Interpreting An Insurance Policy

How To Determine Residency

July 5, 2012 | Mark S. Humphreys

Weatherford lawyers and those in Mineral Wells, Aledo, Springtown, Willow Park, Millsap, Brock, Hudson Oaks, Azle, and other places in Parker County need to know how to determine residency in an insurance policy.

The Houston Court of Appeals, 1st District, decided a case in 1996, that provides guidance on this issue. The style of the case is, State Farm Mutual Automobile Ins. Co. v. Nguyen. Here is some background.

The court had to decide whether the family member exclusion in Nguyen’ automobile liability insurance policy applied and, therefore, limited the amount of their recovery. The court had to also decide whether their child, whose entire six-day life was spent in a hospital, was a “resident” of Nguyens’ “household.” The court held that the child was a resident of the household and that the family member exclusion limited Nguyens’ recovery to $20,000.

Residents Of The Same Household Issue

July 3, 2012 | Mark S. Humphreys

Grand Prairie lawyers and those in Arlington, Fort Worth, Dallas, Grapevine, Richardson, Farmers Branch, Carrollton, Mesquite, and other places in the DFW area need to understand this part of an insurance policy.

It is the part dealing with defining “residents of a household.” This is usually a fact question for a judge or jury to decide.

A 1958, El Paso Court of Appeals case, Afredo Arellano v. Maryland Casualty Company issued an opinion that is still good guidance today.

Coverage Under An Insurance Policy

June 28, 2012 | Mark S. Humphreys

Grand Prairie lawyers who handle insurance disputes and those in Dallas, Fort Worth, Mansfield, De Soto, Duncanville, Irving, Arlington, and other places in the Dallas Fort Worth area need to understand the coverages under an insurance policy. Specifically, they need to know what an ‘occurrence’ or ‘loss’ is under a policy.

The Fort Worth Court of Appeals issued an opinion in 1996, in the case styled, State Farm Lloyds and State Farm Fire and Casualty Company v. Paul and Mary Kessler. The insurers here filed a declaratory judgement pleading they had no duty to defend a suit pending against the Kesslers by the Fannings’ who had purchased a home from the Kesslers. The trial court ruled in favor of the Kesslers and this appeal followed.

This court said the following: We hold that State Farm has no duty to defend the Kesslers because (1) the Fannings’ petition does not allege property damage as defined by the policy and (2) it does not allege damages from an occurrence or loss as defined by the policy.”

Turning In Claim to Insurance Company

June 26, 2012 | Mark S. Humphreys

Insurance lawyers in Grand Prairie, Fort Worth, Dallas, Richardson, Mesquite, Garland, and other places in the Dallas and Fort Worth area need to know and understand this case. It discusses one of the responsibilities of an insured under an insurance policy relating to claims made and notifying the insurance company.

The case opinion was issued by the Fort Worth Court of Appeals in 1969, and is still good law. The style of the case is, National Union Fire Insurance Company et al. v. Joe Bourn, Jr. Here is some relevant information.

The facts are longs and rather detailed. What is relevant is that on October 5, 1965, Bourn was involved as a victim in an assault and resulting injuries. Bourn sued the attackers and won a judgment against them. National Union defended in the resulting lawsuit but refused to pay any damages rendered against their insureds.

Lender-Placed Policies

June 23, 2012 | Mark S. Humphreys

Grand Prairie insurance lawyers and those in Fort Worth, Dallas, Carrollton, Garland, Irving, Mesquite, Richardson, and other places in North Texas will get the occasional phone call wanting to discuss a situation involving a lender-placed insurance policy.

The Houston Court of Appeals, 14th District, issued an opinion on May 17, 2012, that discussed this issue. The case had other points that will not be discussed here. The style of the case is, Milton Garcia v. Bank of America Corporation, BAC Home Loan Servicing, LP, and Newport Insurance Company. Here is legal background.

This was a consolidated appeal by Milton Garcia from the trial court’s grant of summary judgments in favor of the defendants. Bank of America (BOA) owned the mortgage on Garcia’s home, BAC was the mortgage servicing company that serviced Garcia’s mortgage, and Newport issued the lender-placed insurance policy to BOA on Garcia’s property. Seeking compensation for damage to his property sustained in Hurricane Ike, Garcia alleged that he was a third-party beneficiary of the insurance policy Newport issued to BOA.

Prompt Notification of Claim

June 19, 2012 | Mark S. Humphreys

Grand Prairie insurance attorneys and those in Irving, Fort Worth, Dallas, De Soto, Cedar Hill, Duncanville, and other places in the Dallas – Fort Worth area would want to know about the following case.

