Dallas Fort Worth Insurance Lawyer Blog

Claims Denial Attorney And Suing Insurance Agents

May 9, 2022 | Mark S. Humphreys

Insurance agents can be responsible for their own actions under the Texas Insurance Code.

Just as an insurance company is liable for its own misconduct, so too agents may be personally liable for their misdeeds, even when acting on behalf of an insurance company. In general, an agent is individually liable for his or her own tort or statutory violation. This is discussed in the 1985, Texas Supreme Court opinion, Weitzel v. Barnes, and in the 1983, Texas Supreme Court opinion, Light v. Wilson, and the 1991, Austin Court of Appeals opinion, State Farm Fire & Casualty v. Gros.

It is not normal for the agent to be liable for breach of contract based on the insurance policy, because the contract of insurance is not between the insured and the agent.

Claims Denial Attorney – Watch For Limitations

May 7, 2022 | Mark S. Humphreys

Being aware of when the statute of limitations runs on a claim is vital so that the limitations period does not expire. This is illustrated in the 2022, opinion from the Western District of Texas, San Antonio Division. The opinion is styled, Tobin Endowment v. Great American Assurance Co.

Tobin Endowment is the insured and Great American is the insurer.

Tobin filed this lawsuit on August 23, 2020, claiming that Great American underpaid the claimed loss. Great American eventually filed this Motion For Summary Judgment stating to the Court that Tobin let too much time expire and that Tobin’s claim is barred by the statute of limitation stated in the policy.

Insurance Claims And Lawsuits

May 2, 2022 | Mark S. Humphreys

Most insurance claims will not end up in a lawsuit. However, for those claims that do end up in a lawsuit it is important for the insured to understand their responsibilities when in the lawsuit. The failure of a party to the lawsuit to cooperate in the litigation process can be fatal to the lawsuit.

The above is illustrated in a 2022, opinion from the Austin Court of Appeals. The opinion is styled, Michael V. Wright and Phyllis F. Wright v. State Farm Lloyds.

The Wrights were insured by State Farm with a homeowners policy. The Wright’s suffered losses stemming from two fires to their residence. One in 2013, and the other in 2015.

Pre-Suit Notice Letter

April 30, 2022 | Mark S. Humphreys

Here is a case where the insurance company complains that it did not receive proper pre-suit notice of the claim. The Court disagreed with the insurance company.

This is a 2022 opinion from the Northern District of Texas, Dallas Division. It is styled, Douglas D. Dailey, et al., vs. Amguard Insurance Company.

Dailey sued Amguard in State Court and Amguard timely and properly removed the case to Federal Court then moved under the Texas Insurance Code, Section 542A.005(a)(1), to abate the case until the 60th day after Dailey give notice that complies with Section 542A.003 of the Texas Insurance Code.

Bad Faith Insurance

April 25, 2022 | Mark S. Humphreys

Bad Faith Insurance Lawyers need to read this 2022 opinion from the Northern District of Texas, Dallas Division. The style of the case is, Vernon Humphries and Rebecca Humphries v. State Farm Lloyds.

The Humphries sued State Farm alleging State Farm failed to pay the full amount of their claim. After litigating some of the case, State Farm filed a motion for summary judgment regarding Humphries’ bad faith claims.

We will not state the detailed facts of this case. To get the facts of this particular case, a reading of the opinion is necessary.

Insurance Claim Denial And Attorney Fees

April 23, 2022 | Mark S. Humphreys

An often asked question by insureds having a claim against their insurance company is, “Can I recover my attorney fees?” There is not a simple straight forward answer to this question. Many variables come into play. “Yes” is a simple answer but does not get into the variables.

A 2022, opinion from the Northern District of Texas, Dallas Division, discusses this issue as it relates to claims under Texas Insurance Code, Section 542A.003. The style of the opinion is, Betty Rahe v. Meridian Security Insurance Company D/B/A State Automobile Mutual Insurance Company and Larysa Santiago.

Plaintiff sued Defendant on a claim arising from wind and hail damage to her property.

Insurance Lawsuits Can Be A Lot Work For The Insured

April 18, 2022 | Mark S. Humphreys

There is lots of information available about actions to be taken before a lawsuit is filed. There is also a lot of information available about the potential wrongs of an insurance company, it’s agents and adjusters. What is rarely discussed is the work an insured has to do in a lawsuit. When we say”insured” we are speaking of the person, not the person’s lawyer.

This issue can be seen in a 2022 opinion from the Austin Court of Appeals. The style of the opinion is Michael V. Wright and Phyllis F. Wright v. State Farm Lloyds.

In this case, the Wrights sued State Farm for breach of contract and various violations of the Texas Insurance Code. The lawsuit arose out of the way the Wrights were treated after they made a claim for benefits after a fire loss.

Disability Claims – Full Time Employee

April 16, 2022 | Mark S. Humphreys

Here is a case wherein one of the issues was whether or not an employee was eligible for Long Term Disability (LTD) based on the definition in the policy of “full time” employee.

This is a 2022, case is from the 5th Circuit Court of Appeals. It is an appeal from the Northern District of Texas. The opinion in the case is styled, James W. Newsom v. Reliance Standard Life Insurance Company.

Newsome had a policy that, among other things, provided short term disability (STD) benefits and LTD benefits. The plan is governed by the Employee Retirement Income Security Act of 1974 (ERISA).

Claims Refusal And Notice

April 11, 2022 | Mark S. Humphreys

Insurance claims attorneys know that the insurance statutes require that a notice letter be sent to an insurance company before filing suit. The notice letter is to be sent 60 days before filing the lawsuit. The purpose is to allow a settlement or resolution of the case before either side incurs legal costs and fees.

Failure to provide the notice letter can result in not being able to make a claim for attorney fees among other claims. This notice letter requirement is the subject of a 2020, opinion from the Northern District of Texas, Dallas Division. The opinion is styled, Paradise Fruits And Vegetables, L.P. v. National Fire & Marine Mutual Insurance, et al.

The case is an insurance despite between Paradise and two of its previous property insurers. First, Paradise seeks payment from a company referred to as “National Fire” for its refusal to cover damage to Paradise sustained in two storms in 2019. Second, Paradise asserts its sustained storm damage in 2020 while insured by its new insurer, State Auto. State Auto denied the claim made related to the damage in the 2020 storm.

Hail Damage Claims – Allocation

April 9, 2022 | Mark S. Humphreys

Hail damage claims, like a lots of other types of claims, have their own nuances that an insurance attorney needs to be prepared to address.

Here is a 2022, opinion from the Northern District of Texas, Fort Worth Division, that addresses a hail damage claim and the assertion that that the insurer made, that at least part of the hail damage, while real, occurred at a time when the policy was not in effect. The style of the case is, Leo Parrish, et al. v. State Auto Insurance Company.

Parish had a policy with State Auto that covered the period November 2, 2019, to November 2, 2020. The policy has a hail damage deductible of $5,921. In March 2020, Parrish noticed neighbors receiving new roofs and subsequently had a neighbors roofer inspect his roof. Parrish was told that his roof was also damaged and then Parrish made a claim against State Auto.