Dallas Fort Worth Insurance Lawyer Blog

Disability Insurance Policies

May 28, 2013 | Mark S. Humphreys

Arlington lawyers need to have understanding of disability insurance policies to properly advise a prospective client.

Regarding the commencement of coverage, disability policies normally require that any claimed disability occur while the policy is in effect or within a specified time after the claimed accident or injury. Here is an example. A policy may provide coverage for an illness or injury that “totally and continuously disables the insured within 30 days of the date of the accident so as to prevent him or her from performing each and every duty pertaining to his or her occupation.”

Most disability insurance policies will distinguish between disabilities caused by illness and those resulting from accidental injury. The Beaumont Court of Appeals issued an opinion in 1978, in the case Lone Star Life Insurance Company v. Griffin, wherein a policy provided that the insurance company would pay the insured $1,000 per month for 60 months for an accidental injury resulting in total disability and that it would pay $1,000 per month for 24 months for total disability resulting from sickness.

Disability Insurance Issues

May 26, 2013 | Mark S. Humphreys

Arlington insurance attorneys need to know the issues presented in policies of disability insurance.

Disability income policies typically specify an amount that will be paid in the event of a disability, as that disability is defined in the policy, and a maximum length of time for which such benefits will be paid. An example would be $1,000 a month for 180 months.

Something to be aware of is that the policy holder does not always have to prove that they actually lost the amount of earnings protected. Most the time, the benefits are payable even if the policy holder is unemployed at the time of the disability.

Test For Disability Coverage

May 25, 2013 | Mark S. Humphreys

Fort Worth insurance attorneys who handle disability insurance claims need to know about this case. It is styled Occidental Life Insurance Co. v. Duncan. The opinion was issued by the San Antonio Court of Appeals in 1966.

Here is some relevant information.

Duncan was engaged in the selling of labels as an independent contractor on a commission basis. The company he represents manufactures labels and Duncan sells them, generally to canners. He has been in the label selling business for some twenty years. He was in an airplane accident on October 25, 1957, and was rather severely injured, Occidental paid him for total disability from the time of his accident until September, 1963, when it stopped payment. This suit by Duncan followed.

Knowledge Of Insurance Misrepresentations

May 23, 2013 | Mark S. Humphreys

Fort Worth Insurance Attorneys need to know an important statute in the Texas Insurance Code.

That statute is Section 705.105.

The 1969, San Antonio Court of Appeals case, Prudential Insurance Company of America v. Torres, does a good job of explaining the statute. Here are some relevant parts of that case:

Life Insurance Lawyer And Incontestability Clause

May 21, 2013 | Mark S. Humphreys

Dallas life insurance attorneys need to know about the incontestability clause in life insurance contracts.

What most people don’t know is that life insurance policies must contain an incontestability clause. This is a paragraph that says the policy will be incontestable after it has been in force during the lifetime of the insured for two years from its date, except for nonpayment of premiums. This is found in a few places in the Texas Insurance Code. Sections 1131.104, and 705.101 through 705.105. The effect of these clauses is to limit the various defenses that insurance companies will write into their policies so that they apply only during the first and second years of the policy. Insurance is a risk and without these laws regulating the policies, the insurance companies would write the policies in such a manner as to take out all the risk for them and leave their customer with only the illusion of insurance coverage.

The purpose of the incontestability clause in protecting the insured is further discussed in the 1972, Texas Supreme Court case, Minnesota Mutual Life Insurance Company v. Morse.

Life Insurance Attorney – Suicide

May 19, 2013 | Mark S. Humphreys

Dallas life insurance attorneys need to read and know this 1986, Amarillo Court of Appeals case. It is styled, Southern Farm Bureau Life Insurance Co v. Dettle. Here is some relevant information:

Southern Farm is appealing from a trial court finding in favor or Dettle. The controversy arose from the Southern Farm’s failure to pay death benefits on a policy insuring the life of Douglas Dee Dettle. The deceased-insured was found dead in his apartment. He died as the result of a single shotgun wound to his lower abdomen and genital area. Southern Farm defended on a suicide exclusion in the policy. In response to special issues, the jury determined that the deceased’s death was not a suicide.

Southern Farm argued “the trial court’s definition of the term ‘suicide’ erroneously included the element of intent, thereby placing upon Southern Farm a greater burden of proof than that required under either its contractual language or Texas law.”

Insurance Law Attorney – Example Of Why To Get One

May 18, 2013 | Mark S. Humphreys

Arlington insurance law attorneys would find this case to be a good case to show clients when trying to explain why the client needs an attorney.

The style of the case is, Amy Warmbrod v. USAA County Mutual Insurance Company. This is an El Paso Court of Appeals opinion issued in April 2012.

Amy Warmbrod filed suit against USAA alleging various causes of action and seeking damages arising out of USAA’s handling of her underinsured motorist (UIM) claim. Warmbrod appeals the summary judgment granted in favor of USAA.

Life Insurance & Separation

May 16, 2013 | Mark S. Humphreys

Dallas life insurance lawyers need to be aware of this 1981, Eastland Court of Appeals case. The style is Pilot Life Insurance Company v. Koch. Here is some of the relevant information:

This is a declaratory judgment case. Pilot Life sought a judgment declaring that it had no duty to pay life insurance proceeds to Lawrence A. Koch because of the death of his wife. Pilot Life had issued a policy of group insurance to Koch’s employer. The policy afforded life insurance coverage for employees and their eligible dependents. Eligible dependents were defined to include “your husband or wife, unless you were legally separated or divorced.” Pilot Life alleged that Mr. and Mrs. Koch were legally separated on the date of her death. A jury found that Mr. and Mrs. Koch were separated at the time of her death. Although that separation was pursuant to a “temporary” court order entered in the pending divorce proceedings between Mr. and Mrs. Koch, the trial court entered judgment for Koch notwithstanding the verdict on the theory that under Texas law there is no status of legal separation of a husband and wife before the marriage is dissolved by a decree of divorce.

On appeal Pilot Life contended that the trial court erred because the evidence established that Mr. and Mrs. Koch were separated pursuant to an order of a district court and thus they were legally separated on the date of Mrs. Koch’s death; and, were, therefore, legally separated within the contemplation of the policy. Pilot Life also urged that the trial court erred in ruling, as a matter of law, that Mr. and Mrs. Koch were not legally separated on the date of Mrs. Koch’s death.

Life Insurance Beneficiary

May 14, 2013 | Mark S. Humphreys

Arlington life insurance attorneys need to have this 1967, Texas Supreme Court case, at hand in case the need for it arises. The style of the case is, McFarland v. Franklin Life Insurance Company. Here is the relevant information.

In 1950, Franklin Life issued a policy of insurance on the life of John V. McFarland, who was about nine years of age at the time. The policy was taken out by his parents, Bernard and Gwendolyn McFarland. Bernard was named in the policy as primary beneficiary, and Gwendolyn was designated as contingent beneficiary. John married in 1962 and died the following year. His father predeceased him; he was survived by his widow and Gwendolyn. McFarland brought this suit against Franklin Life to recover the amount due on the policy plus the statutory penalty and attorney’s fees. Franklin Life interpleaded Mrs. John V. McFarland, admitted liability for the proceeds of the policy, and paid the funds into court. The trial court, sitting without a jury, awarded McFarland the money so deposited but allowed no penalty or attorney’s fee, and the Court of Civil Appeals affirmed. The only question brought forward on appeal was whether McFarland is entitled to recover such penalty, attorney’s fee and court costs.

It is generally held that ‘where the insurer admits liability, but has reasonable grounds for anticipating rival claims, and in good faith declines to pay the named beneficiary, and deposits the money in court to be paid to the rightful person as determined by the court, it is not liable for more than the face amount of the policy.’

Life Insurance And Good Health Provision

May 12, 2013 | Mark S. Humphreys

Grand Prairie life insurance attorneys need to know about this 1979, Texas Supreme Court case. It is styled, A. W. Washington v. The Reliable Life Insurance Company. Here is the relevant information.

In October 1974 Reliable issued three life insurance policies pursuant to separate applications made by the insured, Ozell Washington, who named her son, A. W. Washington, as beneficiary.

The facts and circumstances surrounding the issuance of these policies are as follows.