Dallas Fort Worth Insurance Lawyer Blog

Lawyers And Home Owners Claim Denial Based On Lateness Of Claim

February 18, 2012 | Mark S. Humphreys

When someone in Grand Prairie, Weatherford, Fort Worth, or anywhere else in the north Texas area suffers an insured loss, how long do they have to report the claim to their insurance company? The answer is a lawyers answer: It Depends.

The Fifth Circuit Court of Appeals dealt with this issue in an opinion it issued in 2005. The style of the case is Ridglea Estate Condominium Association v. Lexington Insurance Company. Here are some of the facts.

In July 2001, after receiving notice from a roofing inspector that its building in Fort Worth, Texas has suffered hail damage, Ridglea filed an insurance claim with its carrier Chubb Custom Insurance. Upon its inspection, however, Chubb informed Ridglea that the damage was not caused by the more recent storm but rather by a storm that occurred on May 5, 1995. Ridglea did so and filed the claim with the 1995 carrier, Lexington Insurance Company. Lexington’s inspection revealed that the damage did not exceed the deductible and that there was not sufficient evidence that the damage occurred in 1995 and denied the claim. After about a year’s worth of negotiations involving Ridglea and all its insurers, Ridglea made a final demand. Lexington again denied the claim and brought a declaratory judgment action seeking a ruling that it was not liable for the damage. Both parties moved for summary judgment and the trial court granted summary judgment in favor of Lexington holding that Ridglea had failed to comply with the notice requirements contained in the policy. Ridglea appealed to the U.S. Court of Appeals for the Fifth Circuit.

Lawyer Getting Knowing Violation Of Insurance Code

February 16, 2012 | Mark S. Humphreys

Insured people in Grand Prairie, Fort Worth, Arlington, Dallas, and other places in the Dallas and Fort Worth metroplex would probably not understand how to hold an insurance company responsible for a knowing violation of the Texas Insurance Code. Here is a case where the lawyer had success in this area of the law.

The style of the case is, State Farm Lloyds v. Johns. The case was decided by the Dallas Court of Appeals in 1998. Here are the facts.

Ms. Johns’ house was built in 1964. Johns moved in to her house in 1972. In the summer of 1990, Johns noticed evidence of extensive foundation problems including door mis-allignment, significant cracks in the interior walls and a slope to the floor. Repairmen later discovered two plumbing leaks under the house. Johns made a claim for foundation damage alleging that the plumbing leaks caused the soil underneath the house to expand resulting in an upheaval of the foundation, thereby damaging the structure. State Farm hired a foundation expert, Mr. Betting, who concluded that Johns’ foundation problems were not caused by the plumbing leaks, but rather asserted that the damage occurred from natural soil movement common to north Texas. State Farm’s homeowners policy excluded damage caused by ordinary settlement. Based on the exclusion State Farm denied the claim.

Lawyer And Bad Faith Insurance

February 14, 2012 | Mark S. Humphreys

Someone in Weatherford, Fort Worth, Aledo, and other places in Tarrant and Parker County might have a hard time understanding what is “bad faith” in most insurance situations. Here is a case that gives some insight into how it works.

The case is State Farm Lloyd’s v. Johns and was decided by the Dallas Court of Appeals in 1998. Here are some of the background facts.

Johns’ house was built in 1964. Johns moved in to her house in 1972. In the summer of 1990, Johns noticed evidence of extensive foundation problems including door misalignment, significant cracks in the interior walls and a slope to the floor. Repairmen later discovered two plumbing leaks under the house. Johns made a claim for foundation damage alleging that the plumbing leaks caused the soil underneath the house to expand resulting in an upheaval of the foundation, thereby damaging the structure. State Farm concluded that Johns’ foundation problems were not caused by the plumbing leaks, but rather asserted that the damage was caused by ordinary settlement. Based on the exclusion, State Farm denied the claim.

Insurance Attorney Arguing Mental Anguish Claim

February 12, 2012 | Mark S. Humphreys

Someone in Grand Prairie, Arlington, Fort Worth, Dallas, or anywhere else in Texas may wonder how “mental anguish” works as a claim. Here is some insight into that how it works in Texas.

The Texas Supreme Court issued an opinion in 1997, in the case styled “The City of Tyler v. Adeline Likes.” Attorneys for the City of Tyler and attorneys for Likes made arguments for their respective clients. Here is some background.

The primary issue was whether Likes could recover for mental anguish resulting from a flood. There were other issues in the case that will not be addressed.

Insurance Law Attorney Arguing Policy Interpretation

February 11, 2012 | Mark S. Humphreys

Business owners in Weatherford, Mineral Wells, Aledo, Azle, Springtown, Millsap, Brock, Hudson Oaks, Willow Park, and other areas of Parker County need to have a good understanding of the coverage provided in their policies.

The United States District Court, Southern District, Houston Division, issued an opinion on December 20, 2011, that dealt with the interpretation of a commercial insurance policy. The style of the case is, H & H Hospitality LLC v. Discover Specialty Insurance Company. The attorney for the business owner had to argue with the attorney for the insurance company as to the correct interpretation of the policy language related to the “business cessation” clause in the policy.

Here is some background.

