Dallas Fort Worth Insurance Lawyer Blog

Insurance Fraud

June 19, 2011 | Mark S. Humphreys

Insurance payers in Grand Prairie, Arlington, Fort Worth, Dallas, Mansfield, De Soto, Cedar Hill, Duncanville, Irving, Cockrell Hill, and other places in Dallas County and Tarrant County do not like insurance fraud.

The Los Angeles Times published an article on May 20, 2011, dealing with insurance fraud in the state of California. The article is written by Marc Lifsher and the title to the article is, Quest Diagnostics Settles Medi-Cal Whistle-Blower Suit.

The article tells us that Quest Diagnostics, Inc., the biggest provider of medical lab services in California, has agreed to pay $241 million to settle a whistle-blower’s lawsuit that accused it of overcharging the state Medi-Cal program. The lawsuit also alleged that the Madison, N.J., company paid illegal kickbacks to doctors, hospitals, and clinics that sent patients their way.

Attorneys Hired By The Insurance Company

June 18, 2011 | Mark S. Humphreys

An attorney in Weatherford, Mineral Wells, Aledo, Willow Park, Hudson Oaks, Azle, Peaster, Millsap, Brock, Poolville, Springtown, or anywhere else in Texas may be a good attorney to help someone with their case. When an insured gets sued he may want one of these attorneys to help him with his case and would expect their insurance company to pay the costs because that is one of the benefits of having insurance. Most of the time the insurance company pays for defense costs. Right?

The answer is no. The insurance company will pay for defense costs but they get to chose who the lawyers are going to be.

The Texas Supreme Court decided a case in 2004 styled, Northern County Mutual Insurance Co. v. Timoteo Davalos. Here is some background.

Insurance Company Slow Paying Claim

June 16, 2011 | Mark S. Humphreys

Someone in Weatherford, Mineral Wells, Aledo, Hudson Oaks, Willow Park, Brock, Millsap, Peaster, Azle, Cool, Cresson, or anywhere else in Parker or Palo Pinto Counties might wonder – How long do I have to give an insurance to pay a claim before I can do something about it? The lawyerly answer to that is – It depends.

First, if an insurance company is being too slow in paying a claim, a person should not have any hesitation in approaching an experienced Insurance Law Attorney.

Second, there is a section of the Texas Insurance Code titled the “Prompt Payment of Claims Act” which gives guidance to the question, – When is too long – too long?

Insurance Policies And Punitive Damages

June 14, 2011 | Mark S. Humphreys

Insured’s in Grand Prairie, Arlington, Fort Worth, Burleson, Crowley, Benbrook, Hurst, Euless, Bedford, North Richland Hills, and other places in Tarrant County and Texas rarely understand what is covered in their auto insurance policy and what is not.

Here is a case decided in 1989, discussing exemplary damages. The case was decided by the El Paso Court of Appeals and is styled, Emigdia C. Manriquez, Individually and on Behalf of all Statutory Wrongful Death Beneficiaries of Jorge Ramon Manriquez, Deceased v. Mid-Century Insurance Company of Texas.

Here are some facts of the case.

Exemplary Damages In Insurance

June 12, 2011 | Mark S. Humphreys

Texans in Grand Prairie, Arlington, Dallas, Fort Worth, Mansfield, Duncanville, De Soto, Cedar Hill, Mesquite, Richardson, Garland, and other places in Dallas County will rarely find themselves in a position wherein they are making a claim for exemplary damages but would be surprised how often they are close to being able to make that claim. Think about this – If someone injures you in a car wreck and the person has been drinking, then you have a claim against that person for your injuries plus a claim for exemplary damages. So how does that work?

The Fort Worth Court of Appeals had a case in December 2004, which discussed exemplary damages. The style of the case is Westchester Fire Insurance Company v. Admiral Insurance Company. Here is some background.

In 1994, PeopleCare Heritage Western Hills, Inc. (PeopleCare), the owner of Heritage Western Hills Nursing Home had a primary policy with Admiral with limits of $1,000,000 and an excess policy with Westchester with limits of $10,000,000. Beulah Cagle was a patient at Western Hills. In December 1994, Beulah (Beulah had been allowed to lie in a urine soaked bed for extended periods of time) and her daughter Lola sued PeopleCare under several legal theories including gross negligence.

