Dallas Fort Worth Insurance Lawyer Blog
The title of this article may really be kinda mis-leading. In fact it probably should be “It Is Easy In Texas To Get Away With Claims Denial For Fraud”. Here is why the second title may be more truthful: Most people don’t know that the first title is more accurate. Confusing? Let me explain.
It is almost routine for a for an insurance company to deny a claim and state as one of the reasons for denial that the person who purchased the insurance lied or committed fraud when they filled out the application for insurance. Unless the person who gets the letter knows to take the letter to an Insurance Law Attorney, they probably get angry, upset, frustrated, and then give up. Thus it was easy for the insurance company to get away with a claim denial based on fraud.
If you are in the Dallas Fort Worth area or out in Parker County and Weatherford, or anywhere else in the State for that matter you can contact Mark Humphreys. Then you will be told that Texas law makes it very difficult for an insurance company to get away with claims denial for fraud. Then you will allow us to file a lawsuit on your behalf for the benefits you have been denied.
Under Texas law, an insurance company must plead and prove the following to avoid a policy because of fraud or misrepresentation by the insured person: (1) the making of the representation; (2) the falsity of the representation; (3) reliance thereon by the insurance company; (4) the intent to deceive on the part of the insured person in making the representation; and (5) the materiality of the representation. Mayes v. Massachusetts Mut. Life Ins. Co. is a Texas Supreme Court case stating so.
Another Texas Supreme Court case, Union Bankers Ins. Co. v. Shelton, said the insurance company was wrong in its denial. In Union Bankers, the insurance company attempted to rescind life insurance policies because the insured person failed to inform the insurance company of a change in his health after he signed the applications.
Claiming fraud or misrepresentation is a very difficult defense for the insurance company. There is a long line of case law in Texas making this difficult. The problem is that most people and even attorneys who do not practice insurance law do not know the law as it relates to this matter and thus when a letter is received from the insurance company denying the claim, there is crying and weeping, and surrender.
If your claim is denied based on fraud or misrepresention or any reason, you have nothing to lose by letting us at Mark Humphreys Law Firm look at you case. Most the time we can help.