Dallas Fort Worth Insurance Lawyer Blog

Insurance Companies Buying Justice In Texas

December 5, 2015 | Mark S. Humphreys

Insurance lawyers keeping up with insurance news will find a recent Texas Tribune article interesting. The title is, “Emails: Prosecutors Got Texas Mutual Great Publicity.”

The article says that Travis County prosecutors say the money they get each year from a large insurance company to prosecute workers’ compensation fraud helps both consumers and businesses by holding down premiums and maintaining a stable market for employers.

But behind the scenes, top officials in the district attorney’s office are highlighting other benefits: They say they’re generating a lot of money and good PR for Texas Mutual Insurance Company.

Wildfire Insurance Claims

December 3, 2015 | Mark S. Humphreys

Texas insurance lawyers will see wildfire insurance claims. Texas Watch published an article that is helpful for Texas insurance attorneys and people who experience damage due to a wildfire. The title of the article is, 5 Things To Know When Filing A Wildfire Insurance Claim.

The article tells us that firefighters continue to bravely battle the Hidden Pines wildfire in Bastrop County Texas, with 80% of the fire contained. The fire has already damaged or destroyed dozens of residential and commercial properties. As families and businesses begin the process of rebuilding, here are some tips for property owners when dealing with their insurance company.

Demand that your insurance company hold up its end of the insurance contract you have with them.

Hail Damage Claim And Adjusters

December 1, 2015 | Mark S. Humphreys

Fort Worth insurance lawyers handling hail damage claims need to ready an opinion from the U.S. District Court for the Southern District of Texas Houston Division. It is styled, Dianne Leidy, et al v. Alterra America Insurance Company, et al.

Leidy sued Alterra and the adjusters assigned to her claim for hail damage. Leidy alleged her property was damaged during a hail storm on August 16, 2013. Leidy alleged she noticed the damage right after the storm and contacted Alterra by phone. Alterra assigned independent adjusters to adjust the claim. Leidy alleged the adjusters failed to conduct a reasonable and adequate investigation, which resulted in the improper denial of Leidy’s claim. The lawsuit was filed in State Court. Alterra removed the lawsuit to Federal Court asserting that the adjusters had been improperly named as defendants in order to defeat diversity jurisdiction. Leidy then filed a motion to remand the case back to State Court.

In response to Leidys’ Motion to Remand, Alterra concedes that independent insurance adjusters can be liable for violations of the Texas Insurance Code. Alterra argues, however, that Leidy failed to allege an adequate factual basis for imposing such liability on the adjusters, Colley or Voelkner in this case. The adequacy of the allegations in Plaintiffs’ complaint is evaluated, for purposes of the improper joinder analysis, under the “fair notice” pleading standard in Texas courts.

Actual Cash Value versus Replacement Value

November 29, 2015 | Mark S. Humphreys

Insurance lawyers in Parker County need to read a Houston Court of Appeals [1st Dist.] opinion issued in October 2105. It is styled, John Davis D/B/A J. D. House of Style v. National Lloyds Insurance Company.

This is an appeal by Davis from a Judge’s ruling on a JNOV in favor of National.

The court submitted two measures of damages to the jury, and the jury determined that Davis sustained $0 damages based on the actual cash value of the property claim and that he sustained $100,000 in damages based on the replacement value of the property claim. National Lloyds moved to disregard the replacement value finding, arguing, in part, that the plain language of the policy itself limited Davis to recovery for the actual cash value of his property damage claim.

Two Hail Storms – Two Different Insurance Companies

November 28, 2015 | Mark S. Humphreys

Layers who handle hail damage claims will frequently run into the situation where an adjuster admits there is hail damage on a roof but that the damage is old or there is old damage and new damage to the roof. The question becomes, what is the best course of action in getting a full recovery. The answer is to file claims / sue both insurance carriers. The U.S. District Court, Western District of Texas, Austin Division had this issue in a recent case. The style of the case is, Evridges, Inc. v. The Travelers LLoyds Insurance Company.

In this case, Evridges filed suit against Travelers for hail damage to its property. When evidence that some of the damage was from another storm when another insurance company and policy were in force, Evridges sought to have Travelers added to the lawsuit. This insurer is Landmark American Insurance Company.

Travelers opposed the joining of Landmark, arguing to the court that the joinder was improper under Federal Rule 20(a) because the claims against Landmark do not arise from the same transactions or occurrences as the claims against asserted against Travelers, and since the claims against Landmark do not present common questions of law or fact as the claim against Travelers, that the joinder is improper.

