Dallas Fort Worth Insurance Lawyer Blog

Life Insurance Lawsuit

October 11, 2016 | Mark S. Humphreys

Life insurance lawyers will try to avoid what happened in an opinion from the Southern District of Texas in 2016. The opinion is styled, Hendrix v. Wal-Mart Stores.

Kimberly Hendrix sued Wal-Mart Stores, Inc., Associates Health and Welfare Plan, and The Prudential Insurance Company of America because they denied her claim under her late husband’s employer-sponsored life insurance.

Randy Hendrix worked for Wal-Mart until July 11, 2012, when he retired. On August 27, he died of a heart attack. His life was insured by a group policy that was sponsored by Wal-Mart. Hendrix filed a claim under the policy and Prudential denied the claim.

False Statements By Insurance Company

October 9, 2016 | Mark S. Humphreys

A Houston Division opinion discusses how to properly plead a lawsuit when an insurance company makes false statements. The opinion is styled, Mt. Olive Missionary Baptist Church v. Underwriters at Lloyds.

Mt. Olive alleges a storm caused damage to the Church including damage to the roof, HVAC, windows, exterior, interior, ceilings, furnishings, and more. After the storm a claim was filed under its insurance policy. A third party adjuster, Herring, was assigned to investigate and adjust the claim. Mt. Olive alleges that Herring failed to perform a thorough investigation of the claim, failed to prepare any estimates reflecting wind damage, and misrepresented that there was no damage to the Church. The claim was denied.

Mt. Olive sued in state court and the case was removed to federal court.

Uninsured/Underinsured Litigation

October 8, 2016 | Mark S. Humphreys

Lawsuits involving claims for uninsured/underinsured (UIM) benefits are in their own little category for the way the courts handle them. This is illustrated in a 2016, Tyler Court of Appeals opinion titled, In Re: AAA Texas County Mutual Insurance Company.

Vehicles driven by Thomas Jackson and Patricia Tompkins collided. Jackson filed a claim for UIM benefits with AAA. He later filed a lawsuit against AAA for breach of the insurance contract, violations of the DTPA, the Texas Insurance Code, and breach of duty of good faith and fair dealing. AAA filed a motion to sever and abate the extracontractual claims and the just denied the motion. This Mandamus action resulted.

AAA argued the judge abused his discretion in not allowing the case to be severed and abated.

Grand Prairie Insurance Lawyers Will See Total Loss Cases

October 6, 2016 | Mark S. Humphreys

Total loss cases dealing with automobiles have certain rules that apply. A Dallas Court of Appeals case discusses this issue. The opinion is styled, Sunny Letot v. United Services Automobile Association. There are multiple issues in this case but the opinion dealing with the total loss of an automobile is something many people will have the occasion to see.

The opinion is an appeal from a summary judgment in favor of USAA. The part of the opinion dealing with total loss was reversed by this appeals court.

Letot was involved in a wreck that resulted in the total loss of her vintage 1983 Mercedes. Letot was offered $2,494.02 by USAA which was rejected. However, USAA still mailed a check for that amount and the check was returned. The same day the check was mailed, USAA sent TxDoT a letter informing them the vehicle had been totaled. Letot had the vehicle scrapped to avoid incurring further storage fees. USAA later filed a report with TxDoT stating the initial report was filed in error.

Inter-pleader Actions

October 4, 2016 | Mark S. Humphreys

Life insurance lawyers need to read this 5th Circuit opinion. The case is styled, Jackson National Life Insurance Company v. Lance Dobbins, et al.

Inter-pleaders are cases where the insurance company knows they owe life insurance proceeds to someone but they are unsure who to pay because there are competing claims to the funds. As a result the insurance company files a lawsuit asking the court to distribute the funds and as part of this process the insurance company asks that money be withheld to compensate them for the costs and attorney fees associated with filing the inter-pleader.

