Dallas Fort Worth Insurance Lawyer Blog

Denial Of Claim Based On Misrepresentation

April 12, 2012 | Mark S. Humphreys

Someone in Grand Prairie, Fort Worth, Arlington, Irving, Dallas, Mansfield, or anywhere else in Texas may find themselves in a situation where an insurance company is denying a claim based on the insured making a misrepresentation in an application for insurance coverage. Does that mean the insurance company wins? Here is a case that might help with the answer.

The case is styled Union Bankers Insurance Company v. Thomas D. Shelton and Ann Shelton. It is a Texas Supreme Court case decided in 1994.

The Sheltons sued Union Bankers and its agent Donny Stone after Union Banker cancelled Mr. Shelton’s health insurance policy on the basis of an alleged misrepresentation in his application. The Sheltons alleged Union Banker breached the contract and the duty of good faith and fair dealing dealing with improperly canceling the policy.

Denial Due To Misrepresentation

April 10, 2012 | Mark S. Humphreys

People in Weatherford, Mineral Wells, Aledo, Azle, Springtown, Peaster, Cool, Millsap, Brock, Willow Park, Hudson Oaks, and other places in Parker County will make mistakes in insurance applications. It just happens. So what if you have a claim denied due to the mistake? Let’s see.

The Houston Court of Appeals, 14th District, issued an opinion in 1991, that is still good law and cited by today’s courts. The style of the case is, Betty Flowers v. United Insurance Company of America.

The basic facts of the case are not in dispute. In November 1987, Betty and her husband, Edward, applied for and were issued a joint life insurance policy with United. In the application for the policy Mr. Flowers was asked a series of questions regarding his health history. In pertinent part, the question asked:

Insureds Under A Policy

April 8, 2012 | Mark S. Humphreys

People in Weatherford, Mineral Wells, Aledo, Azle, Springtown, Millsap, Brock, Willow Park, Hudson Oaks, and other places in Parker County and Texas need to have an understanding of who is covered in their insurance policies.

The Houston Court of Appeals, 1st District, issued an opinion in 1998, dealing with this issue. The style of the case is, Sears, Roebuck and Company v. Commercial Union Insurance Corporation. Here are some of the facts of the case.

Sears and Weingarten Realty, Inc. entered into a lease agreement whereby Sears leased space in a shopping center owned by Weingarten. Under the terms of the lease, Weingarten was required to maintain comprehensive public liability insurance protecting Sears against liability for injury to persons or property occurring in common areas of the shopping center. Weingarten purchased a commercial general liability policy from Commercial Union Insurance Corporation. The first page of the policy listed the “Named Insured” as Weingarten Realty Investors, et al. An endorsement on the second page included Weingarten Realty Investors, Weingarten Properties, Inc., WRI Holdings, Inc. and “all subsidiary, affiliated, associated, or allied companies, corporations, firms, organizations, including partnership and joint ventures as are now or hereafter are constituted for which the Named Insured has the responsibility of placing insurance and for which the other insurance is not otherwise more specifically provided.”

Bad Faith Attorney Helps Homeowner

April 7, 2012 | Mark S. Humphreys

Homeowners in Grand Prairie, Fort Worth, Arlington, Hurst, Euless, Bedford, and other places in Tarrant County and Texas should find the following article interesting.

This is an article from the L A Times that ran on March 18, 2012. The title of the article is “Insurance Company Ordered To Pay Homeowner $8 Million.”

The article tells us that an elderly Hollywood Hills resident whose home was nearly destroyed when a dump truck crashed into it, rupturing a gas line and causing an explosion, was awarded more than $8 million after jurors found that his insurance company of more than 50 years failed to honor its contract.

Notice To Insurance Company

April 5, 2012 | Mark S. Humphreys

People in Grand Prairie, Fort Worth, Mansfield, Crowley, Burleson, Benbrook, Joshua, and other places in Tarrant and Johnson County need to understand the importance of notifying the company quickly when a potential claim arises.

The Fort Worth Court of Appeals issued an opinion in 2007 dealing with “notice” to an insurance company about a claim. This one is a little unusual but still illustrates the importance of notifying the insurance company about potential claims as soon as possible. The style of the case is, Allstate Insurance Company and Allstate Texas Lloyd’s v. John Hunter and Wife, Carmen Hunter. Here are some facts.

