Dallas Fort Worth Insurance Lawyer Blog

Geographic Limitation In Insurance Policy

December 21, 2013 | Mark S. Humphreys

Aledo insurance lawyers will not often run across what happened in this case, but it something to know about. The case is styled, McCallas v. State Farm Mutual. The opinion was issued by the Houston Court of Appeals [14th Dist.] in 1986.

The issue presented is whether the trial court was correct in holding that Personal Injury Protection (PIP) benefits can be denied on a geographic basis. This appeals court agreed with the decision of the trial court.

On March 3, 1984, McCalla was involved in an automobile accident on the island of Jamaica. He was hospitalized and treated. He has incurred expenses in excess of $2,500. Before the accident, McCalla was issued an insurance policy which was in effect at the time of the accident. This policy contained PIP coverage which was mandated by the Legislature. State Farm denied benefits because the policy applied only to accidents and losses which occurred in the United States and its territories or possessions, Puerto Rico or Canada. Thus, State Farm argued, the policy was not in effect when McCalla was driving in Jamaica.

Claim Denial Of Auto Policy Due To Cancellation

December 19, 2013 | Mark S. Humphreys

Fort Worth insurance attorneys will see situations where claims are denied due to policy cancellation. Here is a case that dealt with that situation. It is a Corpus Christi Court of Appeals opinion issued in 2001. The style of the case is, Jones v. Ray Insurance Agency. Here is some of the relevant information.

Jones purchased a new 1998 Pontiac automobile and purchased a State & County Mutual Fire Insurance Company (insurer) insurance policy from Ray and Harbor Insurance covering the automobile. Jones discussed with Ray that her sister lived with her, and was advised by him that would not be a problem, and as long as she paid the premiums on time she would have insurance. The policy excludes coverage for anyone residing with Ray age fourteen or over unless listed. Ray paid the November and December premium payments. The policy was effective from November 7, 1997 through May 7, 1998.

On December 28, 1977, Jone’s automobile was severely damaged when hit by another automobile driven by an uninsured drunk driver. Her vehicle was towed to Collision Clinic, Inc. The day after the accident, Jones was told by the insurer that she was in the computer and was fully covered by the insurance policy. Less than thirty minutes after she was told she was covered, Jones received a call from the insurer and was told she no longer was covered by the policy. At first appellant was told the policy was cancelled because she had not excluded her sister as a driver. Later she was told that the cancellation was because she had not provided a copy of her driver’s license. Ray alleged the notice of cancellation was sent by letter on November 25, 1997, to Jones at 9109 Fondren # 605, Houston, Texas 77074, but Jones denies receiving the letter and notice of cancellation. The letter allegedly advised Jones that her insurance policy would be cancelled on December 4, 1997. Ray has not returned Jones’s December 1997 premium payment or any part thereof.

When Is Property A Total Loss?

December 17, 2013 | Mark S. Humphreys

Dallas insurance lawyers will get a lot of calls wherein someone is asking the above question. This most often arises in the context of a motor vehicle accident. The Tyler Court of Appeals addressed this issue in a 2007 opinion styled, Canal Insurance v. Hopkins Towing. Here is some of the relevant information.

Henry Sweeney was operating a tractor-trailer rig hauling a load of peas when he lost control of the rig, which traveled off the road and into a deep ditch. The tractor-trailer struck several small trees and, eventually, rolled over onto its left side. Sweeney was the lessee and operator of the tractor, which was owned by Mullinax. Mullinax also owned the trailer. Both the tractor and trailer were insured against physical damage under an insurance policy issued by Canal. Mullinax was the named insured.

Trooper Faulkner ordered that a wrecker service be called in to tow the tractor and trailer. After two other wrecker services had refused the job because they “didn’t have the capabilities to do it,” Hopkins was called in to do the job. Because of the layout of the wreck site and the position of the tractor and trailer, Hopkins determined that they would have to use special air bags to return the trailer to an upright position. Hopkins recruited a subcontractor out of Tyler, Texas to supply the necessary air bags and operating personnel. In addition, Hopkins supplied three of his tow trucks and seven or eight employees who worked through the night, and in the rain, in order to remove the tractor and trailer from the ditch.