Sueing An Insurance Company

June 11, 2011 | Mark S. Humphreys

Someone in Grand Prairie, Arlington. Fort Worth, Keller, Hurst, Euless, Bedford, Richland Hills, Saginaw, Lake Worth, Benbrook, or anywhere else in the Tarrant County area would only be normal to think about sueing an insurance company someday. Particularly if they are doing you wrong.

Here is a case where a business that works with one insurance company got screwed around by apparently not sueing the insurance company correctly. One way to lessen the chances of this happening is to work with an experienced Insurance Law Attorney.

Here is some of the background of the case.

Personal Injury Protection (PIP)

June 9, 2011 | Mark S. Humphreys

Lots of insureds in Weatherford, Aledo, Willow Park, Mineral Wells, Millsap, Brock, Azle, Peaster, Cool, Hudson Oaks, and other places in Parker County will have Personal Injury Protection benefits included in their auto insurance policies.

Here is an article that discusses an antic one company was using to save money on these PIP claims.

The article was published by the Houston Chronicle on May 13, 2011, and is authored by staff writer, Patrick Danner. The title of the article is, USAA Sued Anew Over Medical Payouts In Crashes Plaintiffs Say Insurer’s Reviews Are “Shams”; Firm Defends Practices.

When Are Claims Paid?

June 7, 2011 | Mark S. Humphreys

It would be natural for someone in Grand Prairie, Fort Worth, Arlington, Dallas, Mesquite, Garland, Farmers Branch, Duncanville, De Soto, or anywhere else to think that a claim should be paid pretty soon after it is made. Here is a case to read and think about the next time an insurance conmpany is slow paying a claim.

The case was decided by the Court of Appeals, Dallas, and is an appeal from County Court at Law No. 5. The opinion was issued in May 2011. The style of the case is “Cypress Texas Lloyds Property and Casualty Insurance Co. v. Fred Carrington.

Carrington won at the trial level and Cypress appealed. Here are some of the facts of the case.

Claim Denied – Policy Interpretation

June 5, 2011 | Mark S. Humphreys

Here is one for residents of Weatherford, Mineral Wells, Aledo, Azle, Springtown, Hudson Oaks, Willow Park, Brock, Millsap, Poolville, and other places in Parker County and Palo Pinto County. This case is unusual.

The Texas Court of Appeals, San Antonio, issued an opinion on May 11, 2011, in a case appealed from the 73rd Judicial District Court. The style of the case is, Dora Gulley v. State Farm Lloyds.

A little legal information first. This is an agreed interlocutory appeal pursuant to Texas Civil Practices & Remedies Code, Section 51.014(d). It is arising out of an insurance case where in both sides in the case filed motions for Summary Judgment asking the court to rule in their favor as a matter of law. The Judge denied both parties motions and allowed them to pursue an appeal pursuant to the above statute. So this case was essentially being given to the appeals court to make a decision / ruling.

Insurance Claim Denied – Experts

June 4, 2011 | Mark S. Humphreys

No matter where you live, Grand Prairie, Arlington, Mansfield, Fort Worth, Dallas, Garland, Mesquite, Richardson, Coppell, Carrollton, or anywhere else in Texas, at some point you are probably going to have an insurance claim denied. To what extent will an insurance company go to prove they do not owe you anything?

The Texas Court of Appeals, Eastland, decided a case in December, 2008, wherein the insurance company appealed the findings of an injured persons own treating experts. The style of the case is, American Casualty Company of Reading, Pa. v. Donna Zachero. Here is some background information.

On March 17, 2003, Zachero was injured at work when she fainted and fell. She hit her chin, shoulder, chest, and elbow during the fall and developed bruises on those areas. She also injured her knee when she fell. On April 17, 2003, Zachero went to the emergency room due to pain and swelling in her knee. She was x-rayed and instructed to see an orthopedic, Dr. Luke, a specialist for the injury.