Dallas Fort Worth Insurance Lawyer Blog

Roof Damage Claims

March 28, 2015 | Mark S. Humphreys

Dallas insurance lawyers who handle roof damage claims will want to ready this “Order” from a Fort Worth Federal Court. The style of the case is, Living Word Teaching Center v. Robert Morris Adams, Jr. and Allstate Insurance Company.

Living Word, a church, secured an insurance policy from Allstate covering its 5,000 square foot church. Living Word later built a large arena next to the church and sought additional coverage for the arena from Allstate. In December 2013, the arena suffered a collapse and was damaged. When Living Word filed an insurance claim with Allstate for the damage suffered, Allstate advised Living Word that the arena was not listed on the policy and therefore, was not covered.

Living Word brought the following claims against Defendants: (1) violations of the Texas Deceptive Trade Practices Act against Allstate insurance agent, Adams; (2) negligent misrepresentation against Adams; (3) negligence/negligent procurement against Adams; and (4) agency and vicarious liability against Adams and Allstate.

ERISA Plan? How Do You Know?

March 26, 2015 | Mark S. Humphreys

Fort Worth lawyers who handle ERISA plans have learned that almost all companies that have their own employee insurance plans will claim they are ERISA plans. The real question though is – are they?

Knowing which employee plans are true ERISA plans and which are not is not always easy to discovery. There are two sections of 29 USC that are helpful in this regard.

Sec. 1022. Summary plan description

Hail Storm Claims

March 24, 2015 | Mark S. Humphreys

Parker County lawyers who handle hail storm claims should keep up legislation dealing with the topic. The Insurance Journal published an article that should be read. The title of the article is, Bills Aimed At Property Claims Litigation Expected In Texas Legislative Session. Here is what the article says.

Texas lawmakers are expected to file legislation this year aimed at stemming the tide of property claims litigation in the wake of catastrophic weather events, such as hailstorms.

Proponents of such legislation would like to see a measure that limits the time in which claims over property losses may be filed, similar to the limitations put in place for the Texas Windstorm Insurance Association after it was inundated with claims-related lawsuits following Hurricane Ike.

Renters Insurance And Breach Of Contract

March 22, 2015 | Mark S. Humphreys

Irving insurance lawyers wishing to sue for breach of contract in an insurance dispute need to read this Houston Court of Appeals opinion styled, Zatorski v. USAA.

Zatorski owned a high-rise, loft residence in Houston. A kitchen pipe broke and flooded the loft. Zatorski rented a single-family home while the loft was being repaired, and he called USAA to buy a renter’s insurance policy. He spoke with a USAA representative, paid for a one-year renter’s insurance policy over the phone, and did not review the written policy when he received it.

Armed intruders broke into Zatorski’s rental home and stole several firearms and his safe, which contained watches, jewelry, and cash; the items stolen had a total value of over $260,000. Zatorski made a claim against his rental policy for the value of the stolen items, and USAA responded that the policy limits were $1,000 for theft of jewelry, $2,000 for theft of firearms, and $200 for theft of cash. USAA paid Zatorski $4,500, which constituted payment of the policy limits for jewelry, firearms, and cash, plus $1,300 for the loss of the safe.

Renters Insurance And Misrepresentation

March 21, 2015 | Mark S. Humphreys

De Soto insurance lawyers who handle renters insurance need to read this case from the Houston Court of Appeals [1st. Dist.]. It is styled Zatorski v. USAA Texas Lloyds.

After Zatorski’s home was burglarized, he sued USAA, alleging that USAA had represented to Zatorski that his renter’s insurance policy would cover greater losses than it did. USAA moved for summary judgment and the trial court granted the motion. This appeals Court affirmed the ruling.

Zatorski owned a high-rise, loft residence in Houston. In October 2009, a kitchen pipe broke and flooded the loft. Zatorski rented a single-family home while the loft was being repaired, and he called USAA to buy a renter’s insurance policy. He spoke with a USAA representative, paid for a one-year renter’s insurance policy over the phone, and did not review the written policy when he received it.

Hail Damage Claims In Texas

March 19, 2015 | Mark S. Humphreys

Dallas lawyers handling hail damage claims need to be aware of the actions taking place in Austin. A recent article from the Insurance Journal needs to be read. The title of the article is, Attorneys, Insurers Facing Off Over Hail Litigation In Texas. Here is what it tells us about the battle between hail claims attorneys and insurance companies.

The vestiges of twin hailstorms that ravaged the south Texas coast in 2012 are now blowing through the halls of the Capitol in Austin.

Two of the state’s most-powerful lobbies, the insurance industry and trial lawyers, are gearing up for a fight over a push to ease penalties against companies that deny homeowners their hail-damage claims.

Insurance Agent Liability In Mineral Wells

March 17, 2015 | Mark S. Humphreys

Mineral Wells insurance lawyers already know about this case from the Eastland Court of Appeals. It is styled, Spurlock v. Beacon Lloyds Insurance Company.