Insurance Company Attempts At Deceit

December 15, 2013 | Mark S. Humphreys

Dallas insurance lawyers who go to trial very often will have run across the situation presented in this 2006, Corpus Christi Court of Appeals opinion. The style of the case is, Perez v. Kleinert. In this case State Farm was sued for uninsured / underinsured motorist (UIM) benefits. The attorney for State Farm attempted to mislead the jury by stating he represented the supposedly at fault driver rather than State Farm. Here is some of the relevant information.

At the time of the accident giving rise to this lawsuit, Perez was a passenger in Garza’s automobile. The automobile was a rental car that had been lent to Garza by either Brian or Jeanne Spacek. Before lending the automobile to Garza, the Spaceks had purchased an insurance policy from State Farm. After the accident, Perez made a claim against State Farm for benefits under the Spacek policy. After State Farm allegedly refused to pay benefits, Perez named State Farm as a defendant in the lawsuit, asserting claims against State Farm for “underinsured or uninsured motorist benefits” under the Spacek policy and for violations of the Texas Insurance Code.

State Farm initially took the position that Garza was an insured person under the Spacek policy. Pursuant to that policy, State Farm provided Garza with legal representation by retaining on her behalf the services of Troy Gilreath. Attorney Gilreath appeared before the trial court as Garza’s attorney of record and filed Garza’s answer to the lawsuit. Garza denied liability and asserted a crossclaim against Kleinert. Notably, Garza also alleged, among other things, that Perez, her passenger, was negligent and that his negligence was the sole proximate cause of the accident.

Policy Coverage In Mexico

December 14, 2013 | Mark S. Humphreys

Irving insurance attorneys will have many clients who travel to Mexico. The question then concerns auto coverage when traveling in Mexico. The first thing to do is to get with their agent and to read the policy. In order to understand how courts look at this issue, reading a 1999, El Paso Court of Appeals case may be helpful. The case is styled, Ruiz v. Geico. Here is some of the relevant information.

This is a summary judgement case wherein judgement was granted in favor of Geico.

Hermilinda Quesada de Ruiz was driving her 1996 Nissan Maxima in Ciudad Juarez, Chihuahua, Mexico, when she was involved in an automobile accident. The accident occurred within ten miles of the United States/Mexico border. As a result of the accident, Mrs. Ruiz incurred medical expenses arising from her injuries. The Ruizes contacted GEICO to advise of the accident and inquire as to coverage. GEICO responded that in accordance with the Ruizes’ policy, there was no coverage for the accident because it occurred in Mexico. The Ruizes received a letter from GEICO denying any and all liability. The Ruizes filed suit claiming that GEICO committed fraud because it negligently failed to disclose any limits of their coverage as it pertained to location. GEICO filed its motion for summary judgment which was granted by the trial court.

Coverage Outside The United States

December 12, 2013 | Mark S. Humphreys

Arlington insurance law lawyers will have clients who travel to foreign countries and as a result will get asked questions about coverage outside the United States. The simple answer to this question would be to read the policy. The Houston Court of Appeals [14th Dist.] issued an opinion in 1986 that partially addressed this issue. The style of the case is McGalla v. State Farm.

Here is some relevant information from that case.

On March 3, 1984, McCalla was involved in an automobile accident on the island of Jamaica. He was hospitalized and treated. He has incurred expenses in excess of $2,500. Before the accident, McGallas was issued an insurance policy which was in effect at the time of the accident. This policy contained PIP coverage which was mandated by the Legislature in the Texas Insurance Code. State Farm denied benefits because the policy applied only to accidents and losses which occurred in the United States and its territories or possessions, Puerto Rico or Canada. Thus, State Farm argues, the policy was not in effect when McCalla was driving in Jamaica.

