Dallas Fort Worth Insurance Lawyer Blog

Homeowners Policy And Mortgagee

June 21, 2014 | Mark S. Humphreys

Insurance attorneys in Fort Worth will deal with homeowners policies at some point. With that in mind, a 2014 opinion from the Houston Court of Appeals [14th Dist.] is important to read. The style of the case is, SWE Homes, LP v. Wellington Insurance Company. Here is some of the relevant information.

There is very little dispute regarding the facts in this case. Edgar Sadberry purchased a residential property with a mortgage from SWE. He bought a Texas Dwelling Policy from Wellington covering the property and naming SWE as the mortgagee. The effective dates of the policy ran from August 11, 2010 until August 11, 2011. The policy covered losses from various hazards including fire. It further contained a Mortgage Clause, which reads in pertinent part as follows:

19. Mortgage Clause . . . .

Negligent Entrustment And Permission To Drive

June 19, 2014 | Mark S. Humphreys

Dallas attorneys handling auto insurance cases would want to know of this 1960 case. It is from the Texarkana Court of Appeals and is styled Hanson v. Green. Here is some of the relevant information.

This is an automobile collision suit wherein Jerry R. Hanson and wife were plaintiffs and Roy Green was defendant. The trial court instructed a verdict in favor of defendant Green and the Hansons have appealed.

The material undisputed facts are briefly in effect as follows: Appellee Roy Green was the owner of a 1955 Chevrolet automobile which was in good mechanical condition. On May 19, 1957, his daughter, Nancy, requested and received permission from her father to drive the automobile over to a friend’s house, the Brownings, for a social visit, and the father cautioned her to be careful. No one accompanied her. Nancy then lacked about two months being 15 years of age, she had no driverhs license, and had been driving ‘close to a year’ prior thereto. At no time prior to May 19, 1957, did appellee have any knowledge that Nancy would permit anyone else to drive the automobile, and if appellee had known on the occasion of May 19, 1957, that Nancy would have permitted any other person to drive the car he would not have let her the car. Nancy permitted one of her friends, Gerald Lee Hunt, a minor, who had no driver’s license, to drive the automobile, and Hunt was driving the automobile at the time of its collision with the vehicle operated by appellant Jerry R. Hanson. Mrs. Hanson was riding in the Hanson car and alleged receipt of personal injuries in the collision for which suit was brought, as well as for property damages to the Hanson automobile.

Furnished For Regular Use

June 17, 2014 | Mark S. Humphreys

Dallas lawyers who deal with uninsured motorist cases need to be knowledgeable of this case from the San Antonio Court of Appeals. It is a 1990, opinion and is styled, Briones v. State Farm. Here is the relevant information.

Briones appealed a take nothing summary judgment granted in his suit against State Farm seeking recovery on his family automobile insurance policy under the uninsured motorists clause, for bodily injuries suffered in a one vehicle automobile accident.

Briones claims the Trial Court erred in granting Defendant’s Motion for Summary Judgment because there is a genuine issue as to material facts regarding the one remaining issue to be litigated by the parties, namely whether the tractor-trailer in which Briones was a passenger at the time of his bodily injuries was furnished or available for his regular use.

Hospital Liens

June 15, 2014 | Mark S. Humphreys

Dealing with hospital liens is a common experience for attorneys dealing with insurance companies. This recent Texas Supreme Court is a must read. It is styled McAllen Hospitals v. State Farm. Here is what the case tells us.

To assist hospitals with securing payment for medical services provided to accident victims, Texas Property Code chapter 55 (the Hospital Lien Statute) allows a hospital to file a lien on a patient’s cause of action against a person whose negligence caused the injury that necessitated the patient’s treatment. If the hospital’s charges secured by a proper lien are not “paid” within the meaning of the statute, any release of the patient’s cause of action is invalid. In this case, two patients treated at the petitioner’s hospital settled with the negligent third party. That party’s liability insurer made the settlement checks jointly payable to the patients and the hospital and delivered the checks to the patients, who deposited them without the hospital’s endorsement. The issue presented is whether the hospital’s charges were “paid” under the Hospital Lien Statute and the Uniform Commercial Code even though the hospital never received notice that the settlement funds had been delivered to the patients and were never reimbursed for the treatment costs. This court said no.

Gil and Hernandez settled with Benavidez for $5,200 and $2,100, respectively, and released their claims against him. The Hospital was not a party to the releases, nor was it informed the parties had settled. State Farm, aware of the Hospital’s liens, informed Gil that he was responsible for paying the Hospital for its services out of the settlement funds. State Farm issued Gil’s settlement check payable to “Jose Antonio Gil & Rafaela Balderas, Individually and as husband and wife & McAllen Medical Center,” and issued Hernandez’s check payable to “Melinda De La Garza Hernandez, a Single Individual & McAllen Medical Center.” State Farm sent the checks to Gil and Hernandez without notifying the Hospital. Both Gil and Hernandez deposited their settlement checks without the Hospital’s endorsement. The Hospital’s charges for treating Gil and Hernandez remain outstanding.

Home Owners Policy Defininitions

June 14, 2014 | Mark S. Humphreys

Parker County insurance attorneys have to know how courts interpret definitions contained within policies. A recent Houston Court of Appeals [1st Dist.] case helps as it relates to the definition of “you” in a homeowners policy. The case is styled, Hodges v. Safeco. Here is some of the relevant information.