In the summer of 2002, the Hunters noticed a strange smell in their home. The Hunter’s HO-B homeowner’s policy with the Allstate companies expired in October 2002, and the Hunters replace it with an HO-A homeowner’s policy. The strange smell persisted, and in December 2002, the Hunters hired a company to conduct air sampling testing in their home. The results revealed no elevated mold content in the air and offered no explanation for the smell. In February 2003, a general contractor inspected the Hunter’s home. When the contractor entered the crawlspace under the home, he saw water damage and mold. The Hunters testified that this was the first time they knew of the mold damage or that the source of the odor that they had been smelling was mold. They made a claim with Allstate two days later.

Insurance Attorney Helping To Recover Benefits

April 3, 2012 | Mark S. Humphreys

Residents of Grand Prairie, Fort Worth, Saginaw, Newark, Boyd, Haslet, Rhome, Roanoke, and other places across Texas who make an insurance claim will sometimes have to get the help of an experienced Insurance Law Attorney at some point. Here is a case that serves as an example of why.

The case is a 2007, opinion issued by the San Antonio Court of Appeals. It is styled, In re Terri Ann Garcia. Here are some relevant facts which get kinda legal in nature but are relevant.

Terri Ann Garcia, the plaintiff in the underlying breach of contract suit seeking underinsured (UM) motorist benefits. She sought a writ of mandamus to vacate the trial court’s order quashing the deposition of a State Farm representative. Her attorney argued that by preventing the deposition of a representative of State Farm, the trial court abused its discretion.

Flood Damage Claim

April 1, 2012 | Mark S. Humphreys

People in Weatherford, Aledo, Azle, Springtown, Hudson Oaks, Willow Park, Millsap, Brock, Mineral Wells, and other places in Parker County prone to flooding losses should be interested in a recent opinion issued by the United States Fifth Circuit Court of Appeals.

The opinion was issued on March 6, 2012, and the style of the case is, Tom Worthen v. Fidelity National Property and Casualty Insurance Company. The case is an appeal by Fidelity National regarding a summary judgment in favor of their insured, Worthen. This appeals court reversed and rendered in favor of Fidelity National.

Here is some background information.

Life Insurance Proceeds – Who Gets Them?

March 31, 2012 | Mark S. Humphreys

Policy holders in Grand Prairie, Arlington, Fort Worth, Dallas, and other places in the Dallas – Fort Worth metroplex area may want to know the answer to the title of this article.

The Salt Lake Tribune printed an article on March 6, 2012, that dealt with this issue to a degree. The title of the article is, New Legal Battle Over Powell Insurance Policies. This article discusses what happened in the present case. At the end of this article, you will get the answer as it relates to Texas Insurance Law.

The article tells us that nine days after Josh Powell killed himself and his two sons in a horrific fire at his home in Washington state, two of his siblings filed claims on insurance policies worth $1.5 million — a move that has now prompted the insurer to ask a U.S. District Court to sort out who, if anyone, is entitled to the money.

Duty To Cooperate

March 29, 2012 | Mark S. Humphreys

Lots of people in Weatherford, Mineral Wells, Aledo, Azle, Willow Park, Hudson Oaks, Springtown, Millsap, Brock, and other places in the Parker County area and for that matter, other places in Texas may not realize that they have responsibility under their insurance policies to cooperate with their insurance company with any claim that is being made against the insurance policy.

This “duty to cooperate” can be confusing at times. There can sometimes be a fine line between what the insurance company has a responsibility for investigating and what the insured must do to help in that investigation.

The Texas Insurance Code, Section 541.060 provides a guideline for some of the things that can be done or asked for by an insurance company in its investigation. Section 541.060(a)(9), is one place where limits are placed on that investigation.

Insurance Lawyers Arguing The Case

March 27, 2012 | Mark S. Humphreys

Attorneys in Grand Prairie, Arlington, Fort Worth, and other places in the Dallas – Fort Worth area are paid to argue cases. Here is a case where the reasoning sounds pretty good.

The style of the case is Raymundo Salcedo v. Evanston Insurance Company. The opinion was issued on February 22, 2012, by the United States Court of Appeals, 5th Circuit. The appeal arises from the district court’s grant of summary judgment in favor of Evanston upon a conclusion that Evanston owed no coverage under its commercial general liability (CGL) insurance policy issued to Villegas & Sons, Incorporated (Villegas). Salcedo, the injured claimant, argued on appeal that the district court errred by construing the “auto” exclusion to preclude coverage for the judgment he obtained in state court against Villegas. Here are the facts.

Salcedo is a judgment creditor of Villegas pursuant to a final judgment entered by the 448th District Court of El Paso, Texas, for $1.1 million plus interest. Evanston denied coverage in the state court proceeding based on the “auto” exclusion in its CGL policy.