Dallas Fort Worth Insurance Lawyer Blog

Delay In Paying Claim In Texas

November 16, 2010 | Mark S. Humphreys

Someone in Dallas, Fort Worth, Grand Prairie, Arlington, Mansfield, Mesquite, Garland, Plano, Weatherford, or anywhere else in Texas, may experience a delay in being paid when making a claim against their insurance company. Is that ok? The answer is no, according to the Texas Prompt Payment of Claims Act.

The Texas Supreme Court decided a case in 2004, wherein the topic had to do with how the Texas Prompt Payment of Claims Act impacted the decision in the case. The style of the case is, Republic Underwriters Insurance Company v. Mex-Tex, Inc. The court phrased the issue this way: We must decide whether the commercial property insurer in this case breached its policy obligation to replace a damaged roof with one of “like kind and quality”, and if so, whether the insurer’s tender of partial payment of the claim avoided, on that amount, the 18% per annum delay penalty imposed by the Prompt Payment of Claims Act of the Texas Insurance Code.

Following a May 25, 1999 hail storm in Amarillo declared by the Texas Department of Insurance to be a weather-related “catastrophe for the purposes of claims processing”, Mex-Tex, Inc. notified its property insurer, Republic Underwriters Insurance Co., of damage to the roof of Signature Mall, a retail shopping center that Mex-Tex owned. Mex-Tex claimed that the roof had been destroyed and should be replaced. Republic immediately investigated the claim but disputed the amount of damage attibutable to hail.

Insurance Policy Appraisal Clause

November 14, 2010 | Mark S. Humphreys

If you have an insurance policy in Dallas, Fort Worth, Grand Prairie, Arlington, Mansfield, or anywhere else in Texas, you should look at it closely. It probably has an “appraisal clause” in it.

The United States Western District of Texas, Austin Division, decided a case on October 27, 2010. The style of the case is Orleans Harbor Homeowners Association, Inc. v. Public Service Mutual Insurance Company. The main issue in the case dealt with the appraisal clause in the insurance policy between Orleans Harbor Homeowners Association, Inc. (Orleans) and Public Service Mutual Insurance Company (Public).

Here is some background:

Life Insurance Claim Denial

November 13, 2010 | Mark S. Humphreys

If you live in Grand Prairie, Dallas, Fort Worth, Arlington, Grapevine, Crowley, Cleburne, Granbury, Weatherford, Mesquite, or anywhere else in Texas, and you have a life insurance policy the following case should be interesting to you.

On August 31, 2010, the Court of Appeals, Fort Worth, issued an opinion in a case regarding a live insurance policy. The style of the case is, Glenda and Larry Rice v. Metropolitan Life Insurance Company.

Here are some underlying facts of the case:

Interpreting A Policy Exclusion

November 11, 2010 | Mark S. Humphreys

A business man in Dallas, Fort Worth, Grand Praire, Arlington, Mansfield, Duncanville, Mesquite, Garland, or anywhere else is Texas, will usually have a hard time understanding exclusions in their commercial insurance policies. Here is a case where policy interpretation and exclusions were the issue.

On October 8, 2020, the United States District Court, S. D. Texas, Houston Division, issued an opinion in the case styled, Associated Marine & Industrial Staffing, Inc. v. Liberty Surplus Insurance Corporation. In the case the court ruled in favor of the insurance company.

Here are some facts:

Exclusion In Liability Policy

November 11, 2010 | Mark S. Humphreys

Someone in Dallas, Fort Worth, Grand Prairie, Keller, Colleyville, Roanoke, Springtown, Azle, Weatherford, or anywhere else in Texas who has a commercial liability policy would assume they have coverge if someone gets hurt. Well, depending on the policy and the exclusions contained in the policy, there may not be any coverage.

On October 5, 2010, the United States District Court, Northern District of Texas, Dallas Division, decided a case styled, Essex Insurance Company v. Michael Clark, d/b/a Ace Construction Company and Augustin Delrazo.