On August 17, 2009, Darrell Lee Hodges, Sr. was assaulted in his home. His son, Darrell Lee Hodges, Jr. [“DJ”], lived at the home with his father. DJ knew the assailants, knew they were looking for his father and that they posed a risk to his safety, but nonetheless failed to warn his father of the men’s presence outside the home and failed to call the police to have the men removed from the premises.

SAFECO had a homeowner’s condominium policy in place at the time of the offense. Mr. Hodges is the named policy holder and DJ is also covered because he lived at the condominium with his father. Mr. Hodges made a claim under the policy for insurance benefits to cover his injuries. SAFECO denied coverage, citing the “homeowner’s exclusion” in the policy, which precludes coverage for “bodily injury to [the named insured] or an insured.”

Wage Replacement Benefits And ERISA

June 12, 2014 | Mark S. Humphreys

Dallas and Fort Worth insurance lawyers need to understand how ERISA policies are different from other types of policies. The difference is that a “plan administrator” makes a decision on a claim and if the claimant disputes that decision and files a lawsuit, the Courts look at the decision and decide whether or not the plan administrator abused their discretion in arriving at their decision.

A decision from the United States 5th Circuit is a good case to read to understand how the courts look at ERISA claims. The style of the case is Patrizia Lalonde v. Christus Health. Here is what we learn.

The facts can be learned by reading the case.

Covered Property

June 10, 2014 | Mark S. Humphreys

Grand Prairie insurance lawyers need to be able to discuss with a client how courts interpret insurance policies. The Houston Court of Appeals [14th Dist] issued an opinion in April 2014, that is worth reading. The style of the case is “ACGS Marine Insurance Company v. Spring Center, Inc.” Here is what the case tells us.

Spring Center owns a business park in the Houston area consisting of eleven buildings, all surrounded by a single fence. It leases space within its eleven buildings to various businesses, including those providing light manufacturing, storage, and light machine repair, among others. Spring Center also has a management office located on the property that is staffed during normal business hours.

A vacant building in the business park was broken into and “completely stripped of electrical wiring.” Major damage was done to the offices and exterior doors were broken. Spring Center timely notified ACGS of the damage and requested coverage under the Policy. During its investigation, ACGS learned from Spring Center’s representative that the building had been vacant for about four months prior to the loss. ACGS informed Spring Center in writing that it would not cover the damage based on the following Policy condition:

Insurance Company Fraud

June 8, 2014 | Mark S. Humphreys

Not very many Texas insurance lawyers really understand what went on in the Farmers fraud case several years ago. The public in general did not know what was going on, only that Farmers was refusing to renew home- owners policy. This was causing the public to be upset. The whole story isn’t that difficult but it is essentially over.

Texas Watch ran an article in April 2014, titled “Judge Concerned About Sweetheart Deal For Farmers Insurance” and the story does not discuss the underlying facts that gave rise to what was discovered but it does talk about some of the repercussions. Here is what the article tells us.

A Texas district court judge refused to allow a sweetheart deal between Farmers Insurance and the State of Texas to move forward today. At a hearing in Judge Scott Jenkins‘ court, lawyers for Farmer Insurance and Attorney General Greg Abbott’s office argued in favor of a deal that allows the insurance giant to avoid paying interest on millions of dollars in excessive premiums.

Insurance Fraud Cases

June 7, 2014 | Mark S. Humphreys

Hudson Oaks insurance attorneys need to be able to distinguish between real insurance claims and fraud claims. The Insurance Journal published an article in April that discussed insurance fraud in Texas. Here is what the article tells us.

Texas Department of Insurance Fraud Unit opened investigations into more than 550 insurance fraud cases in 2013.

More than $10.3 million in insurance fraud was identified in criminal cases referred for prosecution in 2013, the department said. Court-ordered restitution for cases that reached final adjudication during this same period totaled more than $7.5 million.

Deleting Vehicle From Insurance Coverage

June 5, 2014 | Mark S. Humphreys

Insurance attorneys in the Dallas and Fort Worth areas need to know about a recent United States Fifth Circuit Court of Appeals decision. It is styled, Bituminous Casualty Corporation v. The Travelers Indemnity Company; Frontier Mining & Material, L.L.C. Here is the relevant information.

Travelers issued a commercial automobile insurance policy to Big D Concrete, Inc. (“Big D”) with a policy period of November 7, 2010 through November 7, 2011. Bituminous issued a commercial automobile insurance policy to Frontier for a policy period of June 10, 2011 through June 10, 2012. In August 2011, Big D leased a 1999 Mack tractor and a 1999 Vantage trailer (“the Tractor and Trailer”) to Frontier as evidenced by an Equipment Lease (“the Lease”) dated in August 2, 2011 and an Addendum to Equipment Lease dated August 5, 2011. The Equipment Lease required Frontier to insure against the entire risk of loss related to the lease equipment and provided that Frontier’s insurance policy coverage would be primary and non-contributing.

On August 10, 2011, a Policy Change Request was submitted on behalf of Big D to Travelers requesting that 10 units owned by Big D be deleted from its commercial automobile insurance policy with Travelers. The Tractor and Trailer were among the 10 units deleted from the policy with Travelers. The Policy Change Request was ultimately approved and an endorsement change (“the Endorsement”) was issued with an approval date retroactively effective to August 8, 2011. Travelers issued to Big D a refund of $3,847 in premiums for the 10 units once the policy change was approved and in effect.