Dallas Fort Worth Insurance Lawyer Blog

Med-Pay And USAA

February 23, 2016 | Mark S. Humphreys

Med-Pay is suppose to be an easy way to get medical bills paid when someone is injured in an automobile accident. As most insurance lawyers can tell you, that is not always the case. The San Antonio Express-News published an article on January 6, 2016, dealing with the way USAA, based in San Antonio, treats its customers when it comes to Med-Pay benefits in their policies. The article is titled, Med Pay Lawsuits Dog USAA.

San Antonio’s USAA continues to be dogged by lawsuits that allege it uses a “cost containment scheme” to delay, deny or reduce medical payouts to customers injured in auto accidents.

USAA has been vigorously defending such cases for more than a decade, though the number of lawsuits couldn’t be determined.

Things To Know About Life Insurance

February 21, 2016 | Mark S. Humphreys

Texas life insurance lawyers who keep up with the world of life insurance will find this article interesting. It is from Forbes. The article is titled, 10 Things You Absolutely Need To Know About Life Insurance.

Life insurance is one of the pillars of personal finance, deserving of consideration by every household. I’d even go so far as to say it’s vital for most. Yet, despite its nearly universal applicability, there remains a great deal of confusion, and even skepticism, regarding life insurance.

Perhaps this is due to life insurance’s complexity, the posture of those who sell it or merely our preference for avoiding the topic of our own demise. But armed with the proper information, you can simplify the decision-making process and arrive at the right choice for you and your family.

Insurance Company Delay In Payment

February 20, 2016 | Mark S. Humphreys

Fort Worth insurance lawyers need to read this 5th Circuit opinion. The case is styled, Cox Operating, L.L.C. v. St. Paul Surplus Lines Insurance Co.

In this Katrina pollution clean-up coverage case, the 5th Circuit sheds a bit more light on the proper method for calculating an insurer’s delay penalty under Texas’ Prompt

Payment of Claims Act (the “Act”). Along the way, the court also determines whether a one-year cost-reporting requirement was an absolute, unwaivable condition precedent under a policy, or whether the insurer could, and did, waive it by anticipatorily denying the claim. The principal issue regarding the Act is whether, under a first-party property-damage policy, the 18% penalty begins to accrue multiple times as each new cost invoice is submitted to the insurer, as is probably the case with defense invoices under a liability policy, or whether the insurer’s first violation of a deadline under the Act starts the clock for the total amount of the claim ultimately determined. As discussed below, the insurer lost on all issues.

When Does Self-Defense Work In The Slayer Statute

February 18, 2016 | Mark S. Humphreys

Arlington life insurance lawyers need to know how self-defense works in the Slayer Statute. The Slayer Statute is found today in the Texas Insurance Code, Section 1103.151. A case discussing self-defense is a Fort Worth Court of Appeals opinion styled, Crawford v. Coleman.

Cornelius Shoaf appeals a judgment denying him insurance proceeds because a jury found he willfully caused the death of his wife, Sandra, the insured.

Four life insurance policies were in force at the time of Sandra’s death. The policies named Cornelius primary beneficiary. The insurance companies filed an interpleader naming the parties to this suit and paid the insurance proceeds into the registry of the court. Upon the trial of the cause, the jury found Cornelius had willfully caused the death of Sandra. The trial court then found that Cornelius had forfeited his right to receive the insurance proceeds under TEX.INS.CODE ANN. art. 21.23 (Vernon 1981) which states:

Slayer’s Statute

February 16, 2016 | Mark S. Humphreys

Fort Worth life insurance lawyers need to read this case on the Slayer’s Statute. The statute is found at Texas Insurance Code, Section 1103.151. The case is from the Houston Court of Appeals [14th Dist.]. It is styled, Rumbaut v. Labagnara.

Texas law disallows recovery of life insurance proceeds by a beneficiary who is a party to willfully causing the insured’s death. This case requires the court to decide whether gross negligence is subsumed within the notion of willfulness. The court held it is not.

Appellant’s wife Ana Maria Rumbaut was lost at sea, when a sudden storm arose in the Gulf of Mexico where the two of them were sailing. Because Mrs. Rumbaut’s will named appellant as executor of her estate, he applied for probate upon his return. Appellees, Mrs. Rumbaut’s sons by a previous marriage, contested the application and alleged that appellant had willfully caused their mother’s death.

