Dallas Fort Worth Insurance Lawyer Blog

Making A Claim

August 11, 2013 | Mark S. Humphreys

Parker County attorneys who deal with insurance companies need to understand the obligations of insureds making a claim.

Though an insured may end up doing many things, the actions are boiled down to two basic duties:

1) to give the insurance company notice of the claim; and 2) to give the insurance company all items they reasonably need to secure proof of loss. Texas Insurance Code, Section 542.055(a) starts the deadline for the insurance company to act, once they receive notice of the claim. Section 542.056(a) imposes other deadlines once they receive all information required to secure final proof of loss.

Moving Insurance Claims

August 10, 2013 | Mark S. Humphreys

A Fort Worth insurance attorney will want to know about specific cases and the way the courts handled the cases. Here is an example of a case that is not seen very often.

The style of the case is, Bekins Moving & Storage Co. v. Williams. This is a Texarkana Court of Appeals case. The opinion was issued in 1997.

Here is some of the relevant information:

What Kinds Of Companies Are Under The Prompt Pay Statute

August 8, 2013 | Mark S. Humphreys

Fort Worth insurance law attorneys need to know what insurance companies fall under the Prompt Pay statutes of the Texas Insurance Code.

The Prompt Payment of Claims Act applies to all insurance companies, except those specifically exempted. The statute provides the following exemptions:

1) a stock life, health, or accident insurance company;

Who Can Make A Claim For An Insurance Company Not Paying On Time?

August 6, 2013 | Mark S. Humphreys

Fort Worth insurance lawyers should be able to discuss with their clients when a claim is not being paid timely and who can hold the insurance company for failing to pay the claim in a timely manner.

Under the Prompt Payment of Claims statutes, Section 542.051 tells us a “claimant” is the person “making a claim.”

A claim is a first party claim that is made by an insured or a policyholder under an insurance policy or contract or by a beneficiary named in the policy contract, and that must be paid by the insurance company directly to the insured or beneficiary.

Dallas insurance attorneys should know about the Prompt Payment of Claims Act

August 4, 2013 | Mark S. Humphreys

Dallas insurance attorneys should know about the Prompt Payment of Claims Act. It is found in Chapter 542 of the Texas Insurance Code.

This statute imposes deadlines for an insurance company to acknowledge, investigate, and accept or reject a claim. An insurance company that violates the statute is liable for attorney fees and an additional 18% per annum in addition to the amount of the claim. The time periods stated in the statute are subject to being very short or very long in the context of how long it actually is takes for an insurance company to pay a claim before having penalties imposed.

Keep in mind that the time limits apply only to first party claims – not third party claims.

What To Do Before Suing On An Insurance Claim

August 3, 2013 | Mark S. Humphreys

Dallas insurance lawyers know the pre-suit requirements of filing a lawsuit against an insurance company.

This essentially means giving the insurance company or agent, at least a sixty day written notice detailing what the complaint is and what you expect them to do about it. This notice must tell the person the specific complaint, the amount of the actual damages and expenses, including attorney fees, incurred in asserting the claim. This is codified in the Texas Insurance Code, Section 541.154(a) and (b).

An exception to the notice requirement would be (1) waiting the 60 days would allow the limitations period to expire, and (2) when the claim is asserted as a counterclaim. This is codified in Section 541.154(c).

Potential Claim Recovery

August 1, 2013 | Mark S. Humphreys

Weatherford Texas insurance lawyers need to be able to discuss with clients the value associated with their claim.

The Texas Insurance Code, Section 541.152, tells us that a winning claimant is entitled to:

1) actual damages 2) additional damages if the insurance company or it’s agent acted knowingly 3) court costs 4) attorney’s fees The most common actual damages are the policy benefits themselves. There can be actual damages beyond the policy benefits and depending on the circumstances, this can take many forms. One example would be in a “credit disability” policy. This would be where a person has credit disability insurance – the insurance company denies the claim – and as a result the insured misses payments and has their credit damaged. In this scenario the insured would have a claim for the damages resulting from damaged credit.

Potential Recovery In Insurance Cases

July 30, 2013 | Mark S. Humphreys

Weatherford insurance attorneys need to be able to discuss with clients what the value of their claim might be. Here is some food for consideration.

Texas Insurance Code, Section 541.152 tells us a person who prevails in a lawsuit may obtain the following:

– the damages actually suffered;

Uninsured Motorist Protection – When Does It Apply?

July 28, 2013 | Mark S. Humphreys

Weatherford insurance lawyers need to be able answer the above question. The problem with an answer is that, depending on the situation it is difficult to know when coverage will apply to a request for coverage for uninsured motorist protection.

In 2008, the Texas Supreme Court issued an opinion in the case styled, “Nationwide Insurance Company v. Elchehimi.” This case is not particularly good news for applicants but is important for an Insurance Law Attorney to know, so as to be able to properly advise clients. This is a summary judgment case in favor of Nationwide. Here is some of the relevant information about the case.

Mohamad Elchehimi’s station wagon collided with a drive axle and attached tandem wheels that had separated from an eighteen-wheel semi-trailer truck. The unidentified truck, which was being driven in the opposite direction on a divided highway, did not stop. Momentum carried the axle-wheel assembly across the dividing median where it struck Elchehimi’s vehicle, injuring the occupants and damaging the car. Elchehimi had purchased from Nationwide a standard Texas personal automobile insurance policy, including the optional statutorily defined unidentified motorist coverage. Nationwide denied Elchehimi’s claim for uninsured motorist benefits because the impact between Elchehimi’s vehicle and the axle-wheel assembly was not “actual physical contact” with an unknown “motor vehicle” as required by the terms of the policy and the Texas Insurance Code.

The Contact Rule For Uninsured Motorist Coverage

July 27, 2013 | Mark S. Humphreys

Dallas insurance lawyers should be aware of the “contact rule” as it relates to uninsured motorist coverage on an automobile. A 1972 case styled, Latham v. Mountain States Mutual Fire Insurance Co is a good example of how the “contact rule” works. This case comes from the Houston Court of Appeals [1st Dist].

As a premise for the case, it is important to start with the statute governing this rule. The statute is found in the Texas Insurance Code, Section 1952.104. It says that for there to be coverage under the uninsured motorist portion of a policy that “…, actual physical contact must have occurred between the motor vehicle owned or operated by the unknown person and the person or property of the insured.”

Here is some of the relevant information in Latham: