Dallas Fort Worth Insurance Lawyer Blog

Who Can Sue An Insurance Company And Win

May 3, 2014 | Mark S. Humphreys

Experienced insurance law attorneys know at least part of the answer to the above question. In that regard, a 1994, Texas Supreme Court case is helpful to read. It is styled, Allstate v. Watson. Here is the relevant information.

Watson was injured in a car accident. The driver of the other car was Townley, an insured under an automobile liability policy issued by Allstate. Watson filed suit against Townley alleging that Townley was negligent and that his negligence was a proximate cause of the accident and her injuries. In the same action, Watson also sued Allstate under the current Insurance Code, Section 541.060(a)(2) for alleged unfair claim settlement practices in failing to attempt in good faith to effectuate prompt settlement of her claims where liability had become reasonably clear and in denying or unreasonably delaying payment of her claim. Watson also alleged that Allstate’s conduct violated 28 Tex. Admin. Code Section 21.3 (Board Order 18663) and section 17.46 of the Texas Deceptive Trade Practices (DTPA), thereby giving rise to her cause of action under Texas Insurance Code, Section 541.060(a)(2). In addition to her claim under Section 541.060, Watson alleged violations of the DTPA, breach of contract, breach of the duty of good faith and fair dealing, and sought a declaratory judgment that Watson was an intended third party beneficiary of the Allstate liability policy.

On Allstate’s motion, the trial court severed the claims against Allstate, struck Watson’s pleadings as to Allstate for failure to state a claim, and granted Allstate’s motion for summary judgment.

Dealing With Uninsured Drivers

May 1, 2014 | Mark S. Humphreys

Dallas and Fort Worth insurance attorneys will find this article interesting. It is from the Insurance Journal. Here is what it tells us.

Most uninsured motorists in the U.S. are responsible, safe drivers who simply cannot afford to purchase liability coverage with their income but who still need to drive for their work, according to a consumer advocacy group.

The Consumer Federation of America (CFA) recommended that instead of cracking down on such motorists with harsh penalties, a better policy would be to find ways to provide more affordable insurance and lower the minimum liability limits for safe, uninsured drivers who have lower income.

Insurance Company Deceptive Advertising

April 29, 2014 | Mark S. Humphreys

Palo Pinto County insurance lawyers will find this article interesting. It is from the Insurance Journal. Here is what it says.

Nationwide Mutual Insurance Co.’s use of the slogan “On Your Side” constitutes false and deceptive advertising because the insurer does not represent insureds as the slogan implies, according to the Tennessee adjuster who is in a trademark battle with the giant insurer over the slogan.

Jeremy Snyder, owner of On Your Side Adjusters Inc., says that his firm, unlike Nationwide, represents the insured policyholder in a claim and his firm’s name, license and contracts reflect this.

Assignment Of Insurance Claims

April 27, 2014 | Mark S. Humphreys

Arlington insurance attorneys will occasionally run across a situation where assigning an insurance claims seems like a good idea. Well it may be, but they need to be aware of this case from the United States Fifth Circuit Court of Appeals. It is styled, Nautilus Insurance Company v. Blanc Lila Villalta et al. Here is the relevant information.

Blanca Lila Villalta and Odis Armando Villalta, each individually and as the surviving parents of Odis Steven Villalta (the “Villaltas”), appealed the district court’s sua sponte grant of summary judgment for Nautilus Insurance Company (“Nautilus”). For the following reasons, the court decided to VACATE and REMAND with direction to ABATE or DISMISS the judgment for Nautilus.

Odis Villalta was shot to death by a security officer employed by Bellaire Security Patrol, Inc. (“Bellaire”). The Villaltas filed a lawsuit in Texas district court against Bellaire and others (the “Villalta case”). Nautilus provided general liability insurance to Bellaire and filed suit in federal district court against the Villaltas, seeking a declaration that the policy issued to Bellaire provides no coverage for damages sought in the Villalta case. The federal district court, sua sponte, issued summary judgment for Nautilus, holding that Nautilus had no duty to defend Bellaire as a matter of law because the “all assault or battery” policy exclusion clearly applied. On appeal, the Villaltas raised two primary issues: (1) whether the district court erred in granting summary judgment concerning Nautilus’s duty to defend; and (2) whether ruling on Nautilus’s duty to indemnify is premature based on the underlying Villalta case, which remains pending in state court.

Agent Misrepresentation Of Policy

April 26, 2014 | Mark S. Humphreys

Insurance attorneys in Irving and Dallas need to know the remedies when an insurance agent makes a misrepresentation about a policy. The United States District Court, Southern District of Texas, Houston Division, issued an opinion that is worth reading. The style of the case is Changiz M. Khoei, et al., vs. Stonebridge Life Insurance Company. Here is the relevant information.

Khoei sued Stonebridge alleging wrongful denial of benefits. Khoei claimed benefits for injuries sustained while they were sitting in a car. Stonebridge denied the claim on the grounds that the policy was for death and dismemberment, covering loss of life, loss of one or both hands or feet, and loss of the sight in one or both eyes. Khoel sued for violations of the Texas Insurance Code and the Texas Deceptive Trade Practices Act. (DTPA)

In August 1992, a telemarkerter contacted Khoei about purchasing insurance and allegedly told Khoei that he could purchase a comprehensive policy that would cover accidents and risks not already covered by his auto and health policies. The telemarketer “implied” that the policy would cover accidents up to the policy limits. The telemarketer did not say the policy covered only loss of life or of a foot, hand, or sight of an eye.

Life Insurance – Missed Payments

April 24, 2014 | Mark S. Humphreys

Aledo life insurance attorneys need to know the effect of payments missed on a life insurance policy. To begin with, each policy is different and thus the policy language needs to be read and then applied to the facts of the situation.

A February 2014, opinion from the Houston Court of Appeals, 1st District dealt with this issue to the detriment of the beneficiary. The style of the case is Lambana v. AIG. Here is some of the relevant information.

Pamela Lombana (“Lombana”), acting as the trustee of the Lombana Investment Trust challenged the trial court’s rendition of summary judgment in favor of AIG on her claims against AIG for breach of contract, breach of an oral or implied contract to reinstate, promissory estoppel, negligence, violations of the Texas Insurance Code, violations of the Texas Deceptive Trade Practices Act (“DTPA”), breach of the duty of good faith and fair dealing, fraud, and fraud by nondisclosure. This appeals court affirmed the trial court decision.

Anti-Technicality Statute

April 22, 2014 | Mark S. Humphreys

Insurance lawyers need to know some of the more obscure areas of the Texas Insurance Code. A United States 5th Circuit of Appeals case dealt with the “Anti-Technically” Statute recently. The case is styled W.W. Rowland Trucking Company, Inc. v. Max America Insurance Company. Here is the relevant information.

Rowland transported a load of video game consoles valued at $354,000 from Marshall, Texas, to its Dallas, Texas terminal. Thieves stole the tractor/trailer loaded with the consoles while it was located at the Dallas terminal. At the time of the theft, Rowland had an insurance policy with Max America, also known as Alterra. The Policy’s section entitled “Coverage” provides for “Legal Liability Coverage,” which covers Rowland’s [L]egal liability for loss to covered property: a. while under [Rowland’s] care, custody, and control; [and] b. that [Rowland] become[s] legally obligated to pay as a common or contract carrier under a bill of lading, contract of carriage, or shipping receipt that is issued by [Rowland] or that is issued on [Rowland’s] behalf.

Under the “Property Covered” section, the Policy provides coverage for “Property in Vehicles,” defined as “direct physical loss caused by a covered peril to property of others described on the ‘schedule of coverages’ while in due course of ‘transit’ including loading and unloading.” The Policy also provides that all eight of Rowland’s terminals must be “100% fenced, gated, locked and lighted 24 hours per day, 7 days per week,” or else the “[c]overage is null and void.” The Policy had a limit of $300,000, and included a $2,500 deductible.

