Dallas Fort Worth Insurance Lawyer Blog

Hail Claims

December 16, 2014 | Mark S. Humphreys

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.

Fort Worth Insurance Lawyers – Read The Policy

December 14, 2014 | Mark S. Humphreys

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.

What Does A Policy Cover

December 13, 2014 | Mark S. Humphreys

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.

Insurance Coverage And Intentional Acts

December 11, 2014 | Mark S. Humphreys

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.

Read Those Title Insurance Policy Exclusions

December 9, 2014 | Mark S. Humphreys

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.

Uninsured Motorist Coverage And Workers Compensation

December 7, 2014 | Mark S. Humphreys

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.

Misrepresentation Of Insurance Policy

December 6, 2014 | Mark S. Humphreys

A Fort Worth insurance lawyer needs to know when there was a misrepresentation of an insurance policy. A 1994, Corpus Christi Court of Appeals is worth reading on this topic. The style of the case is Celestino v. Mid-American Indemnity Insurance Company. Here is some of the information from that case.

Celestino is the assignee of Sabastian. The instant dispute involves Sebastian’s insurance policy, which Donald Donaho of the Donaho Insurance Agency (Donaho) purchased from Mid-American through underwriters Richard McNeil and Pro., Inc. With the full participation and cooperation of Sebastian, the Celestinos sued Mid-American.

As chief executive officer of Sebastian, Tommy Funk determines what insurance the company requires and obtains the necessary coverage. Funk maintained a primary policy for both workers’ compensation insurance and employer’s liability insurance as well as an umbrella policy for excess employer’s liability coverage. A later change in policies resulted in coverage with Mid-American.

Insurance Policy Cancellation And Other Law

December 4, 2014 | Mark S. Humphreys

Mineral Wells lawyers who handle insurance cases need to be aware of the different ways that insurance policy cancellations work as it relates to other laws. A 1994, Waco Court of Appeals case shows a good example of this. The style of the case is, Truck Insurance Exchange v. Martin. Here is some information from that case.

On July 13, 1991, an employee of Martin was involved in a truck accident. Mr. and Mrs. Salazar were the driver and the passenger of the vehicle which was rear-ended by the eighteen-wheel Martin vehicle driven by Martin employee Terry Lawley.

The Salazars sued Martin and Lawley. Counsel provided jointly by Harco and by Truck defended Truck. The action was settled by Harco’s payment of $725,000 on behalf of Martin and Lawley. Truck did not participate in the settlement.

Use Of Vehicle

December 2, 2014 | Mark S. Humphreys

A Grand Prairie insurance lawyer needs to be able to hear the facts in a case and compare those facts to the policy and the law. When it comes to how the courts look at situations where “use” of a vehicle is at issue there is a 1994, Dallas Court of Appeals case that is good to know about. The style of the case is, Nationwide Property v. McFarland. Here is the relevant information from that case.

McFarland was working underneath his auto. The car was sitting up on jacks. While McFarland was underneath the car, Mashewske got in the car to see if it would start. When Mashewske shifted the car into neutral, it rolled backward, fell off the jacks, and landed on McFarland. McFarland sustained injuries from the accident.

At the time of the accident, McFarland was covered by an automobile insurance policy issued by Nationwide. The policy covered McFarland, as the named insured, and any other person “using” the covered auto. The policy identified McFarland’s auto as the “covered auto.” McFarland sued Mashewske for negligence. Mashewske tendered his defense to Nationwide, claiming he was entitled to coverage under McFarland’s policy because he was “using” the covered auto at the time of the accident. Nationwide agreed to provide Mashewske’s defense under a reservation of rights.

Is It Bad Faith To Cancel A Policy?

November 30, 2014 | Mark S. Humphreys

Lawyers handling bad faith cases in the Dallas and Fort Worth areas need to recognize a bad faith case when they see it. This is not always easy. An El Paso Court of Appeals case from 1996, is an example. The style of the case is, Columbia Universal Life Insurance Co. v. Miles.

Miles met with his insurance agent to change his heath insurance coverage. The agent filled out the application by asking Miles the questions listed on the application. Miles testified that he provided the agent with a complete medical history. The agent said Miles only talked about the conditions that appeared on the application. It turned out that Miles had an extensive medical history that was not listed on the application including immune deficiency and other chronic illnesses. Miles says he signed the application without signing it.

Shortly after filling out the application, Columbia called Miles to conduct a personal history interview and to confirm the information on the application. Miles told Columbia that the information on the application was true and correct. He did not mention his other medical problems and the policy was issued.