Concurrent Causation Clauses

November 26, 2015 | Mark S. Humphreys

Dallas area insurance attorneys are most likely to see insurance companies argue “concurrent causation” in claims related to homeowners policies. The Claims Journal published an article discussing this topic in October of 2015. The title of the article is “Texas Supreme Court Upholds Anti-Concurrent-Causation Clauses In Property Policies.”

The article tells us the Texas Supreme Court in JAW the Point, LLC v. Lexington Ins. Co., 460 S.W.3d 597 (Tex. 2015) held, on first impression, that losses incurred in demolishing and rebuilding property damage resulting from Hurricane Ike to comply with city ordinances were excluded under the policy’s anti-concurrent-causation clause. Prior to the Texas Supreme Court’s JAW decision, federal and lower state courts of appeal had interpreted and upheld the applicability of anti-concurrent-causation clauses under Texas law.

Taking its lead from the United States Circuit Court of Appeals for the Fifth Circuit, the Texas Supreme Court held that a policy anti-concurrent-causation clause together with an exclusion for losses caused by flood, when read together, excluded from coverage any damage caused by a combination of wind and water. Previously, the Fifth Circuit Court of Appeals in Leonard v. Nationwide Mut. Ins. Co., had concluded in situations involving combinations of covered wind damage and excluded flood damage that the only species covered under a policy with an anti-concurrent-causation clause is damage caused exclusively by wind. But when wind and water synergistically cause the same damage, such damage is excluded.

Suing The Insurance Adjuster

November 24, 2015 | Mark S. Humphreys

Attorneys handling hail damage insurance claims need to read this opinion from the U.S. District Court, Northern District of Texas, Fort Worth Division. The case is styled, Monclat Hospitality, LLC vs Landmark American Insurance Company.

This case was filed in State District Court in Tarrant County and then removed by Landmark to Federal Court base on there being a lack of diversity of citizenship subject matter jurisdiction as contemplated by 28 U.S.C. Section 1332(a). Insurance companies always want to fight insurance disputes in Federal Court because matters are more in their favor in Federal Court. Monclat had attempted to prevent the removal by suing the adjuster and then trying to convince the Court why suing the adjuster was proper in this case.

Monclat filed this lawsuit to recover benefits from Landmark under a policy issued by Landmark. Monclat alleged that it had suffered damages due to wind and hail.

Suing An Insurance Company And Trying To Stay Out Of Federal Court

November 22, 2015 | Mark S. Humphreys

Most Palo Pinto insurance lawyers already know that it helps their clients to be able to stay out of Federal Court on insurance disputes. They are many points that need to be kept in mind. A few of those are discussed in a U.S. Southern District of Texas, McAllen Division opinion. It is styled, Jose Villareal v. State Farm Lloyds.

Villareal filed his lawsuit in state court, asserting various insurance related causes of action for damages resulting from a wind or hail storm. State Farm removed the case to Federal Court asserting diversity jurisdiction pursuant to 28 U.S.C. Section 1332. Villareal countered that the amount in controversy does not exceed $75,000, thus the court lacks jurisdiction.

A court does not have subject matter jurisdiction unless the parties are completely diverse and the amount in controversy exceeds $75,000. Generally, the sum demanded in good faith in the initial pleading shall be deemed to be the amount in controversy. Here, however, the state practice does not permit a demand for a specific sum. State Farm can show the amount in controversy exceeds $75,000 by

Suing An Insurance Company For Uninsured / Underinsured Coverage

November 21, 2015 | Mark S. Humphreys

Most Mineral Wells insurance lawyers already know the rules governing uninsured / underinsured (UIM) cases. But a reminder is put forth in an Austin Court of Appeals decision. The style of the case is, In re Farmers Texas County Mutual Insurance Company.

The real party in interest is Guy Gimenez. He sued a third party and upon receiving written permission from Farmers, settled the third party case, then brought suit against Farmers for UIM. The UIM case was severed from the extra-contractual claims but the trial court refused to abate the extra-contractual claims. As a result, this mandamus action was filed.

Farmers argued that court abused it’s discretion by refusing to abate the extra-contractual claims which had not accrued and may be rendered moot by the outcome of the contract action.

Offers To Settle

November 19, 2015 | Mark S. Humphreys

Dallas area insurance lawyers need to be aware of a case currently pending before the United States Supreme Court. USA Today published an article discussing the case. The title of the article is, Supreme Court Conundrum: How To Make A Lawsuit Go Away. Here is the discussion.

The Supreme Court debated to a draw Wednesday over an unusual question with broad implications for businesses and consumers: If a defendant in a civil case offers to pay the plaintiff in full, is the lawsuit moot? Is it settled? Or can it live on?

What the justices decide either could give companies a way to avoid class-action lawsuits or prevent consumers from having their challenges ended with a simple payoff.