Solutions are what someone in Grand Prairie, Fort Worth, Dallas, Arlington, Cockrell Hill, Irving, Mesquite, Richardson, Garland, Duncanville, and other places want when it comes to a situation where they are being taken advantage of by an insurance company.
One of the first things an experienced Insurance Law Attorney has to decide when taking on an insurance case is – Who can be sued.
The Texas Insurance Code, Section 541.151, provides that a person who has sustained damages caused by another’s engaging in unfair or deceptive insurance practices may sue the person engaging in those acts or practices. The statute itself defines “person” to mean “an individual, corporation, association, partnership, reciprocal or interinsurance exchange, Lloyd’s plan, fraternal benefit society, or any other legal entity engaged in the business of incurance, including an agent, broker, adjuster or life insurance counselor.
A Texas Supreme Court case decided in 1998, applied the plain language of the statute to hold that “person” includes businesses and individuals “engaged in the business of insurance.” The style of this case is, Liberty Mutual Insurance Company v. Garrison Contractors, Inc. However, the statute does not apply to an insurance company employee that was not engaged in the “business of insurance.”
Engaging in unfair practices in “the business of insurance” is the key to holding an individual to liability. Those engaged in it may be held liable. Those who are not may not be held liable. In the Garrison case, an insurance agent whose job duties included soliciting and obtaining policy sales, explaining policy terms, and explaining premiums was engaged in the business of insurance and could be held liable under the statute.
In another Texas Supreme Court case, Great American Insurance Company v. North Austin Municiple Utility District No. 1, decided in 1995, the court held that contracts of suretyship are not part of the business of insurance, and the court decided that a surety could not be liable for unfair insurance practices.
A clear and understandable distinction was made in the Garrison case when the court said, “On the other hand, an employee who has no responsibility for the sale or servicing of insurance policies and no special insurance expertise, such as a clerical worker or janitor, does not engage in the insurance business.”
In addition to the holding in Liberty Mutual Insurance Company v. Garrison Contractors, Inc. that the sale of a policy is part of the business of insurance, the court also has held that the investigation and adjustment of claims and losses are too. This is from a 1988, Texas Supreme Court case styled, Vail v. Texas Farm Bureau Mutual Insurance Company.
Knowing who to sue and sueing for the right reasons can make a big difference in the eventual outcome of a case. The next step regards discovering and knowing what it is that can be recovered in a resulting lawsuit.