Articles Posted in Interpreting An Insurance Policy

Hail claims lawyers need to read the Texas Supreme Court opinion styled, JAW The Point, L.L.C. v. Lexington Insurance Company. This is a 2015, opinion that is relevant to most hail damage claims, as well as lots of other claims. The case is written about in the State Bar of Texas Insurance Journal It is hard to believe that this case is the Texas Supreme Court’s first occasion to address the proper application of the so-called “anti-concurrent-causation” (the “ACC”) exclusion, which in this case bars coverage for:

loss or damage caused directly or indirectlyby any [excluded cause or event], regardless

of any other cause or event that contributes concurrently or in any sequence to the loss.

Attorneys handling hail damage claims need to read this case. It is a 2015, Texas Supreme Court opinion styled, JAW The Point, L.L.C. v. Lexington Insurance Co.

In this case, the “anti-concurrent causation” (ACC) exclusion reads:

loss or damage caused directly or indirectly by any [excluded cause or event], regardless of any other cause or event that contributes concurrently or in any sequence to the loss.

Mineral Wells insurance lawyers are aware of appraisal clauses in insurance contracts. Interpreting them is not always easy. The Amarillo Court of Appeals issued an opinion in a 2015 case that needs to be read. It is styled, In Re Century Surety Company.

This is a mandamus proceeding that arises from a lawsuit by an insured, Jefferson, against Century.

The lawsuit filed on December 16, 2013, arises out of a claim submitted for hail damage which occurred on May 28, 2013, alleging breach of contract and extra-contractual claims. A lawsuit was filed suing Century, an adjusting company, and two individuals.

Insurance lawyers need to recognize when coverage will be provided in cases when an insured is being accused of being liable for harm caused to a third party. A 1988, Texas Supreme Court case is insightful to this issue. The style of the case is, Adela Snellberger v Rosita Hernandez.

This is an appeal in a wrongful death action brought by the heirs of Harold Snellenberger against Rosita Hernandez Rodriguez. The trial court granted a summary judgment for Rodriguez. This Court affirmed that finding.

Rodriguez drove her automobile over and critically injured a small child. At the time of the accident, Snellenberger was employed as a police officer. When he and another officer were notified of the accident, they immediately proceeded to the scene in their separate patrol cars. Upon arrival, the other officer administered CPR to the child, while officer Snellenberger moved back the crowd of people which had gathered at the scene. Included in the crowd was the grief-stricken mother of the injured child. As officer Snellenberger began controlling the crowd, he suddenly collapsed and later died of a heart attack. His widow and children brought this action relying upon the rescue doctrine.

Dallas insurance lawyers can tell a client that one of the most important things to do when looking at an insurance claim is to read the policy. What the policy says, coupled with the facts of the claim, go a long way in determining whether or not a claim should be paid. The Texas Supreme Court issued an opinion in 2015, that is a must read for insurance law attorneys. The case is styled, RSUI Indemnity Company v. Lynd Company.

This claim involves two insurance companies, RSUI which provided excess coverage and Westchester Fire Insurance Company which provided a $20 million dollar limit. The total loss was $24.5 million spread over several properties owned by Lynd. The parties agreed that the loss was from a loss from a single occurrence. Westchester paid it’s $20 million dollar limit but RSUI refused to pay the remaining $4.5 million and instead paid Lynd only $750,000.

RSUI cited the excess policy’s “Scheduled Limit of Liability” endorsement as the basis for its denial of coverage. Lynd sued RSUI to recover the difference between its $24.5 million in losses and the $20,750,000 Westchester and RSUI paid out under the policies. As a result, the question of whether coverage existed under the excess policy depended on the interpretation of the “Scheduled Limit of Liability” endorsement.

Springtown life insurance lawyers would want to know about an opinion from a Florida Court dealing with beneficiaries under a life insurance policy. The Court looked at the law in Florida at issue and then looked at the language of the policy and issued a ruling that many would disagree with. The opinion is discussed at WealthManagement.com. The article is titled, When Is An Adoption Not Effective To Change Inheritance Rights?