This case deals with the issue of notifying the insurance company promptly when a claim arises. The case ruling was issued May 10, 2012, by the Houston Division, Southern District of Texas, United States District Court. The style of the case is, Centaurus GF Champions, LLC D/B/A La Jolla Champions Apartments v. Nutmeg Insurance Company, Scottsdale Insurance Company, Cramer, Johnson Wiggins & Associates, Inc. and Ted W. Allen & Associates, Inc.

Here is some background:

Automobile Insurance Policy Exclusions

June 17, 2012 | Mark S. Humphreys

Weatherford insurance lawyers and those in Mineral Wells, Springtown, Aledo, Azle, Willow Park, Hudson Oaks, Peaster, Poolville, Cool, Millsap, Brock, and other places in Parker County would want to know about the opinion in this case.

The case is from the Eastland Court of Appeals and was decided in 1965. The style of the case is, Hilliard Gonzales et al. v. Farmers Insurance Exchange.

Hilliard Gonzales and Noe Mata filed suit against Farmers for benefits under a family automobile policy written for Ramon Gonzales, the father of Hilliard. The case was tried to the Judge without a jury and judgment was rendered against Gonzales.

Insurance Policy Exclusion

June 16, 2012 | Mark S. Humphreys

Grand Prairie insurance attorneys and those in Dallas, Fort Worth, Arlington, Mansfield, Grapevine, and other places in the Dallas – Fort Worth metroplex need to be aware of the exclusions in insurance policies and how to interpret them. Here is a case that deals with an exclusion in an automobile policy.

The style of the case is, “Carl Calvin Futrell v. Indiana Lumbermens Mutual Insurance Company. This is a 1971, opinion issued by the Houston Court of Appeals. Here is some background.

The case is a suit on medical payment benefits under an automobile insurance policy. The insured sued for medical expenses incurred by his minor son, who was injured while riding a motorbike when it collided with a motorcycle. Futrell contended that the trial court erred in concluding that a motorcycle is not an automobile within the meaning of that term as it is used in the medical payments coverage of the Texas family combination automobile insurance policy.

Life Insurance / Suicide

June 10, 2012 | Mark S. Humphreys

Grand Prairie insurance lawyers, and those in Dallas, Fort Worth, Richardson, Mesquite, Garland, Irving, Arlington, and other places in the North Texas area who deal with life insurance cases involving a suicide would want to be aware of this case.

The case is an opinion issued by the Amarillo Court of Appeals in 1986. The style of the case is, Southern Farm Bureau Life Insurance Co. v. Steven M. Dettle, et al. Here is some background.

Southern Farm Bureau appealed from a trial court’s judgment rendered in favor of Steven M. Dettle and Phillip D. Dettle, as administrators of the estate of Douglas Dee Dettle, deceased. The controversy arose from Farm Bureau’s failure to pay benefits on a policy insuring Douglas Dee Dettle. The deceased – insured was found dead in his apartment in Stratford, Texas. He died as the result of a single shotgun wound to his lower abdomen and genital area. Farm Bureau defended on a suicide exclusion in the policy and certain alleged misrepresentations in the deceased’s application for insurance. (Here, we will discuss only the suicide issue). In response to special issues, the jury determined that the deceased’s death was not a suicide and that the deceased’s “no” answer to the question in the application, “Have you in the past 5 years used alcoholic beverages to excess or intoxication?” was false.

Misrepresentation In Purchase Of Insurance Policy

June 5, 2012 | Mark S. Humphreys

Weatherford attorneys and those in Mineral Wells, Aledo, Azle, Springtown, Peaster, Millsap, Brock, Hudson Oaks, Willow Park, and other places in Parker County would want to read the case decided in July 2011, by the San Antonio Court of Appeals. The case is styled, Texas Farm Bureau Mutual Insurance Co. v. Shannan Rogers and Cristen Bazan et al. Here is some background.

In 2008, Cynthia Bazan purchased a house in Kerr County with a mortgage from Regency Solutions, which required her to obtain insurance on the house. Bazan purchased a policy from Farm Bureau. On January 14, 2009, a fire completely destroyed her house and all of its contents. She made a claim and Farm Bureau began a criminal background check of Bazan and the cause of the fire. The fire was determined to be of “undetermined” origin. Bazan, in her interview admitted to a criminal history. However, she had denied the criminal history in her application for insurance. In fact, she had a lengthy criminal history. Farm Bureau made a decision to rescind the policy, thus denying Bazan policy benefits for the fire loss.

The specific policy language relied on by Farm Bureau read: