Dallas Fort Worth Insurance Lawyer Blog

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.

Federal Court And Insurance Lawsuits

December 3, 2013 | Mark S. Humphreys

Grand Prairie insurance attorneys usually want to stay out of Federal Court because it is usually better for their clients to remain in State Court. The United States District Court, Dallas Division issued an opinion in September 2013, that is worth reading. The style of the case is Ridgeview Presbyterian Church v. Philadelphia Indemnity Insurance Company. Here is some of the relevant information.

This concerns a Motion To Remand.

This case involves an insurance claim filed after a storm damaged Ridgeview’s building. Ridgeview alleges that its insurance carrier, Philadelphia Indemnity acted in concert with an independent adjusting company, Crawford and a licensed adjuster, Lumpkin, to breach the insurance agreement and commit bad faith.

Providing Notice Of Claim To Insurance Company

December 1, 2013 | Mark S. Humphreys

Fort Worth insurance lawyers need to tell their clients to immediately report it to their insurance company when they are served with lawsuit papers. A 1995, Texas Supreme Court case styled, Harwell v. State Farm illustrates why.

Here is some of the relevant information from the Harwell opinion.

On December 5, 1986, Tammy D. Hubbard and Eric Christopher Leatherman were in an automobile accident. The collision killed Hubbard and seriously injured Leatherman. Hubbard was insured by State Farm under her mother’s policy.

Modifications To Insurance Policy

November 30, 2013 | Mark S. Humphreys

Dallas insurance attorneys understand that the way an insurance policy is interpreted is key to whether there is coverage and the extent of that coverage.

The Houston Court of Appeals [14th Dist.] issued an opinion last month that dealt with policy interpretation. The style of the case is, Shafaii Children’s Trust and Party and Reception Center, Inc. v. West American Insurance Company, Liberty Mutual Insurance Company, Ohio Casualty Insurance Company, and America First Insurance Company. Here is some of the relevant information.

This is a summary judgment case that was in favor of the insurance companies and Shafaii appealed.

Life insurance Reinstatement

November 28, 2013 | Mark S. Humphreys

Dallas life insurance attorneys need to read this opinion just issued from the Fifth Circuit Court of Appeals. The style of the case is, Cardenas v. United of Omaha Life Insurance Company.

This case arises from United of Omaha Life Insurance Company’s denial of Cardenas’s claim for benefits from a life insurance policy taken out by Cardenas’s daughter, Elvia Sierra. The policy lapsed and was subsequently reinstated; Sierra died thirteen months after the reinstatement. As required by the Texas Insurance Code, the policy contained a provision that it would become incontestable if it remained in force “for two years from its date of issue during the lifetime of the insured.” Although the policy does not have a provision dealing with contestability following reinstatement, the parties agree there is such a period. They differ over how the death of the insured during the contestability period will affect the reinstatement. The district court found that the reinstated policy never became incontestable because Sierra died before the two-year period ran. Cardenas argues that a section of the Texas Administrative Code controls and requires finding that the reinstated policy became incontestable.

United of Omaha Life issued a life insurance policy to Cardenas’s daughter, Elvia Sierra, on March 26, 2001. The policy lapsed for nonpayment of premiums in June 2005.

Uninsured Motorist Claim And Prompt Payment

November 26, 2013 | Mark S. Humphreys

Arlington attorneys who handle uninsured and underinsured cases need to be aware of this decision issued by the United States District Court, Houston Division. The decision was issued in September 2013, and is styled, Terry v. Safeco Insurance Company of America. Here is some of the relevant information.

The Terrys were involved in a car accident with an uninsured driver. In a letter from counsel dated November 20, 2009, the Terrys demanded benefits under their UM coverage. This letter stated that “Mr. Terry was willing to settle his claim for $20,000.00 and Ms. Terry was willing to settle her claim for $35,000.00.” The letter stated that the demands were “for an unconditional release of any further liability related to the incident made the basis of this potential lawsuit” and cautioned that the “offer would remain open for a period of ten days from” receipt. The letter also stated that “all written offers would be reviewed” with the Terrys but warned that “any written offer which is less than the latest written demand should be considered rejected in advance for the purposes of calculating prejudgment interest.”

In a letter dated December 4, 2009, Safeco acknowledged receipt and stated that the “demand to settle Jack Terry’s Uninsured Motorist Bodily Injury (UMBI) claim for $20,000 … must be declined and the demand to settle Mary Eden Terry’s UMBI claim for $35,000 must be declined.” After asserting that Jack Terry was 15% at fault for the accident and summarizing the Terrys’ medical bills, Safeco’s letter stated: Considering the negligence on Mr.Terry’s part and the PIP offset of $2,500 (previously paid) and the reasonable net medical bills of $5,408.92, my offer to settle Mr. Terry’s UMBI claim is $6,300.