Dallas Fort Worth Insurance Lawyer Blog

Is It Really Insurance – Insurance Denial Attorneys

October 15, 2022 | Mark S. Humphreys

Insurance Lawyers, here’s one you probably never heard about. This is a 2022,case from the Northern District of Texas, Dallas Division. The opinion is styled, Emmy Von Der Ahe and Thomas Von Der Ahe v. 1-880-Pack-Rat, LLC and Zippy Shell Inc. This case involves allegations that the moving company damaged goods.

While many people will think this is about insurance, it is not, but it’s importance is realizing that it is not or the lawyer can end up making a big mistake. Here, the Ahes had purchased a “contents-protection policy insurance contract” at the time of the move.

The Ahes sued the Defendants in an amended complaint asserting a claim under the Carmack Amendment and violations of the DTPA, violations of the Texas Insurance Code, and breach of the duty of good faith and fair dealing. The Ahes assert the claim is in two phases, 10 the storage phase of the relationship, and 2) under the “contents-protection policy insurance contract.”

Delay In Paying Insurance Claim – What The Lawyer Should Know

October 10, 2022 | Mark S. Humphreys

Bad Faith Insurance Attorneys need to read this 2022, opinion from the 14th Court of Appeals. The case is styled, Texas Fair Plan Association v. Adil Ahmed.

The Blog from October 8, 2022, sets forth the law related to this Texas Prompt Payment of Claims fight. The facts and procedural history of the case can be obtained from the opinion.

This is an appeal from summary judgment.

Delay In Paying Claims – Insurance Denial Lawyers

October 8, 2022 | Mark S. Humphreys

The Texas Prompt Payment of Claims Act is at issue in this 2022, opinion from the 14th Court of Appeals. The opinion is styled, Texas Fair Plan Association v. Adil Ahmed.

The facts and history of the case can be gleamed from reading the opinion.

This Courts’ stating of the law regarding the Texas Prompt Pay statute is what is relevant to this posting.

Life Insurance Claim Attorney – Divorce

October 3, 2022 | Mark S. Humphreys

Here’s is another situation that a Life Insurance Claim Attorney will learn quickly. It deals with life insurance beneficiaries and divorces.

This is a 1987 opinion from the 14th Court of Appeals. It is styled, Novotny v. Wittner. It stands for the proposition that a pre-divorce designation of a former spouse is invalidated upon divorce unless the spouse is re-designated after the divorce. This opinion is now codified in Texas Family Code, Section 9.301.

This is an appeal from the award of insurance proceeds to the successor guardian of the decedent’s children. The dispute over the ownership of the proceeds of the life insurance policy is between the decedent’s former wife, who was the named beneficiary on the policy, the administrator of the decedent’s estate, and the successor guardian of the decedent’s two children. The decedent and Appellant were divorced twenty-one days before the decedent’s death. Although the divorce decree awarded all insurance on decedent’s life to him as his sole and separate property, and divested Appellant of all interest in the policies, he had not yet changed the beneficiary designation on one policy. The trial court found that the divorce decree terminated Appellant’s beneficial interest in the policy and awarded the proceeds to the decedent’s children. The Court agreed.

Life Insurance Claim Lawyer – Ex Spouses

October 1, 2022 | Mark S. Humphreys

Life Insurance Attorney will quickly learn about Texas Family Code, Section 9.301. This sections says that a spouse named as a beneficiary in a life insurance policy is automatically excluded upon divorce.

One of the first cases that discusses this issue is a 1981, Eastland Court of Appeals opinion. It is styled, Pilot Life Ins. Co. v. Koch. The opinion focuses on wording of the policy. Be aware of exceptions to the general rule.

This is a declaratory judgment case. Pilot Life Insurance Company 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.

Appraisal – Timely Invocation Or Waiver

September 26, 2022 | Mark S. Humphreys

How long does someone have to invoke the appraisal process in an insurance contract? This was addressed in a 2012, opinion from the Beaumont Court of Appeals. The opinion is styled, In Re: Cypress Texas Lloyds.

Cypress Texas Lloyds seeks mandamus relief from an order that denies a motion to compel appraisal. The insureds sued Cypress. Their homeowner’s insurance policy issued by Cypress includes an appraisal clause. Cypress pleaded the failure to submit to the appraisal process and requested abatement in its original answer and in a series of amended answers. Cypress subsequently moved to compel appraisal.

To establish waiver of appraisal, a party must show that the failure to invoke the policy’s appraisal provision within a reasonable time after an impasse was reached caused prejudice. Cypress argues that its first notice of impasse occurred when the Newmans filed suit, and that Cypress invoked the appraisal provision in its pleadings by specifically pleading the failure to submit to the appraisal process by requesting an abatement until that condition was satisfied. Notwithstanding the notice provided by Cypress’s pleadings, the Newmans proceeded with discovery without seeking appraisal under the policy. Cypress argues it did not unreasonably delay before invoking appraisal and any harm suffered by the Newmans stems from their failure to comply with the policy and undergo appraisal before filing suit.

Texas Prompt Payment Of Claims Act

September 24, 2022 | Mark S. Humphreys

Insurance Claims, when not timely paid are subject to the Texas Prompt Payment of Claims Act. So the question becomes when is a claim not timely paid?

A 2022, opinion from the Western District of Texas, San Antonio Division, is worth reading. The opinion is styled, John H. Winston III v. State Farm Lloyds.

This case arises from a dispute between Dr. Winston and his homeowner’s insurance carrier, State Farm. In April 2019, Dr. Winston filed a claim with State Farm for hailstorm damage to his home. State Farm paid Dr. Winston based on its inspector’s assessment of the damage. Dr. Winston was dissatisfied with the payment because the parties disagree about the extent of the damage—specifically, Dr. Winston contends that his roof needs to be replaced, while State Farm believes it could be repaired. When the parties reached an impasse, Dr. Winston invoked an appraisal clause in the parties’ contract to determine the actual amount of loss. The appraisal was conducted in October 2019, finding that $91,138.71 was necessary to replace the roof. State Farm continued to maintain that the roof did not need to be replaced. As such, State Farm reduced the appraisal award by $91,138.71 and paid Dr. Winston the amount it estimated was necessary to repair the roof, plus some additional funds for other damages to the home. All told, State Farm paid Dr. Winston $28,193.74 for hail damage. At issue in the case was whether State Farm breached the parties’ contract by refusing to pay $91,138.71 to replace Dr. Winston’s roof. The case went to trial and a jury found that State Farm had breached the contract.

Bad Faith Life Insurance Lawyer – Is This Bad Faith

September 19, 2022 | Mark S. Humphreys

Here is a 1980, Texas Supreme Court opinion wherein the Court found no bad faith and in fact found in favor of the insurance company. The opinion is styled, Life Ins. Co. of the Southwest v. Overstreet.

This was an unusual case in that the dispute was over whether or not a premium had been timely paid.

Maxie Overstreet, the insured, died on April 24, 1974, at which time he had not paid the 1974 annual premium on the policy. Life Insurance Company (LIC) says that by the date of death, the policy had lapsed because the premium had fallen due on March 15, 1974, the thirty-one-day grace period had expired on April 15, and the insured’s death on April 24 had occurred nine days after the grace period’s termination. Jacquei Overstreet says that the premium payment date was April 18 rather than March 15, that non-payment of the annual premium on April 18 did not end the policy until thirty-one more days, and that Overstreet’s death on April 24 was well within the grace period.

Life Insurance Claim Lawyer – Which Law Applies?

September 17, 2022 | Mark S. Humphreys

Life insurance lawyers need to read this 2022, opinion from the Fort Worth Court of Appeals. The opinion is styled, Government Personnel Mutual Life Insurance Company v. Lincoln Factoring.

Many times where a person buys an insurance policy, where they die, where a beneficiary resides, or what the contract says may play a part in determining under which State law applies to disputes over the life insurance policy.

In this case, the question dealt with whether Texas law applied to the case or whether Louisiana law applied to the case. The facts of the case can be gleamed from reading the opinion. Here is a brief way the Court looked at the case and what life insurance lawyers need to know about when filing a lawsuit.

Insurance Policies And The Statute Of Limitations

September 12, 2022 | Mark S. Humphreys

What insurance attorney hasn’t had someone call after the statute of limitations has already run on the case?

The Dallas Court of Appeals issued an opinion in July 2022, that deals with statute of limitations issues. The opinion is styled, Knox Mediterranean Foods, Inc., v. Amtrust Financial Services.

Knox has incurred a burglary loss on June 16, 2016, and submitted a loss claim to its insurance company, Amtrust. Amtrust paid part of the claim March 15, 2017, along with a letter requesting further information. On June 13, 2017, Amtrust sent a follow up letter that stated in relevant part that due to the requested information not being provided that Amtrust was closing the file. The current lawsuit was filed on May 20, 2020. This summary judgment motion was filed by Amtrust asserting the statute of limitations defense. The judgment was granted.