Dallas Fort Worth Insurance Lawyer Blog

A List That Adjusters Have Violated

August 9, 2016 | Mark S. Humphreys

The Texas Insurance Code has a list of violations ofter committed by insurance adjusters that most Fort Worth Insurance Attorneys know well. This list is found in Section 541.060 and covers most wrongs adjusters commit.

(a) It is an unfair method of competition or an unfair or deceptive act or practice in the business of insurance to engage in the following unfair settlement practices with respect to a claim by an insured or beneficiary:

(1) misrepresenting to a claimant a material fact or policy provision relating to coverage at issue;

Punitive Damages In Insurance Cases

August 7, 2016 | Mark S. Humphreys

Insurance attorneys in Weatherford can tell you that an insurance company will often times mistreat their customers. The question would be, does the conduct arise to the level as to allow punitive damages and if so, how do you know that and what are the punitive damages.

Their are a couple places in the Texas Insurance Code to look for answers. The first place is under “definitions” which is found in Section 541.002.

(1) “Knowingly” means actual awareness of the falsity, unfairness, or deceptiveness of the act or practice on which a claim for damages under Subchapter D is based. Actual awareness may be inferred if objective manifestations indicate that a person acted with actual awareness.

Unfair Claims Settlement Practices

August 6, 2016 | Mark S. Humphreys

Weatherford insurance lawyers know resources to research to discover or confirm whether or not an insurance company adjuster doing their job properly. The Texas Insurance Code has specific sections that deal with unfair claims settlement practices that an adjuster may employ.

Sec. 541.060. UNFAIR SETTLEMENT PRACTICES. (a) It is an unfair method of competition or an unfair or deceptive act or practice in the business of insurance to engage in the following unfair settlement practices with respect to a claim by an insured or beneficiary:

(1) misrepresenting to a claimant a material fact or policy provision relating to coverage at issue;

Exclusions In Homeowners Policies

August 4, 2016 | Mark S. Humphreys

Fort Worth insurance attorneys will advise their clients to carefully read the exclusions in their homeowners policy. A 2006, Houston Court of Appeals [14th Dist.] case illustrates why. The opinion is styled, Fire Insurance Exchange v. Sullivan.
The insured brought suit against Fire Insurance Exchange for breach of contract, bad faith, violations of the DTPA and the Texas Insurance Code. A pipe in the attic had burst at the home of the insured, to which the carrier’s claims adjuster assessed the repairs at $2,944.75. The insured obtained a second estimate which was an additional $5,000. The insured hired an attorney who sent a written claim to the carrier, and after claiming they did not receive a satisfactory response from the carrier, the insured hired a contractor. The contractor found several additional leaks, which the insured reported to the carrier. The carrier assigned a second claims adjuster who concluded nearly the entire house had mold growth. Subsequently, the carrier issued two checks to the insured, totaling $82,430.57. The insured was unsatisfied with this amount and brought suit alleging the delay and mishandling of the claims by the carrier resulted in the deterioration of the home. In the trial court, the jury found that the carrier had breached the dwelling coverage portion of the policy, but not the personal property and additional living expenses coverage provisions. However, the jury awarded costs for mold remediation and repair of the home, as well as property damage. Ultimately, the trial court concluded that the insured was entitled to: (1) recover damages on the breach of contract and DTPA claims; (2) recover penalty under the Prompt Payment of Claims Act; and recover reasonable attorney fees. The trial court awarded $85,864.78 in total damages. The carrier appealed.
This Court reversed the trial court judgment in favor of the insured and rendered judgment that the insured take nothing on the claims against the carrier. The court improperly disregarded the jury’s finding that accidental leakage or discharge caused only 45% of cost of mold remediation; the trial court should have disregarded the jury finding on cost to clean or replace personal property since the policy provided no coverage for that loss; the cost to remediate damage to personal property could not be awarded to insureds under the DTPA or the Prompt Payment of Claims Act; any liability for interest stopped when the insurer tendered more than the amount it owed prior to trial; the insureds could not recover attorney fees on claims for breach of contract or DTPA; and the parties stipulation limited liability for attorney fees to 40% of interest. The potential total liability of carrier to the insured was $64,534.50, which was less than the amount the carrier had previously tendered to the insured. The court also noted that the jury did not find that the carrier breached the personal property portion of the policy and failed to attribute any cause of the damage to the covered causes. Therefore, the jury’s award for damages for that breach under the Prompt Payment Act should have been disregarded. Finally, the court found that the carrier’s unconditional payments should have been applied before assessing attorney’s fees and interest.

Bad Faith Insurance Law In Texas

August 2, 2016 | Mark S. Humphreys

Insurance attorneys in Dallas can tell you where the relevant laws to be used in insurance bad faith cases can be found. One place is the Texas Insurance Code.

Here is a starter.

Sec. 541.002. DEFINITIONS. In this chapter:

Life Insurance And Marijuana Business Man???

July 31, 2016 | Mark S. Humphreys

Life insurance attorneys might find this story interesting. It is from U.S. News. The story is titled, Marijuana Business Man Denied Life Insurance.

A successful businessman with a growing footprint in several states says he was shocked when he was refused a personal life insurance policy by Mutual of Omaha, one of the nation’s largest insurers.

The company informed Derek Peterson, CEO of Terra Tech Corp., in a letter dated June 13 that “we cannot accept premium[s] from individuals or entities who are associated with the marijuana industry.”

Agent Responsibility For Coverage

July 30, 2016 | Mark S. Humphreys

Dallas insurance lawyers need to be able to discuss with clients when an insurance agent may or may not have liability for their actions or lack thereof. A 2003, Beaumont Court of Appeals case is good reading on this subject. The case is styled, Stroman Realty, Inc. v. State Farm Lloyds.

