Irving insurance lawyers should be able discuss with clients how exclusions in an insurance policy effect coverage. A 1994, Fort Worth Court of Appeals case is worth knowing about on this issue. The style of the case is, Union Pacific Resources Co. v. Aetna Casualty & Surety Co. Here is relevant information from that case.

Over a three year period Union Pacific (UP) disposed of potentially polluting waste in an industrial landfill. Even though dumping of such waste was legal and an accepted form of disposal at the time the EPA subsequently sued UP and others to recover clean up costs at the landfill site. UP entered into a partial consent degree agreeing to participate in limiting pollution hazards at the landfill. UP alleged that it had received third-party claims regarding the landfill and anticipated further claims.

Aetna denied coverage on the basis that the depositing of the waste in the landfill violated the various policies’ pollution exclusion clauses. Some of the policies contained a “sudden and accidental” exclusion which excluded liability for property damage arising out of the discharge, disbursal, release, or escape of waste materials or other irritants, contaminants, or pollutants into or upon the land, the atmosphere, or any water, course, or body of water.

Arlington insurance attorneys will tell their clients they need to be aware of exclusions in insurance policies and how they are interpreted. Just reading the declarations page is not enough. The entire policy needs to be including the exclusions. A 1998, Texarkana Court of Appeals case serves as an example. The style of the case is, Allen V. St. Paul Fire & Marine Insurance Company. Here is some of the relevant information from that case.

This suit alleged damages arising out of Tawakoni Water System’s failure to provide “potable” water, “good quality” water, water “reasonably fit for family residential use,” or water “approved and/or certified by the appropriate State of Texas and federal authorities.” The Allens also alleged that the water received was of “unpalatable quality,” “unfit for human consumption and/or use,” and that the water was contaminated.

St. Paul denied coverage and refused to provide a defense for Tawakoni. St. Paul based its denial of coverage on pollution exclusions allegedly included in the five policies upon which the Allens sued. Following a bench trial, a judgment of $17,326,174 was rendered in favor of the Allens. Tawakoni then assigned to the Allens its claim against St. Paul for wrongful refusal to defend in return for a covenant not to execute.

Fort Worth insurance lawyers who handle hail damage claims need to be know how courts interpret appraisal clauses in insurance policies. A 2009, Texas Supreme Court case is a must read for helping to understand the appraisal process. The style of the case is, State Farm Lloyds v. Johnson. Here is some of the relevant facts and information to be taken from the case.

A hailstorm moved through Plano, Texas in April of 2003, damaging the roof of Johnson’s home. She filed a claim under her homeowners insurance policy with State Farm Lloyds. State Farm’s inspector concluded that hail had damaged only the ridgeline of her roof, and estimated repair costs at $499.50 (less than the policy’s $1,477 deductible). By contrast, Johnson’s roofing contractor concluded the entire roof needed to be replaced at a cost of more than $13,000.

To settle this difference, Johnson demanded appraisal of the ” amount of loss” under the following provision in her standard-form policy:

Dallas insurance lawyers need to know how the Courts look at policy language when deciding how to rule on cases involving insurance. A 1997, Amarillo Court of Appeals case is a good one to read to help understand how the Courts interpret certain policies. The style of the Amarillo case is, Home State County Mutual Insurance Company v. Acceptance Insurance Company. Here is some of the relevant information.

Esquival was engaged to deliver rock and sand, called “base,” for a road construction project. Esquival had a commercial auto liability policy issued by Home State and a CGL policy issued by Acceptance. Pritchard, an employee of Jordan Paving, another subcontractor responsible for leveling and spreading the base, collided with a load of base which had previously been unloaded at the site by Esquival. Pritchard sued Esquival and Esquival brought a declaratory judgment action against Acceptance. Acceptance likewise sought a declaratory judgment that Home State’s auto policy provided coverage for Pritchard’s injuries. The trial court held that the auto policy provided coverage and granted Acceptance a summary judgment.