Texas High-Risk Pool Ending

December 10, 2013 | Mark S. Humphreys

Aledo insurance attorneys need to know what is happening in the world of insurance news and events. The Texas Tribune published an article October 17, 2013, that would be of interest to at least 23,000 people in Texas. The article is titled, “Texas Prepares to Shutter High-Risk Insurance Pool.” It is written by David Maly.

Here is what the article tells us:

At year’s end, Texas will shut down its high-risk insurance pool for some of the state’s sickest residents, pushing participants to find private coverage in the federal health insurance marketplace created under the federal Affordable Care Act. And patient advocates say those participants should focus on making the transition sooner rather than later to ensure that they don’t experience a lapse in coverage or lose access to current health care providers and services.

Lower Homeowner Insurance Costs?

December 8, 2013 | Mark S. Humphreys

Mineral Wells attorneys who handle insurance related cases would like to think they keep up with the law in insurance and part of that involves keeping up with news in the insurance industry. A good source of insurance related news for both the law and general news is the Insurance Journal. Reporter, Stephanie Jones, wrote an article that published on October 18, 2013, that should be interesting to those who follow insurance issues. The title of the article is, “Texas Senator: How Can We Lower Homeowner Insurance Costs?” Here is what the article tells us:

Senator John Carona, a Texas lawmaker, has asked the state insurance department to come up with suggestions for ways to lower homeowners insurance rates in the state.

Texas has consistently been ranked, along with Florida and Louisiana, one of the top three states with the highest homeowners insurance rates in the country. That means there are forty-seven states with lower rates.

Med-Pay And Subrogation

December 7, 2013 | Mark S. Humphreys

Fort Worth lawyers who handle car wreck cases need to be aware of the subrogation rights an insurance company has when a Med-Pay claim is made. The Dallas Court of Appeals dealt with this issue in 1970, in the case styled, Foundation Reserve Insurance Company v. Cody. Here is what happened.

Cody brought this action against Foundation seeking to recover the sum of $500, together with interest, penalty and attorney’s fees, alleged to be due him pursuant to the terms of ‘Medical Pay’ coverage of a family automobile policy issued to John D. McKee.

The facts were stipulated. On January 21, 1969 William Don Cody was riding in an automobile driven by John D. McKee in Dallas County, Texas when the car was involved in an accidental collision with another vehicle resulting in bodily injury to Cody. As a result of the accident Cody incurred reasonable medical expenses in excess of $500 within one year following the date of the accident. In due time Cody furnished proof of loss to Foundation in which he made demand for payment of the sum of $500, being the maximum amount of recovery provided for medical payments in the family automobile policy issued to McKee. In the meantime Cody made a claim against a third party for bodily injury and medical expenses arising from the collision and has heretofore settled his claim with such third party for a sum in excess of $500 by giving a general release to such third party. Foundation is a foreign insurance company and not qualified to write insurance in the State of Texas, such policy having been issued within the State of New Mexico to McKee who was then a resident of the State of New Mexico. The policy afforded various coverages including public liability, physical damage, uninsured motorist coverage, and expenses for medical services.

Named Driver Exclusion

December 5, 2013 | Mark S. Humphreys

Fort Worth insurance attorneys will have run across the type of situation that is presented in this 1996, opinion. This is a Corpus Christi Court of Appeals case styled, Zamora v. Dairyland County Mutual Insurance Company. Here is the relevant information.

Gracie Vela (wife of Jesus Toc) was operating Jesus Toc’s automobile when she was involved in an accident with Pete and Janie Zamora. At the time of the accident, Gracie Vela was named as an excluded driver in Mr. Toc’s automobile insurance policy with Dairyland. The Zamoras filed suit based on negligence, gross negligence, and negligent entrustment. Dairyland denied coverage on the basis of the named driver exclusion in the policy.

Thereafter, the Zamoras entered into an agreed judgment against Jesus Toc and Gracie Vela, and both parties filed suit against Dairyland on the basis that Dairyland wrongfully failed to provide coverage. Dairyland filed motion for a summary judgment asserting it had no duty to provide coverage because Gracie Vela was an excluded driver. The trial court granted the summary judgment in favor of Dairyland and this appeal ensued.