Delay In Paying A Claim

April 20, 2014 | Mark S. Humphreys

Fort Worth insurance attorneys need to be aware of this 5th Circuit Court of Appeals decision. The style of the case is W.W. Rowland Trucking Company, Inc. v. Max America Insurance Co. Here is the relevant information from the case.

W.W. Rowland Trucking Company, Inc.’s Dallas, Texas truck terminal, in addition to an 18% penalty. For the foregoing reasons, the judgment of the court was affirmed.

Rowland transported a load of video game consoles valued at $354,000 from Marshall, Texas, to its Dallas, Texas terminal. Thieves stole the tractor/trailer loaded with the consoles while it was located at the Dallas terminal. At the time of the theft, Rowland had an insurance policy Max America, also known as Alterra. The Policy’s section entitled “Coverage” provides for “Legal Liability Coverage,” which covers Rowland’s [L]egal liability for loss to covered property: a. while under [Rowland’s] care, custody, and control; [and] b. that [Rowland] become[s] legally obligated to pay as a common or contract carrier under a bill of lading, contract of carriage, or shipping receipt that is issued by [Rowland] or that is issued on [Rowland’s] behalf.

Life Insurance And Missed Payments

April 19, 2014 | Mark S. Humphreys

North Richland Hills Lawyers who handle life insurance claims can read this case and then tell potential clients they better hire an attorney. This case is from the United States District Court, Northern District, Fort Worth Division. The style is Doretha Hall v. Fidelity & Guaranty Life Insurance Company. Here is the relevant information.

Fidelity issued a term life insurance policy to Mr. Hall in the face amount of $75,000.00. In his application, Mr. Hall designated Doretha as the beneficiary of the policy, and no changes to that designation were ever made. Mr. Hall also requested the premium payments be drafted from his checking account. However, the payment due November 1, 2010, in the amount of $73.65, was rejected because Mr. Hall’s checking account was closed. On November 8, 2010, Fidelity sent a notice of the rejected payment to Mr. Hall’s home address. On December 3, 2010, Fidelity sent Mr. Hall a late payment notice informing him that his premium payment was past due and that the policy would lapse if the premium was not paid by the end of the grace period. When Fidelity still had not received any payment, it sent a second late payment notice on January 3, 2011, informing Mr. Hall again that his payment was past due and that his policy would lapse if the premium was not paid by the end of the grace period. On February 2, 2011, Fidelity mailed Mr. Hall a lapse notice indicating that Mr. Hall’s policy had lapsed and terminated on December 2, 2010, because Mr. Hall had failed to pay his premiums. The lapse notice expressly stated that to apply for reinstatement, Mr. Hall must complete the enclosed application for reinstatement and submit it with the past due premium amounts. On February 10, 2011, Fidelity received a check in regards to Mr. Hall’s policy in the amount of $73.65. Fidelity held the check in suspense and then refunded it to Mr. Hall on March 18, 2011, because Fidelity did not receive a reinstatement application or the remaining past-due premiums.

Doretha notified Fidelity of Mr. Hall’s death on April 17, 2011. However, Fidelity denied the claim for benefits under Mr. Hall’s policy because the policy had lapsed and terminated for nonpayment of premiums prior to Mr. Hall’s death.

Policy Exclusions – Interpretations

April 17, 2014 | Mark S. Humphreys

Arlington insurance lawyers need to be able to know how the courts interpret insurance policy exclusions. A recent finding from a United States Magistrate Judge in the Northern District of Texas is helpful. The style of the case is, The Burlington Insurance Company v. Midlothian Chamber of Commerce, et al.

The Chamber sponsored a bike-a-thon in which John Shumaker participated. Shumaker was seriously injured and later sued the Chamber in Texas district court, claiming that his personal injuries resulted from various acts of negligence at the event. Shumaker alleges that the Chamber “organized and promoted” the bike-a-thon, which was a “scenic ride and tour of historic homes as well as newer neighborhood[s]” and was “not a race.” He asserts claims in the nature of negligence.

TBIC is paying the Chamber’s defense costs in the state case but initiated this declaratory judgment, requesting that the Court find that TBIC has no duty to defend the state suit or to indemnify the Chamber for the claims that Shumaker asserts.