Stroman sued State Farm for breach of contract, violations of the Texas Insurance Code, and breach of the duty of good faith and fair dealing. State Farm filed a motion for summary judgment.

Stromans’ Insurance Code claims focused on alleged false, misleading, or deceptive representations on the part of Barnhill as the insurance agent representing State Farm Lloyds. However, an examination of the deposition of Wayne Stroman, president of Stroman Realty, Inc., upon whose testimony they rely, provides no support for Stromans’ allegations. By Stroman’s own testimony, he was responsible ultimately for there not being named as an insured on any insurance policy. The entirety of Stroman’s testimony consisted of admitting to being unaware of even very basic or generalized knowledge of the insurance circumstances. Stroman’s deposition contains many responses using the ambiguous word “we” with regard to insurance coverage for his many companies and business interests. Stroman was under the mistaken impression that his company was covered by liability insurance as an entity separate and distinct from Stroman Realty, Inc. But nowhere in Stroman’s deposition testimony does he explicitly state that he or anyone else in his employ ever made a specific request to Mack Barnhill to cover Ad-Net, Inc. in a separate liability insurance policy. Nor does his deposition indicate that at any time Stroman specifically requested that Barnhill add Ad-Net, Inc. to the existing policy for Stroman Realty, Inc.

Get Experts For A Hail Damage Claim

July 28, 2016 | Mark S. Humphreys

Lawyers who handle hail damage claims can tell you that most of the time a person who has experienced hail damage and had their claim for benefits denied, needs to have an expert help them in the lawsuit that will result. An insured can always walk away and accept the insurance company denial but if you want to fight for the benefits you have paid for, an expert is well worth while.

Usually the roofer who will be doing the repairs will qualify as an expert and just as often he will not charge an expert fee or if he does, it will be minimal. An experienced insurance lawyer can tell you if your expert will be a good witness.

When an expert is not hired,or he does not do a good job, the result will be a disappointing loss like one of those described in the Insurance Journal in June, 2016. The Insurance Journal story is titled, Texas Insurers Hope Court Decisions Will Curtail Hail-Related Lawsuits.

What Is An “Occurrence” In An Insurance Policy?

July 26, 2016 | Mark S. Humphreys

Arlington insurance lawyers need to understand the definition of “occurrence” as used in an insurance policy. A 1998, San Antonio Court of Appeals opinion lends some insight into how the Courts look at that definition. The opinion is styled, Foust v. Ranger Insurance Company.

In 1994, Foust farmed various tracts of land which abutted land owned and farmed by Walters Farms. In May 1994, Walters Farms retained Lindeman to crop dust the milo crop on its property. The herbicide used is dangerous to cotton. Some of the herbicide drifted from the target area on to various tracts of land being farmed by Foust, causing severe damage to Foust’ cotton crop. Foust sued Lindeman, Walters Farms and the manufacturer of the herbicide for loss of income suffered as a result of the damaged cotton crop.

Ranger insured Lindeman under an aircraft insurance policy which had limits of $100,000 per occurrence and $200,000 per policy. Ranger provide Lindeman a defense in the underlying litigation and instituted this declaratory judgment action to determine whether the damages arose from a single occurrence or multiple occurrences under the terms of the policy. The trial court granted Ranger’s Motion for Summary Judgment finding, as a matter of law, that Lindeman’s application of the herbicide on May 14, 1994, amounted to a single occurrence under the terms of the Ranger policy.

Knowledge Of Policy And The Law

July 24, 2016 | Mark S. Humphreys

Irving insurance attorneys know that an insured is responsible for knowing what is in their policy. Courts have also ruled that insureds are responsible for knowledge of certain areas of the law. A Federal, Galveston Division opinion is a good read to understand this imputed knowledge. The opinion is styled, Danuta Lobeck v. Tina M. Licatino, et al.

The basic premise of each of Lobeck’s claims, when considered under relevant law, makes any lengthy summary of the facts in the light most favorable to Lobeck a waste of time. In a nutshell, Lobeck bought property that, unknown to her, was located within the boundaries of the Coastal Barrier Resources System. Lobeck’s mortgage loan required her to maintain flood insurance on the property so she innocently procured an SFIP through these Defendants. The policy was subsequently reissued and then renewed the following year. During the renewal year Hurricane Ike completely destroyed the building on the property and only then was Lobeck informed that her policy was void and had never afforded coverage. She received nothing for her property damage. Consequently, Lobeck filed suit against, inter alios, these Defendants alleging that they knew or should have known that the property was ineligible for flood insurance under the NFIP, that the policy was void when issued, and that the policy offered absolutely no coverage. According to Lobeck, the express and implicit misrepresentations of these Defendants, upon which she ignorantly, but reasonably relied, caused her losses.

The United States Supreme Court held that all citizens are charged with the knowledge of the law regarding federal insurance programs, like the NFIP. The Supreme Court has held that citizens seeking to benefit from a federal benefit program, like the NFIP, are charged with familiarizing themselves with the requirements of that program “and may not rely on the conduct of government agents contrary to the law.” The Fifth Circuit declared that a prospective SFIP holder cannot rely on a WYO’s representations to determine a property’s SFIP insurability, but instead has his own duty to determine whether its location in the CBRS disqualifies it. The Court has held that under this reasoning any reliance by a Plaintiff on misrepresentations of private insurance agents regarding the scope of coverage afforded by an SFIP are unreasonable as a matter of law and, therefore, cannot raise a genuine issue of material fact to avoid summary judgment.