Dallas Fort Worth Insurance Lawyer Blog

Life Insurance Application

April 15, 2017 | Mark S. Humphreys

Granbury life insurance lawyers need to read this 1975, Texas Supreme Court opinion. It is styled, Johnson v. Prudential Insurance Company of America.

This is a suit to collect benefits under a group life insurance policy. Prudential resisted payment based on their assertion that the deceased willfully deceived the company by her statements made in procuring coverage. The beneficiary contends that the statements of the insured were inadmissible and could not be considered because copies of the application were not furnished to the insured in compliance with what is now the Texas Insurance Code, Section 705.103.

Ten years before applying for this insurance, Mrs. Johnson, the insured, had her right breast removed because of cancer. Mrs. Johnson made what she could have regarded as true statements, but they were incomplete and misleading.

Delay In Asserting Misrepresentation Defense

April 13, 2017 | Mark S. Humphreys

How long does an insurance company have to discover and assert the defense of misrepresentation? This is discussed in a 2008, Amarillo Court of Appeals opinion styled, Myers v. Mega Life and Health Insurance Company.

Myers filed suit based upon an insurance contract issued by Mega Life. In addition to a declaratory judgment action, Myers sought damages for breach of contract and violations of the Texas Insurance Code. Mega Life asserted the policy was rescinded due to misrepresentation in the insurance application.

Myers asserted that Texas Insurance Code, Section 705.005 prevents Mega Life from asserting the misrepresentation defense. This section reads:

Life Insurance Misrepresentation – Age

April 11, 2017 | Mark S. Humphreys

The Galveston Court of Appeals issued an opinion in 1938 that is still good law. The case is styled, Texas State Life Insurance Company v. Freeman Barton.

This is an appeal from a trial to the Judge wherein Texas State was ordered to pay the life insurance proceeds to the beneficiary together with the statutory penalty and attorney fees.

The policy had been issued on Marie Clemons on July 10, 1935, with Barton as beneficiary and Marie having died on November 29, 1935. (As a side note, this case points out “both of them being negroes,” – makes you wonder about that time in history).

Life Insurance Sitting Around?

April 9, 2017 | Mark S. Humphreys

Have you ever wondered if someone has left you an insurance policy you do not know about. The Los Angeles Times published an article in March 2017, that you might find interesting. It is titled, How To Score A Piece Of California’s $365 Million In Unclaimed Life Insurance Benefits.

It might surprise you to learn that the state of California is sitting on a pile of cash that belongs to consumers — a big pile of cash — and is having trouble giving it away.

At issue are life-insurance payouts owed to state residents. Under California law, insurers are required to turn over to the state any funds that go unclaimed for three years. But audits of insurers’ books that began in 2008 found that the companies were clinging to billions of dollars that didn’t belong to them.

A Dallas County Claim

April 8, 2017 | Mark S. Humphreys

The Texas Supreme Court issued an opinion in 2014, in a case styled, In Re National Lloyds Insurance Company. For insurance lawyers, this case discusses relevant discovery issues.

This case involves allegations of underpaid insurance claims. In September 2011 and June 2012, storms swept through Cedar Hill and caused damaged to Mary Erving’s home. Erving filed a claim with Nation Lloyds and an adjuster was sent in response to each claim. Following the inspections, National Lloyds paid the claims.

Concerned that National Lloyds had undervalued the claims, Erving sued for breach of contract and violations of the Texas Insurance Code and the Texas DTPA. During the discovery process, Erving requested production of all claim files from the previous six years involving three individual adjusters. She also requested all claim files from the past year for properties in Dallas and Tarrant Counties involving Team On Adjusting, LLC, and Ideal Adjusting, Inc., the two adjusting firms that handled Erving’s claim. Erving sought via interrogatory the names, addresses, phone numbers, policy numbers, and claim numbers associated with the requested claim files.

Credit Life Insurance Policy

April 6, 2017 | Mark S. Humphreys

Insurance lawyers in Menard, Junction, Mason, Fredricksburg, and Kerrville need to read this case from the Southern District Court, Houston Division. It is styled, Ruben N. Saenz, Individually and as Representative of the Estate of Decideria Saenz, Deceased v. Transamerica Life Insurance Company.