In a case styled Lubin v. AT&T Ret. Sav. Plan (2015 WL 4397703), an adoption was not given effect in determining who would receive the life insurance benefits at issue.

In this case, Austin Hardy participated in a Retirement Savings Plan (“Plan”), which included a life insurance benefit. At his death, he was survived by his sisters, Pauline Lubin and Frances Koryn (Plaintiffs), and his biological daughter, Jennifer Krokey. Although Krokey was Hardy’s biological child, she had been subsequently adopted by a step-father. Under Florida law, a child who is adopted is the child of the adopting parent and ceases to be a child of the biological parent for all purposes.

Insurance lawyers in Parker County need to read a Houston Court of Appeals [1st Dist.] opinion issued in October 2105. It is styled, John Davis D/B/A J. D. House of Style v. National Lloyds Insurance Company.

This is an appeal by Davis from a Judge’s ruling on a JNOV in favor of National.

The court submitted two measures of damages to the jury, and the jury determined that Davis sustained $0 damages based on the actual cash value of the property claim and that he sustained $100,000 in damages based on the replacement value of the property claim. National Lloyds moved to disregard the replacement value finding, arguing, in part, that the plain language of the policy itself limited Davis to recovery for the actual cash value of his property damage claim.

Dallas area insurance attorneys are most likely to see insurance companies argue “concurrent causation” in claims related to homeowners policies. The Claims Journal published an article discussing this topic in October of 2015. The title of the article is “Texas Supreme Court Upholds Anti-Concurrent-Causation Clauses In Property Policies.”

The article tells us the Texas Supreme Court in JAW the Point, LLC v. Lexington Ins. Co., 460 S.W.3d 597 (Tex. 2015) held, on first impression, that losses incurred in demolishing and rebuilding property damage resulting from Hurricane Ike to comply with city ordinances were excluded under the policy’s anti-concurrent-causation clause. Prior to the Texas Supreme Court’s JAW decision, federal and lower state courts of appeal had interpreted and upheld the applicability of anti-concurrent-causation clauses under Texas law.

Taking its lead from the United States Circuit Court of Appeals for the Fifth Circuit, the Texas Supreme Court held that a policy anti-concurrent-causation clause together with an exclusion for losses caused by flood, when read together, excluded from coverage any damage caused by a combination of wind and water. Previously, the Fifth Circuit Court of Appeals in Leonard v. Nationwide Mut. Ins. Co., had concluded in situations involving combinations of covered wind damage and excluded flood damage that the only species covered under a policy with an anti-concurrent-causation clause is damage caused exclusively by wind. But when wind and water synergistically cause the same damage, such damage is excluded.

Arlington insurance attorneys, as well as all insurance attorneys might run across a situation that was seen in a recent 14th Court of Appeals opinion. The style of the case is Nassar v. Liberty Mutual Fire Insurance Company.

This is an appeal from a motion of summary judgment in favor of Liberty.

The Nassars owned a residence situated on six acres. In addition to the residence itself, these six acres contain a system of fences, barns, and outbuildings. Liberty insured the dwelling and other structures pursuant to a Texas Homeowners Policy Form A. This policy was in effect when Hurricane Ike hit the area and caused losses.

Forth Worth lawyers handling hail damage claims need to read a recent opinion from the Amarillo Court of Appeals. The case is styled, In Re GuideOne National Insurance Company.

The case involves two insurance claims: one for fire damage and another for wind or hail damage to property. The insurer is GuideOne who sought appraisal in this case. A lawsuit had been filed and the property owners requested that the Court not allow the appraisal. This request was sought long after the law suit had been filed and the property owners had incurred substantial costs. The Court denied the appraisal request and this mandamus action followed. This Court upheld the trial Court decision.

Appraisal clauses provide a means to resolve disputes about the amount of loss for a covered claim. As the Texas Supreme Court has explained: “In every property damage claim, someone must determine the ‘amount of loss,’ as that is what the insurer must pay. An appraisal clause ‘binds the parties to have the extent or amount of the loss determined in a particular way.'”

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