Insurance Claims For Emotional Distress

February 9, 2012 | Mark S. Humphreys

Someone in Weatherford, Mineral Wells, Aledo, Hudson Oaks, Springtown, Azle, Brock, Millsap, Cool, Willow Park, or anywhere else in Parker County would have a hard time understanding the coverages in their insurance policy. Most policies cover an insured when they are sued but that is not always the case.

The United States Court of Appeals for the 5th Circuit issued an opinion in a case in 1994, that says the insurance company did not have to defend a case where the insured was sued for “emotional distress.” The style of the case is Travelers Indemnity Company v. Holloway. Here is some background and facts.

This was a declaratory judgment action wherein the insurance carrier, Travelers Indemnity Company of Rhode Island, contended that it had no duty to defend its insured, Wanda Holloway, against a lawsuit for intentional infliction of emotional distress, since this claim was not covered by the policy. Holloway, the mother of a junior high school student competing for a cheerleader position, allegedly plotted to kill Heath, the mother of one of her daughter’s competitors. The mother of the competitor brought suit against Holloway alleging “outrageous conduct causing severe emotional distress” or “intentional infliction of emotional distress.” Holloway sought a defense from Travelers. Travelers argued that Holloway was not entitled to a defense and that there was no coverage, since (1) the conduct did not constitute an “occurrence” under the policy, (2) the conduct was excluded from coverage as intentional conduct, and (3) the conduct was not alleged to have caused “bodily injury” as defined by the policy.

Credit Life Insurance Case

February 7, 2012 | Mark S. Humphreys

When someone in Grand Prairie, Arlington, Fort Worth, Saginaw, Roanoke, Keller, Rhome, Colleyville, and other places in Tarrant County and Texas purchase something on credit or take out a loan, they will often times have the option of purchasing some sort of credit life and disability insurance. Here is a case dealing with what happened in one situation where this was done.

The style of the case is Norman v. League City National Bank and Life of America Insurance Company. This is a 1998, Houston Court of Appeals (1st Dist) case. Here is some background.

Mr. Norman applied for and obtained two loans from the Bank. In connection with the loans, he applied for and obtained credit life insurance from Life of America Insurance Company. Mr. Norman died before making any payments on either loan. The Bank submitted a claim to Life of America, but the claim was denied. The Bank then filed suit against Life of America for payment under the insurance policies. The bank also filed suit in probate court against Mr. Norman’s estate and Mrs. Norman for payment of the loans. Mrs. Norman then filed suit against the Bank and Life of America asserting claims under the Texas Insurance Code, the Texas Deceptive Trade Practices Act, (DTPA) and for breach of warranty. All actions by all parties were consolidated in the probate court.

Force Placed Insurance Claims

February 5, 2012 | Mark S. Humphreys

If you are in Grand Prairie, Arlington, Fort Worth, Roanoke, Keller, Colleyville, Saginaw, or some other place in Tarrant County or Texas and find yourself in some financial trouble, it may be that you find yourself letting your homeowners insurance lapse. If that happens the mortgage lender on your home will buy what is called a force-placed insurance policy and charge you with the premium. There are a bunch of problems when this happens. Two of these problems are real important to you.

First, is that force-placed insurance is very expensive and you are responsible for paying it.

Second, is that a force-place policy covers the mortgage holder not you. In other words, none of your personal property or the contents of the house is covered in the event of a fire loss. Further, if you are sued by someone, the insurance does not cover you. If you get burglarized, you are not covered.

Arson By Spouse

February 4, 2012 | Mark S. Humphreys

No one in Grand Prairie, Weatherford, Fort Worth, Dallas, or anywhere else in the North Texas area would want to be in a situation where their spouse deliberately sets the house on fire. This is something that might happen in a divorce setting or maybe it is just the result of a really bad fight. So what happens as it relates to insurance?

A San Antonio Court of Appeals opinion issued in 1996, sheds some light on this question. Here is some background. The style of the case is Sanders v. Commonwealth Lloyd’s Insurance Company.

Jan and Dan Saunders’ house was completely burned down by a fire. The insurance company investigated the claim and concluded that Dan was responsible for setting the fire. Dan was convicted of a felony of conspiring to burn down the house which was later reversed and he was acquitted. In the meantime, the insurance company, Commonwealth Lloyd’s, denied the claim.

Is Late Payment Of A Claim, Bad Faith Insurance?

February 2, 2012 | Mark S. Humphreys

Most people in Weatherford, Mineral Wells, Aledo, Azle, Willow Park, Hudson Oaks, and other places in Parker County would have a hard time understanding what constitutes “bad faith” in insurance. But most would believe that being late in paying a claim is bad faith. That does not appear to be the case.

The United States 5th Circuit made a ruling in a case in 1997, that addresses this issue. The style of the case is Higginbotham v. State Farm Mutual Automobile Insurance Company. Here are some of the background facts.

Higgnbotham’s Porsche was stolen on June 8, 1993, from an unsecured parking lot next to his residence. The car was later recovered that day but it had been stripped of its top, seats, interior and exterior trim but was not damaged or destroyed with regard to mechanical connections, wiring harnesses or the engine. Higginbotham reported the theft to State Farm on June 9, 1993. State Farm denied his claim five months later on November 19, 1993.