Generally stated, the purpose of an inter-pleader action is to protect a stakeholder from liability when faced with the threat of multiple inconsistent claims to a single fund. It does this by allowing the stakeholder to tender the contested funds to the court in lieu of defending against multiple possible lawsuits. An inter-pleader action allows the stakeholder to pay the money in dispute into court, withdraw from the proceedings, and leave the claimants to litigate between themselves their entitlement to the funds.

Specific Acts Of Adjuster Have To Be Detailed

September 22, 2016 | Mark S. Humphreys

When an insurance attorney is representing someone suing an adjuster, there have to be specific acts alleged against the adjuster and those acts have to be detailed. This is illustrated in a Southern District, Houston Division opinion. The opinion is styled, Gregory Young v. Travelers Personal Security Insurance Company and Robert Finley.

This a hail / storm damage claim wherein Young was insured by Travelers and the adjuster assigned to the claim was Finley.

The case was filed in State Court but Travelers had the case removed to Federal Court alleging that Finley was improperly joined in the case in order to defeat diversity jurisdiction. Travelers claims that the allegations against Finley do not meet pleadings standards and thus Finley should be dismissed and the Federal Court has jurisdiction over the case.

Suing Adjusters In Hail Claims

September 20, 2016 | Mark S. Humphreys

Insurance lawyers in Irving who sue for hail claims need to know the best ways to stay out of Federal Court, unless of course that is where they want to be.

This is illustrated in a Sherman Division case styled, Lillian Elizondo v. Metropolitan Lloyds Insurance Company of Texas, Tailored Adjustment Services, Inc. and Brad Conrad.

This is a dispute that arises out of a claim for hail and wind storm damages sustained by Plaintiff, Elizondo. The insurer is Metropolitan. The adjuster is Conrad who worked for Tailored.

Penalties For Delay In Paying Claim

September 18, 2016 | Mark S. Humphreys

Benbrook insurance attorneys can discuss the penalties for delays in paying a claim. These penalties are spelled out in the Texas Prompt Payment of Claims Act (TPPCL) and are found in the Texas Insurance Code.

The amount of an insured’s claim (and/or the amount for which an insurer is liable) is often based on third-party invoices that the insured has not incurred, in amounts the insured cannot necessarily predict, at the time the insured submits its notice of claim to the insurer. Consider duty to defend or environmental clean-up coverage, where the amount of the claim can increase every month.

Naturally, there are questions regarding when the 18% penalty begins to accrue on such claims. The TPPCA language does not provide specific guidance on these calculations, but courts in the Fifth Circuit have recently indicated the methodology is based on the date of the TPPCA violation and not necessarily the date the cost was incurred.

Prompt Pay Law

September 17, 2016 | Mark S. Humphreys

Burleson insurance lawyers know that when an insurance company is slow to pay a claim that there are possible consequences to the insurance company under the Texas Prompt Payment of Claims Act (TPPCA).

Historically, one area of contention in TPPCA disputes has been the calculation of the penalty when an insurer violates an early claims-handling deadline and later denies a covered claim. Insurers have pointed out that §542.058 is the only subsection that references the enforcement provision (§542.060), and thus argue that only a violation of §542.058 triggers the penalty. The Fifth Circuit recently rejected this argument and ruled any violation of §§542.055-542.058 triggers the penalty, while the Texas Supreme Court has not addressed the issue.

Because courts have previously calculated the penalty interest when only a violation of §542.058 is pleaded and proved, there has been a dearth of guidance regarding when the penalty begins to accrue when an insurer violates §§542.055 or 542.056.

Prompt Payment Of Claims Act In Texas

September 15, 2016 | Mark S. Humphreys

It is important for Dallas and Fort Worth Attorneys to understand how the Texas Prompt Payment of Claims Act (TPPCA) works.

The deadlines imposed by the TPPCA are presented chronologically in terms of the claims-handling process.

First, §542.055 states the insurer shall acknowledge receipt of the claim, request information the insurer believes it requires, and begin investigation of the claim, within 15 days [or 30 days, for surplus lines insurers] of receiving notice of the claim;