Contingent Beneficiary Receiving Life Insurance Proceeds

February 14, 2016 | Mark S. Humphreys

Parker County life insurance lawyers need to read and understand this 1992, Houston Court of Appeals [14th Dist.] opinion. It is styled, Francis v. Marshall.

This is an appeal from a summary judgment granted in favor of appellee, Doris E. Marshall. She brought suit to recover as a beneficiary under a life insurance policy and the trial court held that she was the proper recipient of the proceeds. This Court affirmed.

Appellant, Douglas C. Francis, was found guilty of the murder of his wife, Karen E. Francis. Mrs. Francis had been insured under a $50,000 life insurance policy. Appellant was the primary beneficiary under this contract, and the deceased’s mother and appellee, Doris E. Marshall, was the contingent beneficiary. Upon appeal, appellant’s murder conviction was affirmed and he is now serving a life sentence.

Life Insurance Beneficiary Causing Death Of The Insured

February 13, 2016 | Mark S. Humphreys

Life insurance lawyers in Texas know what the “Slayer Statute” says. It has been in use for many years. A 1973, Eastland Court of Appeals case talks about this statute. The case is styled, Cooley v. Cooley.

Mutual Life Insurance Company of New York brought an interpleader action to determine the proper beneficiary under a policy of life insurance issued on the life of Melvin K. Cooley. The defendants were Mrs. Doris Cooley, the named beneficiary, Mary Helen Cooley as guardian of the estates of three minors. Mary Helen Cooley contended that Doris Cooley should be disqualified as a beneficiary on the grounds that Doris Cooley willfully brought about the death of the insured, Melvin K. Cooley, being convicted and sentenced for same in the country of Iran. On the jury’s finding that Mrs. Doris Cooley did not willfully bring about the death of Melvin K. Cooley, the trial court entered judgment for Doris Cooley. Mary Helen Cooley appeals.

It was established on the trial of the cause that Mary Helen Cooley married Melvin Cooley in 1956. He was the father of her three children for whom she was duly qualified as guardian. This marriage terminated in 1962 by divorce.

Insurance Customers Caught Cheating

February 11, 2016 | Mark S. Humphreys

Colleyville insurance lawyers do not want to waste their time on cases where a person is trying to commit a fraud. The Insurance Journal ran an article in late December 2015, wherein they publicized some extreme attempts at insurance fraud. The article is titled, Insurance Fraud Hall of Shame Reveals 2015 Inductees.

Blown up houses, staged wrecks and bogus spine surgeries were among the damage inflicted by nine convicted scammers newly selected to the Insurance Fraud Hall of Shame.

They were enshrined by the Coalition Against Insurance Fraud. The Hall of Shame recognizes the year’s most extreme insurance schemers. All were convicted or had other legal closure in 2015.

Anti-Concurrent-Causation Exclusions

February 9, 2016 | Mark S. Humphreys

Hail claims lawyers need to read the Texas Supreme Court opinion styled, JAW The Point, L.L.C. v. Lexington Insurance Company. This is a 2015, opinion that is relevant to most hail damage claims, as well as lots of other claims. The case is written about in the State Bar of Texas Insurance Journal It is hard to believe that this case is the Texas Supreme Court’s first occasion to address the proper application of the so-called “anti-concurrent-causation” (the “ACC”) exclusion, which in this case bars coverage for:

loss or damage caused directly or indirectlyby any [excluded cause or event], regardless

of any other cause or event that contributes concurrently or in any sequence to the loss.

ERISA Briefly

February 7, 2016 | Mark S. Humphreys

ERISA lawyers are in a position to be the bearers of bad news as it relates to persons having ERISA claims. Here are some paragraphs from a recent article on ERISA submitted to the State Bar of Texas.

ERISA, Employee Retirement Income Security Act of 1974. This is a federal program originally designed to be of benefit to employees who work in the private sector in this country. Although the primary focus is the protection of pension benefits, the Act’s application is broad, covering health, disability, and life insurance benefits offered to private-sector employees. Health, disability and life insurance benefits are collectively referred to as welfare benefits within ERISA, and the Act provides that those who administer welfare benefit plans are subject to some of the same fiduciary responsibilities as administrators of pension plans. The Act included the creation of pension insurance administered by the Pension Benefit Guaranty Corporation, providing employees a government guaranty that upon retirement they would receive at least some, if not all, of their vested pension benefits if their employer could not meet its pension obligations.

Congress explained its purpose in enacting ERISA within the first section of the Act: