Dallas Fort Worth Insurance Lawyer Blog

Hail Damage Claim Attorney

August 12, 2023 | Mark S. Humphreys

Here is a hail damage claim that has a frequently heard assertion by the insurance company. That assertion being that whatever hail damage exists occurred outside the policy period.

This is a 2023, summary judgment opinion from the Western District of Texas, San Antonio Division. The opinion is styled, PMJ Bleu Terre Management, LLC v. AmTrust Insurance Company of Kansas, Inc.

The facts presented in the motion are lengthy and should be read. Here is the analysis of the case by the Magistrate Judge.

Life Insurance and divorce have to be reconciled when an insured dies. There are many issues that arise in these situations. Here is a 2023 opinion from the Eastern District of Texas, Sherman Division that is a necessary read for any attorney handling life insurance cases wherein an insured dies after a divorce. The opinion is styled, Transamerica Life Insurance Company v. Holly L Moore and Jeffrey H. Simpson.

This is an interpleader action wherein Transamerica owed money after an insured died but was uncertain to whom the money should be paid. The competing claimants are Moore and Simpson.

In February 2018, the Decedent purchased the policy at issue. At the time that he purchased the Policy, the Decedent identified himself as single, and he was engaged to marry Moore later that fall. The Decedent designated Moore, his then-fiancée, as the primary beneficiary of the Policy and Simpson, his father, as the Policy’s contingent beneficiary.

Bad Faith Insurance & Mis-Representations

August 5, 2023 | Mark S. Humphreys

Here is a 2023 opinion wherein the lawsuit alleges the insurer mis-handled a claim. The opinion is from the Southern District of Texas, Brownsville Division, and is styled, Maria Alcala v. Allstate Vehicle And Property Insurance Company.

Allstate filed a Rule 12(n)(6) motion seeking a partial dismissal.

First, Allstate requests dismissal of Alcala’s claim under the Texas Insurance Code for “failure to promptly provide . . . a reasonable explanation . . . for the insurer’s denial of a claim”, in violation of Texas Insurance Code, Section 541.060(a)(3). Allstate argues that the Court should dismiss this cause of action because Alcala did not allege reliance or how any allegedly unreasonable explanation contributed to her damages. As to the initial point, neither Section 541.060(a)(3) nor the caselaw on which Allstate relies indicates that a plaintiff must plead reliance as part of a Section 541.060(a)(3) claim. And other authorities recognize that a Section 541.060(a)(3) claim “does not involve reliance on material misrepresentations”. As to damages, Alcala alleges that “because Allstate’s adjuster failed to properly inspect and account for the covered losses, Defendant issued no payment to Plaintiff for the extensive damage to her property. These allegations suffice to support the cause of action at this stage of the proceedings. As a result, the Court finds both of Allstate’s arguments to dismiss this claim unavailing.

Bad Faith – Texas Insurance Code

July 31, 2023 | Mark S. Humphreys

Bad Faith or Texas Insurance Code violations are alleged is the vast majority of situations where an insurance company denies a claim. So, how do the courts look at these case. Here is a 2023 case from the Southern District of Texas, Brownsville Division. It is styled, Maria Alcala v. Allstate Vehicle and Property Insurance Company.

Plaintiff Maria Alcala filed this action in Texas state court against Defendant Allstate Vehicle and Property Insurance, alleging violations of the Texas Insurance Code and the state’s Deceptive Trade Practices Act. Alcala also alleged that Allstate breached their contract and breached the common law duty of good faith and fair dealing. Allstate removed the case to federal court, and Alcala initially filed an Amended Complaint and later a Second Amended Complaint.

Allstate filed a Rule 12(b)(6) motion to dismiss. The Court granted part of the motion and denied part of the motion.

Bad Faith Lawyer – Statute Of Limitations

July 29, 2023 | Mark S. Humphreys

Insurance lawyers have to understand how the statute of limitations is looked at by the courts. Here is a 2023 opinion from the Fort Worth Court of Appeals. The opinion is styled, Erica Quinn v. State farm Lloyds, et al.

A statute of limitations establishes a time limit for suing in a civil case. A statute of limitations operates as an affirmative defense to a cause of action.

A statute of limitations begins to run on the accrual date, which is the date that the cause of action accrues. Generally, a cause of action accrues when facts giving rise to the cause of action come into existence, even if those facts are not discovered, or the resulting injuries do not occur, until later.

