Life Insurance

Life Insurance Denial – Misrepresentation – 1

June 24, 2023 | Mark S. Humphreys

Life Insurance claims denial attorney are well aware of this 2023 opinion from the Texas Supreme Court. The opinion is styled, Arce v. American National Insurance Company.

On April 28, 2023, the Texas Supreme Court held that a life insurer seeking to avoid a life insurance policy via a Texas Insurance Code statutory misrepresentation defense must, just like under a common-law misrepresentation defense, prove the insured had “intent to deceive” when it made a misrepresentation in a life, accident, or health insurance application.

In making this ruling, the Texas Supreme Court rejected American’s argument that Texas Insurance Code, Section 705.051 did not require intent to deceive just because the statute was silent on whether intent to deceive was required.

Life Insurance – Date Of Termination – Claims Denial Attorney

June 17, 2023 | Mark S. Humphreys

Credit Life Insurance is the type of policy at issue in this 1979 opinion from the Fort Worth Court of Appeals. The opinion is styled, Leach v. Eureka Life Insurance Company of America.

Tommy Leach took out a loan from a bank and as part of the loan agreement, Tommy was required to purchase credit life insurance. The credit life insurance was for six months which began on March 13, 1977, and ended on September 13, 1977. Tragically, Tommy was reported killed in an auto accident that is showed a time of death as 12:45 a.m., September 14, 1977, Central Daylight Time.

Tommy’s widow, Mary Leach, made a demand on Eureka to pay the loan balance to the bank. Eureka refused payment, stating that the policy had terminated on September 13, 1977. This lawsuit resulted and the trial resulted in a ruling in favor of Eureka.

Life Insurance And More Than One Beneficiary – Life Insurance Claim Denial Attorney

June 10, 2023 | Mark S. Humphreys

Here is an unusual life insurance situation. It is an opinion from 1992. The opinion is from the Amarillo Court of Appeals and is styled, Ester Belle Medlin, Appellant v. Earnest G. Medlin, Floyd W. Medlin, Brenda E. Burford and Carolyn E. Medlin, Appellees.

The question to be determined in this matter is whether appellant Esther or appellees are entitled to one-half of insurance proceeds which had become payable due to the death of Jessie F. Medlin, Jr. (Jessie), the insured. Appellant is the insured’s mother and appellees are the insured’s children by a previous marriage. From a trial court judgment awarding those proceeds to appellees, appellant brings this appeal. For reasons hereinafter expressed, we reverse the judgment of the trial court and render judgment awarding the proceeds in question to appellant.

The beneficiary clause of the insurance policy provides in pertinent part:

Life Insurance – Electronic Funds Transfer

May 15, 2023 | Mark S. Humphreys

Life Insurance lawyers will eventually receive a phone call wherein the potential new client complains that the life insurance company quit making agreed upon payments for the life insurance from the potential client’s bank account.

Here is a 2023 opinion from the Southern District of Texas, Victoria Division, that discusses this issue. The opinion is styled, Gloria Fric v. Allstate Life Insurance Company.

The opinion discusses several legal issues. The focus here will be the issue related to the electronic funds transfer.

Life Insurance – Duty Of Good Faith And Fair Dealing

May 13, 2023 | Mark S. Humphreys

Life insurance lawyers and other attorneys dealing with insurance companies will often speak of the insurance company “duty of good faith and fair dealing.” This issue is discussed in a 2023 opinion from the Northern District of Texas, Dallas Division. The opinion is styled, Avery D. Ensley v. Genworth Life and Annuity Insurance Company.

The facts of the case can be read in the opinion. It is the discussion related to the issue of the “duty of good faith and fair dealing” that is discussed here.

The Court addressed Plaintiffs bad faith claim. Plaintiff alleges that (1) Defendant breached its duty when it failed to adequately notify Plaintiff of premium changes, the Policy’s alleged depleted cash value, and the Policy’s pending lapse; (2) Defendant breached its duty by failing to proceed with automatic withdrawals until Plaintiff was notified of the deficit and given an opportunity to make the requisite payment; and (3) Defendant breached its duty when it failed to reinstate the Policy.

Life Insurance Lawyers – Intent To Deceive

May 6, 2023 | Mark S. Humphreys

Life Insurance Attorney must read this 2023 opinion from the Texas Supreme Court. The opinion is styled, American National Insurance Company v. Bertha Arce.

This is arguably the most important life insurance opinion in many years in Texas and centers around whether or not the insurer must prove intent to deceive when denying a claim for life insurance benefits. The language of the Court in defining this issue is thus:

The primary issue before us is whether the common-law scienter requirement is repugnant to the plain language of section 705.051 of the Texas Insurance Code, which provides that “[a] misrepresentation in an application for a life, accident, or health insurance policy does not defeat recovery under the policy unless the misrepresentation: (1) is of a material fact; and (2) affects the risks assumed.”

When Does Life Insurance Coverage Terminate?

April 17, 2023 | Mark S. Humphreys

Life insurance lawyers will tell you that the answer to the titled question is dependent on the wording of the insurance policy and the facts of the case.

This issue was discussed in the 1979, Fort Worth Court of Appeals opinion styled, Leach v. Eureka Life Insurance Company of America.

This case involved a credit life insurance policy. The deceased in Tommy Leach and the executrix of the estate is Mary Leach, the Plaintiff here.

Life Insurance Attorney – Who Is Entitled To Life Insurance Benefits

April 15, 2023 | Mark S. Humphreys

The designated beneficiary of a life insurance policy generally is entitled to the proceeds upon the death of the insured. Absent an adverse claim, the insurer may pay the benefits to the designated beneficiary.

This is discussed in the 1967, Texas Supreme Court opinion styled, McFarland v. Franklin Life Ins. Co.

In 1950 respondent issued a policy of insurance on the life of John V. McFarland, who was about nine years of age at the time. The policy was taken out by his parents, Bernard and Gwendolyn McFarland, the latter of whom is petitioner here. Bernard was named in the policy as primary beneficiary, and petitioner was designated as contingent beneficiary. John married in 1962 and died the following year. His father predeceased him; he was survived by his widow and petitioner.

Life Insurance Claims Denial – Trial

April 10, 2023 | Mark S. Humphreys

Here is a life insurance case that went to trial in 2023. The case is styled, Mirna Guzman v. Allstate Assurance Company. The case was tried in the Northern District of Texas, Amarillo Division.

Allstate filed a declaratory judgment action against Guzman to have the life insurance policy she had applied for, rescinded due to misrepresentations in the policy application.

This was a lawsuit originally filed by Guzman and Allstate had countered with the declaratory judgment action.

Bad Faith Life Insurance Denial

March 25, 2023 | Mark S. Humphreys

Imagine this. A life insurance claim is denied. The beneficiary goes to an attorney who makes sends a demand letter to the life insurance company demanding payment and monies for their bad faith actions. In response to the demand letter the life insurance company sends the policy proceeds, plus interest. Does that end the matter?

This was answered as far back in Texas as 1908, in the Texas Supreme Court opinion styled, Penn Mutual Life Ins. Co. v. Manor.

For the full facts the opinion, which is kinda long, needs to be read.