’s policy. Through its investigation, USAA determined that the foundation damage was caused by a combination of several excluded perils under the Wallises’ policy, including settlement, poor surface drainage, the topography of the lot, and surrounding vegetation. Plumbing leaks, which are covered perils, were also detected; however, based on soil testing and continued earth settlement following repair of the Wallises’ plumbing system, USAA concluded that the leaks were negligible and had not caused or contributed to the complained-of damage. USAA believed improper compaction of the fill dirt upon which the Wallises’ foundation rests was the primary source of the problem. Elevation tests indicated that the Wallises’ home, which was built upon a sloping lot, had settled as much as fifteen inches on the low end of the hill where soil was placed to create a plane for the foundation. In short, USAA’s investigation revealed that the Wallises’ home was sliding down the lot. Experts for the Wallises did not refute USAA’s evidence regarding the excluded perils. They did, however, challenge the conclusion drawn regarding the effect of the plumbing leaks, and claimed instead that the leaks could not be excluded as a contributing cause of the damage.

At trial, the jury was asked to determine whether “earthquake, landslide, or earth movement,” perils excluded under exclusion k of the policy, caused the Wallises’ damage. The jury was also charged under question two of the charge with determining whether “accidental discharge, leakage, or overflow of water from within a plumbing system” contributed to the Wallises’ damage. The jury answered both questions affirmatively and, under question three, found that thirty-five percent of the Wallises’ damage was caused by plumbing leaks.

Additional Living Expense

January 7, 2014 | Mark S. Humphreys

Insurance lawyers in the Dallas – Fort Worth area need to be able to discuss coverage for “additional living expense” ALE with clients.

In 2005, the United States District Court for the Southern District of Texas issued an opinion in the case styled, Howard v. State Farm Lloyds. Here is some of what the case says.

The insured, Howard, filed a mold claim with her insurer, State Farm, under a standard homeowner’s policy. Under the terms of the policy, the insurer extended coverage to the insured for ALE she incurred as a result of inability to live in her residence pending remediation. Shortly thereafter the insured presented a six-month lease on another residence along with a copy of a check for $12,500 allegedly representing first and last months rent at $4,500 per month plus deposits on the residence. Based on these and similar representations, the insurer paid total ALE benefits to the insured of more than $126,000 over a two year period. As it turned out, the ALE benefits included overpayments of more than $80,000 procured through submission of false documents. The insured subsequently sued her insurer for breach of contract, breach of duty of good faith and fair dealing, and violations of the Texas Deceptive Trade Practices Act (DTPA) and Sections of the Texas Insurance Code, including violations of the Prompt Payment of Claims Act. The insurer counter-claimed and filed a motion for summary judgment on the affirmative defense of concealment and fraud.

What Is A Motor Vehicle

October 31, 2013 | Mark S. Humphreys

Arlington insurance attorneys will be called on by potential clients to discuss how an insurance policy is interpreted. Especially so when a claim is denied.

As it relates to the use of the term “motor vehicle” in an insurance policy, the 1985, Fort Worth Court of Appeals case, Western Insurance Companies v. Andrus is good to look at for guidance. Here is some background information.

Here, Western Insurance is appealing from a judgment in favor of Andrus and complains of the trial court failure to grant it’s motion for judgment non obstante.

Forced Placed Policies

October 15, 2013 | Mark S. Humphreys

Dallas insurance attorneys who deal with homeowners claims are usually going to have some familiarity with forced-placed insurance policies.

Most people will not ever have to deal with forced placed policies, but if you do, it can be a nightmare.

Forced place insurance is an insurance policy taken out by a lender or creditor when a customer does not carry insurance on an asset. The charges for this insurance are passed on to the customer.

Insurance Payments And Coverage

August 22, 2013 | Mark S. Humphreys

Parker County attorneys probably know the law about this case even if they have not read the case. The case is an opinion from the Houston Court of Appeals, First District. The style of the case is, Texas Farm Bureau Underwriters and Texas Farm Bureau Insurance v. Douglas Rasmussen and Kathy Rasmussen.

The Rasmussens owned a rental house located in Texas. Beginning in 2006, the Rasmussens insured the house with Texas Farm Bureau. To encourage a shift in their insurance provider, the insurance agent, Bolton, told the Rasmussens that he would take care of the Rasmussens’ insurance needs, provide more personalized service, and notify them of any changes to their policies.

The Rasmussens renewed the policy that covered the rental home in June 2007. They paid the premium for the term of June 1, 2007 to June 1, 2008. They did not pay the premium when it was again due in June 2008. In January 2009, the fire occurred. The Rasmussens submitted an insurance claim, but the Texas Farm Bureau denied it.

Insurance Claims As Breach Of Contract Claims

June 22, 2013 | Mark S. Humphreys

Fort Worth insurance attorneys will tell you that an insurance policy is a contract. A 1992, Dallas Court of Appeals case gives a good example of how the Courts deal with this concept. The style of the case is, St Paul Insurance Company v. Rakkar.

This case deals with many insurance issues but here are the issues as it relates to contracts:

Rakkar owned a house in Jewett, Texas. On August 27, 1988, after the tenants who had been living in the house vacated the property, Rakkar travelled the four hours from his home in Whitesboro, Texas, to Jewett to inspect the property with the real estate agent who helped him manage the property. Rakkar planned to grill some hot dogs for his dinner, spend the night in the house, and return to Whitesboro the next day. With this plan in mind, Rakkar bought hot dogs, a small hibachi-type grill, lighter fluid, and obtained some charcoal. He also bought a bottle of drinking water because the water at the house had been shut off. When he got to the house, he opened the windows to air out the house and started the air conditioner. Because the grass around the house was tall and dry, he decided to light the grill in the kitchen and then carry it onto the patio after clearing a space for the grill on the patio. Rakkar set the grill on the kitchen floor. After lighting the grill, he had begun to work on the ceiling fan when his real estate agent arrived. She told Rakkar that she smelled something “hot,” and Rakkar showed her the hibachi grill sitting on the kitchen floor. She told him that he should move it outside because the heat from the grill could burn the linoleum flooring. After declining Rakkar’s invitation to join him for a hot dog, the real estate agent left. Rakkar decided to take the grill onto the patio. When he bent over the coals, he passed out. When he awoke five or six minutes later, the grill was overturned near the base of the cabinets, the coals were scattered over the kitchen floor, and the cabinets were on fire. Rakkar ran to the sink, but no water came out. Rakkar then ran to his neighbors to get assistance, but they were not at home. He then drove the half mile to the marina and called the fire department, which was fifteen to twenty miles away. By the time the fire truck arrived, the house was completely engulfed in flames. T he house burned to the ground.

Federal Court – Trying To Stay Out

June 16, 2013 | Mark S. Humphreys

Dallas insurance lawyers would want to be aware of this recent case out of the United States Southern District Court, McAllen Division. The style is Samuel Gacia, et al, v. Geovera Specialty Insurance Company.

Insurance companies prefer to have cases in Federal Court. Attorneys suing insurance companies prefer to be in State Court. The reasons will not be discussed here. But this case discusses how a Federal Court looks at which Court a case should be in.

Here is some of the relevant information:

Beneficiary Under A Fire Policy

April 16, 2013 | Mark S. Humphreys

Weatherford attorneys may run across a situation in a recent Waco Court of Appeals opinion. Here is what it tells us.

The dispute in this case centers on who is entitled to insurance proceeds associated with a house that burned down. Taylor claims that she is entitled to the proceeds because, she and Lough lived together in a house from 2005 to 2007. Apparently, Taylor continued living in the house after the couple broke up and Lough moved out in mid-2007.

In any event, on March 1, 2007, Lough, an “unmarried person,” executed a homestead lien contract and deed of trust with the Bank for a loan secured by the property at issue in this case–the proceeds of which, according to Taylor, were used to buy land to move Lough’s feed store. The contract and deed of trust specifically stated that Lough granted the Bank a lien . . . “in and to the following described real property, together with all improvements, all proceeds (including without limitation premium refunds) of each policy of insurance relating to any of the improvements, or the Real Property . . . .”

Insurable Interests

March 3, 2013 | Mark S. Humphreys

Fort Worth insurance attorneys need to be able to advise a person whether or not they are entitled to recover under a policy of insurance. Just because a person has insurance does not mean they are automatically entitled to make a recovery on lost property. From a legal standpoint – a person must have an insurable interest.

A 1993, Dallas Court of Appeals case sheds some insight into how a person who has insurance on a piece of property, not be be able to recover for the loss of that property. The case is styled, Jones v. Texas Pacific Indemnity Company.

Here is some background:

Insurance Claim Denial

October 27, 2012 | Mark S. Humphreys

Grand Prairie insurance lawyers and those in Dallas and other areas will run across situations where an insurance company is denying a claim based on the defense of arson. This happened in the case, Southland Lloyd’s Insurance Company v. Tomberlain. The case is a Texas Supreme Court case decided in 1996.

Here is some relevant information:

Charles W. Tomberlain is an independent insurance agent who owns the Charles Tomberlain Insurance Agency in Longview. His son, Chuck Tomberlain, is an agent with the agency. In addition, Chuck Tomberlain owns and manages numerous real properties in and around Longview. In 1988, Chuck Tomberlain purchased a small house, for $13,200.00. Chuck Tomberlain then spent approximately $500.00-$1,000.00 improving the house. On September 9, 1988, Chuck Tomberlain executed a contract for sale of the house to Trennis Willis for $20,000.00, to be paid in monthly installments over ten years at twelve percent interest. Willis immediately began occupying the house. Chuck Tomberlain, acting as agent for the Charles Tomberlain Insurance Agency, issued a policy on the house with Republic Insurance Company in August 1988. On August 15, 1991, the Republic insurance policy on the house expired. Chuck Tomberlain did not renew the policy at that time because his father’s agency had stopped writing policies with Republic.