Tarrant county insurance attorneys need to read this opinion from the United States, Northern District Court, Amarillo Division. It is styled, Johnnie Shannon v. Underwriters at Lloyd’s London, et al. There are many reasons an insurance company would prefer to have a legal fight in Federal Court rather than State Court. This opinion helps insurance law attorneys keep those cases that qualify in State Court.

Shannon filed a lawsuit in State Court against Underwriters for violations of the Texas Insurance Code among other reasons. Underwriters timely filed a motion for removal to Federal Court. Shannon filed a motion to remand which was granted by the Court.

Title 28, U.S. Code, Section 1441 states that a civil action is not removable if any “of the parties in interest properly joined and served as defendants is a citizen of the State in which such action is brought.” A case must be remanded if at any time before final judgment it appears that the district court lacks subject matter federal jurisdiction. A conclusion that the suit was improvidently removed requires remand.

Insurance attorneys in Dallas County need to be able to know how the courts interpret exclusions in policies when the exclusions rule out coverage for injury resulting from intoxication of narcotics. The United States Western District Court in Austin issued an opinion in June of 2015, dealing with this issue. It is styled, Eleanor Crose v. Humana Insurance.

This is an adverse ruling to Crose involving a summary judgment.

Crose is insured under a health insurance policy issued by Humana. Crose suffered a stroke which left him mentally and physically impaired. He filed a claim which Humana rejected citing a policy exclusion rendering benefits non-payable when the insured’s injury is “due to being intoxicated or under the influence of any narcotic unless administered on the advice of a health care practitioner.” Crose sued for violations of the Texas Insurance Code Sections under 541.060 and 542.051.

Insurance attorneys need to be able to discuss the Texas Guaranty Fund with their clients and how this fund works.

Four large insurance companies were declared insolvent in 2013, and as a result lawyers will have situations where a client has their insurance company become insolvent. The Texas Property and Casualty Insurance Guaranty Association (TPCIGA), was established in Chapter 462 of the Texas Insurance Code. Insurance companies do not file bankruptcy, they become insolvent. When an insurance company becomes insolvent or impaired, TPCIGA assumes the handling of the claims of the defunct insurance company. TPCIGA is a non-profit, unincorporated association of all Texas licensed property and casualty insurance companies. The Texas Legislature created the TPCIGA to provide protections to Texas insurance policyholders and claimants when an insurance company fails.

Chapter 462 states the TPCIGA must only pay “covered claims.” In general, a covered claim is an unpaid claim that arises out of a policy issued by an insolvent insurance company. The claim must be made by a Texas resident at the time of the insured event or must be a first-party claim for damage or property that is permanently located in Texas.

Insurance lawyers get calls from companies that have an assignment of benefits (AOB). This AOB is discussed in an article published by Claims Journal. It does a good job of discussing it and even though it talks about events in Florida, Texas has essentially the same laws and these AOB’s are being seen in Texas.

The problem for property insurers? No one is willing to take a firm position against the surge of AOB lawsuits, which are proliferating to the point where they are in danger of strangling insurers. The Courts are deferring to the Legislature but the Legislature is seemingly uninterested in making change.

The problems are endemic to Florida’s private market. The “carrier of last resort,” Citizens Property Insurance Corporation, is in the midst of a legislatively mandated, large-scale depopulation program, in which it has slashed its number of policies by about a third in the last several years. Citizens’ loss is a gain for several upstart carriers, but the AOB crisis is showing no signs of abetting and costs to defend these frivolous claims are becoming exorbitant.

Mansfield insurance lawyers need to read the Houston Court of Appeals [14th Dist.] opinion styled, Daugherty v. American Motorists Insurance Company. It was issued in 1998.

Daugherty filed suit against American for refusing to pay his claim. The trial court ruled in favor of American. Daugherty appealed.

The record reflects that Daugherty purchased a BMW on January 12, 1994.   The sales price of the vehicle was $58,148.88. With the addition of taxes and fees, Daugherty paid a total of $64,678.97 for the automobile. The car was stolen on February 15, 1994. Daugherty promptly reported the theft to American. On February 25, 1994, Daugherty submitted an affidavit of vehicle theft to American in which he claimed a loss of $68,895.42.

Dallas insurance attorneys can tell lots of stories where the insurance company is ripping off and taking advantage of it’s insureds. The Insurance Journal recently published a couple of stories where an insured was involved in ripping off the insurance company. The punishment for getting caught can be grim.

An ex-worker at a Houston home decor store has pleaded guilty in a $2 million insurance scam in which customers intentionally fell and then filed claims.

The case involved more than two dozen false claims approved by Johnson and settlements topping $2 million. Prosecutors say the money was shared by Johnson, the fake victims and others in the scheme.

Irving insurance law attorneys who handle claims involving homeowner policy’s need to read this recent opinion out of the Dallas Court of Appeals. It is styled, David Fusaro v. Trinity Universal Insurance Company.

David Fusaro appeals from a summary judgment in favor of Trinity Universal Insurance Company (TUIC). Among other things he contends that his claims asserted against TUIC’s insured were covered under TUIC’s policy.

Christopher Becherer’s mother drove her Isuzu Rodeo to Becherer’s house where she left it with Becherer to replace the brakes. Becherer used a hydraulic jack centered on the front of the vehicle to jack up the vehicle, remove the front wheels, and work on the brakes. Although Becherer had jack stands nearby, he did not use them. Becherer’s friend, Fusaro, was at his house and offered to help when Becherer had difficulty removing a brake caliper. While Fusaro was partially under the front passenger wheel well struggling to loosen a caliper bolt, the hydraulic “jack gave way” and the vehicle suddenly fell on top of Fusaro.

Farmers Branch insurance lawyers will run across situations where an insurance company is defending a lawsuit under a “reservation of rights” and then filing a declaratory judgment lawsuit against their insured. This is what happened in an opinion styled, Broussard v. Texas Farm Bureau. The opinion is from the Houston Court of Appeals [14th Dist.].

Farm Bureau issued a homeowner’s insurance policy to Becky and Joseph Broussard for their property. Becky injured an individual while she was operating an all-terrain vehicle. The Broussards reported a claim to Farm Bureau for the accident. The injured individual filed suit against the Broussards (the underlying suit), and the Broussards requested Farm Bureau defend and indemnify the underlying suit. Farm Bureau provided a defense to the Broussards with a reservation of rights.

At the same time, Farm Bureau filed a declaratory judgment action seeking a declaration that it has no duty to (a) defend or indemnify the Broussards for the underlying suit and (b) make medical payments to the injured plaintiff in the underlying suit. The Broussards answered with a general denial and a counterclaim for a declaration that Farm Bureau owed them both a duty to defend and indemnify and to make medical payments in the injured plaintiff in the underlying suit and for violations of the DTPA.

Irving insurance lawyers will run into situations where a renters insurance policy is at issue. The Dallas Court of Appeals issued an opinion in 2015, that should be read. It is styled, Chambers v. American Hallmark Insurance. This case is a good illustration why an experienced insurance law attorney needs to be involved.

This is an appeal by Chambers wherein the trial court granted summary judgment in favor of Hallmark.

Chambers purchased a renter’s insurance policy (the Policy) from Hallmark that went into effect on February 1, 2010. The insurance policy covered the Chambers premises. Chambers paid $252.00 in premiums on the Policy. On or about March 13, 2010, Chambers reported a loss of personal property from the residence identified on the Policy. Chambers submitted his claim for coverage with Hallmark. Hallmark claimed that the alleged theft was not a covered loss under the Policy and denied the claim.

Arlington insurance lawyers should read the 1999, Tyler Court of Appeals case styled, Dunn v. Southern Farm Bureau. The opinion discusses an insurance company’e responsibilities under the Texas Prompt Payment of Claims statutes.

Dunn was insured under a standard form automobile liability policy issued by Farm Bureau which contained uninsured/underinsured motorist (“UM”) coverage. She was injured when her vehicle was struck from the rear by an underinsured motorist. In her suit Dunn sought to recover not only UM benefits, but additional damages and attorney fees as the result of Farm Bureau’s alleged violation of the prompt payment requirements of the Texas Insurance Code. After a bench trial, the trial court rendered judgment in favor of Dunn in the amount of $220,000.00 for personal injury damages and $118,251.22 for prejudgment interest. However, the trial court did not award Dunn the requested 18 percent additional damages and attorney fees provided for in the Prompt Pay Statute. In her sole issue presented, Dunn asserts that the trial court erred by refusing to award the 18 percent penalty, attorney’s fees, and prejudgment interest.

At the heart of this case is the interpretation and application of the prompt payment provisions. The relevant provisions of the statute state:

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