This lawsuit arise out of the denial of an insurance claim for credit life insurance purchased at the time a car was purchased and financed. Saenz wife died and Ruben Saenz made the claim for benefits. Transamerica filed a motion to dismiss the case alleging that Saenz does not have proper standing to file the lawsuit.

Because Transamerica’s motion contains factual evidence, the court treats the motion as a factual attack. As a factual attack, there is substantial authority that the trial court is free to weigh the evidence and satisfy itself as to the existence of power to hear the case.

Suing The Adjuster

April 4, 2017 | Mark S. Humphreys

A 2017, opinion from the Northern District, Dallas Division, is an example of how not to sue an adjuster to keep a case out of Federal Court. The opinion is styled, Hutchins Warehouse Limited Partners, v. American Automobile Insurance Company, et al.

Hutchins sued American and their adjuster in State Court after their claim for benefits was not properly paid. The allegations against the adjuster, McMillan, were that he made numerous errors in his estimate, which resulted in American underpaying and partially denying Hutchins’s claims.

28 U.S.C., 1441(a) permits the removal of any civil action brought in a state court of which the district courts of the United States have original jurisdiction. The statute allows a defendant to remove a state court action to federal court only if the action could have originally been filed in federal court.

Fort Worth Homeowners Hail Claims

April 2, 2017 | Mark S. Humphreys

The Fort Worth Court of Appeals issued an opinion in February 2017, that is good reading for insurance lawyers. It essentially points out in a case, what was not done correctly. The opinion is styled, Seim v. Allstate Texas Lloyds.

This is claim against a homeowners policy issued by Allstate to the Seims. It is an appeal from a summary judgment in favor of Allstate. The Allstate policy provided coverage on the Seims home for the period April 27, 2013, through April 27, 2014. On or about August 28, 2013, the Seims notified Allstate of damage that had occurred earlier in August. The property was inspected on or about September 10. The adjuster, Scott, testified in deposition that the Seims’ property had some interior water damage, but the roof did not have any wind or hail damage. Scott further testified that in order for the interior water damage to be covered under the Seims’ policy, “there had to be an opening in the roof caused by wind or hail … and the Seims did not have that. The claim was denied by Allstate and a few months later the Seims sued Allstate for insurance code violations and breach of contract.

In the pleading filed by the Seims, they claimed damage was caused by storms in 2013, April 2007, April 2008, and May 2012. In their lasted amended pleading, references to the 2007, 2008, and 2012, storms was removed.

Underinsured Motorist Claim

April 1, 2017 | Mark S. Humphreys

Most insurance lawyers know this – – that a first party uninsured motorist claim cannot litigate bad faith until there has been a resolution to the uninsured motorist (UM) part of the claim. This is illustrated in the February 2017, opinion from the 14th Court of Appeals styled, In Re Allstate County Mutual Insurance Company.

Allstate was sued for UM benefits and at the same time sued for extra-contractual bad faith claims. The Judge in the case would not sever and abate the extra-contractual causes of action from the UM claim and this mandamus action resulted.

The real party in interest, Alexa St. Julian was involved in an automobile accident with an uninsured driver. Alexa was unable to reach a settlement with Allstate, who had made a settlement offer, and the lawsuit resulted. Allstate sought for the UM claim to severed and abated from the extra-contractual claims.

Here Is Why You Need An Insurance Lawyer

March 30, 2017 | Mark S. Humphreys

An article ran in February 2017, that explains why people need experienced insurance lawyers to help with their insurance claims. The article is titled, State Can’t Help With Most Unpaid Insurance Claims.

The Texas Department of Insurance claims it can help resolve complaints against insurance companies and boasts of helping Texas consumers get millions of dollars in unpaid claims every year. However, a KXAN Investigation finds that only happens in certain situations and most of the time the state has no power to do anything at all, leaving you—the consumer—without much recourse.

In the spring of 2013, a storm swept through pummeling hail down on Carol Fredenburg’s house. A roofing contractor told her the roof needed replacing but when she filed a claim with State Farm, they told her the damage only affected part of her roof and they would not pay for the entire roof to be replaced. They estimated her repairs at $7,600, with a $2,841 deductible.