Prompt Payment Of Claims Statute – Other Issues

July 24, 2023 | Mark S. Humphreys

The Texas Prompt Payment of Claims statute is helpful to claimants when an insurance company drags it feet on paying a claim. This statute is found in the Texas Insurance Code, Sections 542.051 – through 542.061.

When an insurance company reasonably requests information from a claimant, deadlines are postponed until the insurance company receives the requested information.

In contrast, the statute does not expressly extend any deadlines while the insurance company awaits information from third parties. However, if the insurance company cannot accept or reject a claim because it is still waiting for such information, Section 542.056(d) allows the insurance company a one-time, 45 day extension.

Late Payment Of Claim – Can The Insurance Company Get Away With It

July 22, 2023 | Mark S. Humphreys

The Texas Prompt Payment of Claims Act is found in the Texas Insurance Code, Section 542.051 thru 542.061. When an insurance company fails to timely pay a claim, are there ways they can escape liability under the Prompt Payment of Claims Act?

If the insurance company cannot accept or reject the claim by the initial deadline, the statute lets the insurer notify the claimant that it cannot accept or reject a claim by the deadline. This is found in Section 542.056(d). This notification has to be sent before the original deadline, and the notice must state the reason why the insurance company needs additional time. The insurance company then has 45 additional days to accept or reject the claim.

The insurance company’s good faith – or its lack of bad faith – is no defense. This is discussed in the 1997, United States 5th Circuit Court of Appeals opinion styled, Higginbotham v. State Farm Mutual Automobile Insurance Company. In reaching this conclusion, the court noted that precedents under the predecessor statute, article 3.62, held that an insurance company’s good faith in denying a claim did not relieve them of liability for penalties. The court concluded that an insurance company that denies a claim takes the risk that it will have to pay additional damages allowed by the statute.

Hail Damage Claims

July 17, 2023 | Mark S. Humphreys

From a statistical point of view, less than 2% of all lawsuits result in an actual trial. They either get thrown out of court on a motion for summary judgment or they they get settled. Most get settled. For the cases that go to trial, the public hears about the “million dollar” wins. What is not reported are the day in and day out loses that occur. It is important to understand why they lost.

Here is a 2023 opinion from the San Antonio Court of Appeals wherein the case appealed had been lost at trial and the insured filed the appeal. The opinion is styled, Brian Jones v. Allstate Vehicle And Property Insurance Company.

Brian sued Allstate on a claim resulting from a 2016 hail storm. He sued for breach of the insurance contract and unfair settlement practices.

Insurance Bad Faith Claims – Experts

July 15, 2023 | Mark S. Humphreys

Insurance lawyers have to know how to deal with experts in a case. Here is a 2023 opinion from the Eastern District of Texas, Beaumont Division, that deals with an expert. The opinion is styled, Juanita Vera v. State Auto Insurance Company and Meridian Security Insurance Company.

This is a dispute for damages alleged to have occurred from Hurricane Laura. Vera hired an expert, Gary Sanders, to testify about causation of Vera’s damages.

The admissibility of expert evidence is a procedural issue governed by Federal Rule of Evidence 702 and the U.S. Supreme Court, Daubert decision. Federal Rule of Evidence 702 sets forth the requirements that must be satisfied to enable a witness designated as an expert to testify to his or her opinions. An expert may testify in the form of an opinion if: (1) the expert’s scientific, technical, or other specialized knowledge will help the trier of fact to understand the evidence or to determine a fact in issue; (2) the testimony is based on sufficient facts or data; (3) the testimony is the product of reliable principles and methods; and (4) the expert has reliably applied the principles and methods to the facts of the case.

Claims Against Insurance Companies – Not Just Bad Faith

July 10, 2023 | Mark S. Humphreys

Insurance transactions tend to resemble one another, so disputes arising from them tend to resemble one another. There are only so many ways that an insurer and an insured can get crossways. Most cases present recurring problems that can be grouped into categories. Insurance law is even more precedent-driven than other areas, as courts try to construe similar policy language consistently. It is not surprising that cases start to look alike.

The starting point is the contract itself. The initial inquiry always begins with the language of the contract to determine what is covered and what is not. Other tort and statutory theories may logically depend on the existence of coverage, or may exist independent of coverage. The interplay between recovery for breach of contract and recovery under other theories needs to be studied. Beyond suit for breach of contract, most insurance cases can be grouped into three categories:

(1) misrepresentations