When this Amarillo Court of Appeals made its’ ruling it held that the judgment of the trial court be reversed and judgment be rendered in favor of Home State. The CGL policy, not the auto policy, provides coverage for Pritchard’s injuries. Texas courts have rejected the “coming to rest” rule to interpret the “loading and unloading” clause contained in the “used” provision of a standard auto liability policy. Instead, Texas courts have adopted the “completed operation” rule which holds that loading and unloading not only includes the immediate transport of goods to and from the vehicle, but the complete operation of transporting the cargo between the vehicle and the place to or from which the cargo is being delivered.

Insurance lawyers in the Dallas / Fort Worth area will see lots of hail claims. An article this year from the “Claims Journal” needs to be read by those lawyers to keep informed. The title of the article is, The Emerging Hail Risk: What The Hail Is Going On? Here is what the article tells us.

The number of reported claims involving hail damage to residential and commercial roofing products has increased dramatically over the past few years. Some reports place the increase at almost double historical claim totals.

What is the cause of this significant increase? There is no disputing that in recent years there have been significant hail events in large metropolitan areas. But does this alone account for the near-double increase in claim filings? Plus, in addition to the increase in the number of claims, an abnormally high percentage of these claims are ending up disputed and ultimately in appraisal or litigation. In Texas, hundreds, literally hundreds, of lawsuits are being filed each week in Dallas, Tarrant, Potter, Hidalgo, and other counties involving alleged underpayment of hail related roof damage claims – far, far more than has ever previously been the case.

Read the policy. Understand what it says. The United States 5th Circuit issued a 1998 opinion that shows how courts will interpret policies. The style of the case is, Lubbock County Hospital District v. National Union Fire Insurance Company of Pittsburg. Here is some relevant information from the case.

Approximately 1,000 gallons of fuel escaped from the fueling system at University Medical Center’s helipad. UMC sued Rocky Mountain Helicopters, Inc., the operators, for the costs of clean up and monitoring. UMC recovered a judgment of nearly $500,000 against Rocky Mountain.

UMC brought suit against National Union seeking a declaration that the insurance policy it issued to Rocky Mountain covered damages for the fuel spill. National Union removed the case to Federal District Court on the basis of diversity. Both parties filed motions for summary judgment. The district court granted summary judgment in favor of UMC finding coverage under two endorsements to the policy.

Aledo insurance attorneys will have clients who have commercial and business related insurance. When an occasion arises wherein it is necessary to make a claim, it is a sad time when they find out the policy does not cover all they believed it covered. It is important to sit down with your agent and make sure what the policy covers and what you want it to cover. Keeping in mind the discussion with the insurance agent helps if all or part of a claim is denied. Relating to an attorney the substance of those conversations, reading the policy, and knowing the facts of the situation allows the insurance attorney to suggest an appropriate course of action. This is illustrated somewhat in a 1998, Dallas Court of Appeals case styled, Fidelity and Casualty Company of New York v. Thompson, et al. Here is some of the relevant information from the case.
Thompson was a licensed, practicing optometrist who also owned and operated an optical clinic. A fire destroyed all of the property. Thompson was insured by Fidelity and made a claim demanding payment of the entire $250,000 policy proceeds. Fidelity paid Thompson $205,342.92 for losses to his medical equipment, office furniture and fixtures, and other “improvements and betterments.” Fidelity denied coverage for the value of Thompson’s optical clinic inventory which included, eyeglass frames, corrective lenses, contact lenses and other items held for sale. Thompson filed a declaratory judgment action seeking a declaration that the policy he purchased from Fidelity afforded coverage for inventory of his optical business. Both Thompson and Fidelity filed motions for summary judgment. The trial court granted Thompson’s motion and denied Fidelity’s. Fidelity filed this appeal.
This Dallas Court of Appeals held that the judgment in favor of Thompson was improper and reversed and rendered in favor of Fidelity. This case involved an optometrist’s professional liability policy. Optometry is the “art of occupation consisting of the examination of the eye for defects or faults of refraction and the prescription of correctional lenses and exercises.” An optometrist prescribes eyewear while an optician dispenses or sells the eyewear. Looking to the definitions of optometrists in Webster’s International Dictionary and the definition of supplies in Black’s Law Dictionary, this Appellate Court found that none of these definitions carries the meaning that supplies usual to the practice of optometry include inventory or prescriptive eyewear held for sale. The policy does not cover items held as inventory for the purpose of sale. Thompson’s medical profession as an optometrist is not, by definition, involved in the sale of frames, contact lenses, or other eyewear.