Kelly Spurlock (Spurlock), as legal representative for the Estate of J.O. Spurlock, brought suit against Beacon to recover proceeds under a homeowner’s insurance policy for the loss of personal property that was allegedly stolen from a residence. Spurlock also named Grantham-Adkins Insurance Agency (Grantham-Adkins) as a defendant. Spurlock asserted that, if the homeowner’s insurance policy that was issued by Beacon did not provide coverage for the loss of personal property, Grantham-Adkins was negligent in failing to procure coverage for the loss. Beacon and Grantham-Adkins filed motions for summary judgment on Spurlock’s claims. The trial court granted the motions in separate orders. Spurlock appealed the trial court’s orders. This Court affirmed the Orders.

Spurlock owed and lived in a house in Mineral Wells, Texas, that was insured with Beacon through Grantham-Adkins.

Mineral Wells Home Owners Claim

March 15, 2015 | Mark S. Humphreys

Mineral Wells insurance attorneys probably already know about this case. It is an Eastland Court of Appeals case styled, Spurlock v Beacon Lloyds Insurance Company.

This case involves the interpretation of a homeowner’s insurance policy. The Court had to construe a policy to determine if coverage exists for a personal property loss alleged to have occurred after the death of the named insured. Kelly Spurlock, as legal representative for the Estate of J.O. Spurlock, brought suit against Beacon to recover proceeds under a homeowner’s insurance policy for the loss of personal property that was allegedly stolen from a residence.

J.O. Spurlock owned and lived in a house in Mineral Wells, Texas, that he insured with Beacon. The policy was effective from May 31, 2008, to May 31, 2009. The “RESIDENCE PREMISES/DWELLING” listed in the declarations page of the policy was identified by the legal description of J.O. Spurlock’s house. The street address of the house was 704 Cedar in Mineral Wells. The policy provided dwelling coverage and personal property coverage.

Giving Notice To The Insurance Company

March 14, 2015 | Mark S. Humphreys

Insurance lawyers in Aledo Texas will tell you that you need to give notice to your insurance company as soon as possible when you know of a potential claim. The United States 5th Circuit dealt with this notice issue recently in a case styled, Berkley Regional Insurance Company v. Philadelphia Indemnity Insurance Company.

This case involves an insurance claim, controlled by Texas law for this diversity action, arising from an injury sustained on the property of Towers of Town Lake Condominiums. Towers, in an attempt to satisfy the notice requirements of an umbrella insurance policy with Philadelphia, sent notice of the claim to the broker of that policy. The core of the dispute is whether this notice satisfied the requirements of the umbrella policy, and, if not, whether Philadelphia was prejudiced as a result. Finding notice to the broker insufficient and Philadelphia prejudiced, the district court granted summary judgment in favor of Philadelphia. This Court affirmed that decision.

In 2004, Venus Rouhani (Rouhani) sued Towers in Texas state court for injuries she sustained at Towers, and a jury awarded her $1,654,663.50 plus interest and costs (totaling $2,167,300.30) in 2006. The damages were covered by a $1,000,000 primary policy issued by Nautilus Insurance Company (Nautilus) and a $20,000,000 umbrella policy (Umbrella Policy) issued by Philadelphia. Nautilus tendered its policy limits plus interest in the amount of $1,457,561.41 to satisfy the judgment, but Philadelphia refused to pay the remainder of the judgment, arguing that Towers failed to give Philadelphia notice of Rouhani’s claim until after the verdict was rendered.

ERISA And Contributing To Impairment

March 12, 2015 | Mark S. Humphreys

North Richland Hills insurance lawyers who handle ERISA claims need to read the 2015, 5th Circuit Court of Appeals opinion styled, George v. Reliance Standard Life Insurance Company. There are a couple of issues in the case but only the issue in the title above will be discussed here.

George served as an Army helicopter pilot. In 1985 George was injured in a helicopter crash, and doctors were forced to amputate one of his legs at the knee. George retired in 1987. After retiring, George began flying helicopters for PHI, Inc. PHI purchased a long-term disability insurance policy for George from Reliance (“RSL”). George flew for PHI for more than twenty years. But in 2008 he began experiencing severe pain at the site of his amputation, which prevented him from safely wearing his prosthetic limb. As a result, he was no longer able to operate the foot controls of a helicopter, and he was forced to retire from flying. George filed a claim for long-term disability benefits with RSL.

The Policy contains two definitions of “Totally Disabled” and “Total Disability,” which apply during different time periods. The Policy also contains a relevant limitation provision (the “Exclusion Clause”). The Exclusion Clause provides that “Monthly Benefits for Total Disability caused by or contributed to by mental or nervous disorders will not be payable beyond an aggregate lifetime maximum duration of twenty-four (24) months.” The Policy defines “Mental or Nervous Disorders” to include “anxiety disorders” and “mental illness.”