Dallas Fort Worth Insurance Lawyer Blog

Life Insurance – Duty Of Good Faith And Fair Dealing

May 13, 2023 | Mark S. Humphreys

Life insurance lawyers and other attorneys dealing with insurance companies will often speak of the insurance company “duty of good faith and fair dealing.” This issue is discussed in a 2023 opinion from the Northern District of Texas, Dallas Division. The opinion is styled, Avery D. Ensley v. Genworth Life and Annuity Insurance Company.

The facts of the case can be read in the opinion. It is the discussion related to the issue of the “duty of good faith and fair dealing” that is discussed here.

The Court addressed Plaintiffs bad faith claim. Plaintiff alleges that (1) Defendant breached its duty when it failed to adequately notify Plaintiff of premium changes, the Policy’s alleged depleted cash value, and the Policy’s pending lapse; (2) Defendant breached its duty by failing to proceed with automatic withdrawals until Plaintiff was notified of the deficit and given an opportunity to make the requisite payment; and (3) Defendant breached its duty when it failed to reinstate the Policy.

Bad Faith Insurance And Statute Of Limitations

May 8, 2023 | Mark S. Humphreys

Lawyers handling insurance claim must have an understanding of the statute of limitations for bad faith claims. This is illustrated in a 2023 opinion from the Western District of Texas, Waco Division. The opinion is styled, Yvan Jayne v. Health Care Service Corp., A Mutual Legal Reserve Co., D/B/A Blue Cross And Blue Shield Of Texas., et al.

A reading of the case will show the facts of this specific case but shown here is the law relating to the statute of limitations on bad faith claims.

Defendant moved to dismiss Plaintiff’s bad–faith breach and Chapter 541 causes of action, arguing that they are barred by the statute of limitations. Defendant has the burden of proving its affirmative defense, including the date on which limitations commenced.

Life Insurance Lawyers – Intent To Deceive

May 6, 2023 | Mark S. Humphreys

Life Insurance Attorney must read this 2023 opinion from the Texas Supreme Court. The opinion is styled, American National Insurance Company v. Bertha Arce.

This is arguably the most important life insurance opinion in many years in Texas and centers around whether or not the insurer must prove intent to deceive when denying a claim for life insurance benefits. The language of the Court in defining this issue is thus:

The primary issue before us is whether the common-law scienter requirement is repugnant to the plain language of section 705.051 of the Texas Insurance Code, which provides that “[a] misrepresentation in an application for a life, accident, or health insurance policy does not defeat recovery under the policy unless the misrepresentation: (1) is of a material fact; and (2) affects the risks assumed.”

The Insurance Policy Has To Be Read Carefully

May 1, 2023 | Mark S. Humphreys

Most people who buy a homeowners insurance policy think that if anything happens to cause damage to their home, that they are covered. Well, that is simply not case way to often. All those pages of the policy are pages explaining what is not covered or placing limitations on what is covered.

Here is a 2023 opinion from the Northern District of Texas, Amarillo Division that deals with a homeowners claim. The opinion is styled, Laur v. Safeco Insurance Company of Indiana.

This opinion is the result of a motion for summary judgment being filed by Safeco.

Reasons To Not Delay In Seeking A Remand

April 29, 2023 | Mark S. Humphreys

As has been discussed many times on this Blog, insurance companies prefer to litigate in Federal Court rather than State or County courts. When an insurance company removes a case to Federal court the insured needs to be prompt in seeking a remand to the State or County court from which is was removed.

This is illustrated in this 2023 opinion from the Northern District of Texas, Dallas Division. The opinion is styled, Thomas Dettmer v. Safeco Insurance Company of Indiana.

Dettmer alleges hail damage to his property. Safeco hired Madsky Managed Repair (Madsky) to inspect the property. Safeco asserts the damages do not exceed the deductible in the policy. Dettmer hired JT Roofing who asserts the damage exceeds $62,826. In an effort to reconcile the vast disparity, Safeco hired ProNet to double check Madsky’s assessment. ProNet’s engineer, Marc Camacho, inspected the property and concluded that the damage to the residence resulted from “intentional mechanical damaged performed … in an attempt to replicate storm damage.”

Hail Claims And Insurance Policies

April 24, 2023 | Mark S. Humphreys

Hail damages claims can be tough and this 2023 opinion doesn’t help. The opinion is from the Northern District of Texas, Amarillo Division. It is styled, Phouthasith Amphay v. Allstate Vehicle and Property Insurance Company.

Plaintiff alleges hail damage to his dwelling and made a claim against his insurer, Allstate. Allstate filed a motion for partial summary judgement because “Plaintiff’s alleged damage to the metal roofs is cosmetic damage and not covered by the express terms of his Homeowner’s Policy.

Summary Judgment is proper if the movant shows there is no genuine dispute of material fact. A fact is “material” if resolving it one way or another would change the outcome of the lawsuit. A genuine dispute over that fact exists if the evidence is such that a reasonable jury could return a verdict for the non-moving party. Courts must view the evidence in the light most favorable to the non-movant and resolve factual controversies in the non-movant’s favor.

Making A Claim Against The Adjuster

April 22, 2023 | Mark S. Humphreys

Making a claim against the adjuster handling the claim is an advantage in lawsuits, or at least that is what many attorneys believe. A proper analysis of making a claim against an adjuster is discussed in this 2023 opinion from the Eastern District of Texas, Sherman Division. The opinion is styled, Lawrence Family Fund, LLC v. Westchester Surplus Lines Insurance Company, et al.

This is a property damage claim alleged to have occurred when Lawrence incurred a theft. A claim was made against Westchester and the adjuster Westchester hired to adjust the claim, Frederick Achala. The lawsuit filed in State Court and Westchester removed the case to Federal Court asserting that Achala was improperly joined in the lawsuit in an effort to defeat diversity jurisdiction under 28 U.S.C. Section 1441 and 28 U.S.C. Section 1332. Lawrence then filed this motion to remand claiming that Achala had not been improperly joined.

The statute permits the removal of any civil action brought in a State court of which the district courts of the United States have original jurisdiction.

When Does Life Insurance Coverage Terminate?

April 17, 2023 | Mark S. Humphreys

Life insurance lawyers will tell you that the answer to the titled question is dependent on the wording of the insurance policy and the facts of the case.

This issue was discussed in the 1979, Fort Worth Court of Appeals opinion styled, Leach v. Eureka Life Insurance Company of America.

This case involved a credit life insurance policy. The deceased in Tommy Leach and the executrix of the estate is Mary Leach, the Plaintiff here.

Life Insurance Attorney – Who Is Entitled To Life Insurance Benefits

April 15, 2023 | Mark S. Humphreys

The designated beneficiary of a life insurance policy generally is entitled to the proceeds upon the death of the insured. Absent an adverse claim, the insurer may pay the benefits to the designated beneficiary.

This is discussed in the 1967, Texas Supreme Court opinion styled, McFarland v. Franklin Life Ins. Co.

In 1950 respondent issued a policy of insurance on the life of John V. McFarland, who was about nine years of age at the time. The policy was taken out by his parents, Bernard and Gwendolyn McFarland, the latter of whom is petitioner here. Bernard was named in the policy as primary beneficiary, and petitioner was designated as contingent beneficiary. John married in 1962 and died the following year. His father predeceased him; he was survived by his widow and petitioner.

Life Insurance Claims Denial – Trial

April 10, 2023 | Mark S. Humphreys

Here is a life insurance case that went to trial in 2023. The case is styled, Mirna Guzman v. Allstate Assurance Company. The case was tried in the Northern District of Texas, Amarillo Division.

Allstate filed a declaratory judgment action against Guzman to have the life insurance policy she had applied for, rescinded due to misrepresentations in the policy application.

This was a lawsuit originally filed by Guzman and Allstate had countered with the declaratory judgment action.