Most Garland insurance lawyers will be able to tell you that the majority of insurance policies do not cover claims that are the result of an intentional act. But just because an act is intentional does not mean that acts of others that may have facilitated the intentional act are excluded from coverage. This is explained in a 1998, Houston Court of Appeals [14th Dist.] case styled, Williamson v. Vanguard Underwriters Insurance Company. Here is some of the relevant information from that case.

Vanguard Insurance Company had issued a homeowners insurance policy to Mr. and Mrs. Wilson. The Wilsons’ son was involved in a plot to rob Mathew Vickers, and during the robbery, Kimberly Williamson was killed. Kimberly’s parents brought a wrongful death suit against Mr. and Mrs. Wilson alleging that they were negligent in their supervision of their son, Michael Wilson. The Wilsons settled the case, and they then sought to be indemnified under the homeowner policy issued by Vanguard. Vanguard filed a declaratory judgement claiming that the “intentional injury” exclusion in the policy barred coverage. The exclusion stated that the insurance did not apply to:

a. bodily injury or property damage which is caused intentionally by or at the direction of the insured.

Mineral Wells insurance lawyers will tell you that you have to be aware of “exclusions” in your insurance policies, otherwise, you risk finding out the hard way. A 1999, Austin Court of Appeals case illustrates this. The style of the case is, Zimmerman v. Chicago Title Insurance Company. Here is the relevant information.

In 1988, the Zimmermans purchased residential property in Austin and obtained a policy of insurance from Chicago Title insuring title to that property. The policy obligates Chicago Title to defend the Zimmermans against any action in which a claim adverse to their title is asserted, unless the claim is based on matters excepted by the policy. In the separate litigation underlying this dispute, the Zimmermans were sued by the owners of adjoining property, Mary Joseph and her four daughters, who asserted title by adverse possession to a twelve- to twenty-inch strip of land insured under the Zimmermans’ policy. Chicago Title refused the Zimmermans’ request to defend them against the suit.

The Zimmermans sued Chicago Title for a declaration that it owed a duty under the policy to defend them in the underlying suit. The Zimmermans subsequently moved for partial summary judgment, asserting that Chicago Title had relied on four policy exclusions to refuse their defense, none of which applied. Chicago Title filed its own motion for summary judgment, arguing that each of the claimed exclusions justified its refusal to defend. Following a hearing, the district court rendered an order denying the Zimmermans’ motion and granting summary judgment for Chicago Title.

Grand Prairie insurance attorneys will run into situations where a person who is covered by workers compensation insurance is injured in a vehicle where the at fault driver does not have liability insurance for themselves but the injured employee does have uninsured motorist coverage. If the person covered by workers compensation accepts workers compensation benefits does their uninsured motorist coverage also have to compensate them for their injuries?

This was answered in a 1973, Houston Court of Appeals [1st Dist.] case styled Hamaker v. American States Insurance Company of Texas. Here is some of the information from that case.

This is an appeal from a summary judgment for the defendant granted in a suit for damages brought under the uninsured motorist provision of an insurance policy. The crucial question concerns the validity of a provision in the policy permitting the insurer to reduce the amount payable under the terms of the policy by the amount the insured has received in workmen’s compensation payments.

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