Here is some background: Essex Insurance Company (Essex) had issued a policy of insurance to Michael Clark (Clark), d/b/a Ace Construction Company (ACC). While the policy of insurance was in force, Delrazo cut his left hand on a table saw while doing work for ACC. Delrazo’s lawsuit alleged atleast eleven things ACC did to cause or contribute to his injuries.

Interpreting Homeowners Policy

November 9, 2010 | Mark S. Humphreys

Homeowners in Grand Prairie, Dallas, Fort Worth, Arlington, Mansfield, Irving, De Soto, Duncanville, Carrollton, Coppell, and other cities throughout Texas, probably have very little understanding about their homeowners insurance policy except that it is suppose to help them rebuild their house if it burns down. In addition to that, it is also suppose to provide coverage for you as a homeowner if someone is injured on your property and then sues you for their injuries.

The United States District Court for the Western District of Texas, Austin Division, issued an opinion on September 7, 2010. The style of the case is, Liberty Mutual Fire Insurance Company v. John Trovato and O’Delle Annette Hall. This case deals with the duty of an insurance company to protect its insured under a homeowners policy when they are sued and the interpretation of the insurance contract in that regard.

Here are some facts. On August 2, 2007, Hall came from a home she owned to help Trovato clean boxes out of Trovato’s attic. While moving boxes from the attic, Hall fell through the ceiling. The fall resulted in serious injuries to Hall. Hall sued Trovato. Trovato asked Liberty Mutual Fire Insurance Company to protect him in the lawsuit filed by Trovato. Liberty refused and this lawsuit resulted when Liberty filed this declaratory judgment action to have the court determine whether or not Liberty had any duties under the homeowners policy.

Insurance Policy And Appraisals

November 7, 2010 | Mark S. Humphreys

If you live in Grand Prairie, Arlington, Irving, Dallas, Fort Worth, Burleson, Keller, or anywhere else in the state of Texas and you have a homeowners insurance policy the policy is likely to contain an “appraisal” provision. So what does that mean?

The Texas Court of Appeals, Houston 14th District, issued an opinion on a case

September, 23, 2010, wherein the main issue dealt with an appraisal clause in an insurance policy. The policy at issue was a commercial policy but is essentially the same as those found in homeowners policies. The style of the case is, In re Continental Casualty Company.

Uninsured / Underinsured Insurance Coverage

November 4, 2010 | Mark S. Humphreys

Grand Prairie, Dallas, Fort Worth, Arlington, Mansfield, Grapevine, Crowley, Weatherford, and all other places in Texas will find someone driving a rental car. So, what happens if the person driving the rental car causes a wreck with someone else and they do not have enough insurance to cover the damages they cause? That was the issue in the case discussed below.

On October 7, 2010, the United States Court of Appeals for the Fifth Circuit, issued an opinion in the case styled, Kenneth McQuinnie v. American Home Assurance Company.

Here are the underlying facts:

Policyholder Lawsuit Against Farmers

November 2, 2010 | Mark S. Humphreys

Can someone in Dallas, Fort Worth, Grand Prairie, Arlington, Mansfield, Granbury, or anywhere else in Texas sue their insurance company when their insurance company is cheating them by charging excessive fees?

According to an article written by Tiffany Hsu and Marc Lifsher, reporters for the Los Angeles Times, that is exactly what some customers of Farmers Group did. The article is titled, “Farmers Group agrees to pay $455 million to settle policyholder suit.”

This article tells us about a class action lawsuit which accused a Los Angeles based insurance management firm of charging excessive fees to customers. Farmers insist the lawsuit is without merit but they agreed to settle the lawsuit anyway.

Life Insurance – Effective / Commencement Date Of Coverage

October 31, 2010 | Mark S. Humphreys

An insured in Grand Prairie, Dallas, Fort Worth, Coppell, Richardson, Duncanville, Aledo, Arlington, or anywhere else in Texas may ask this question: When does the life insurance policy become effective? Here is some guidance.

Most life insurance policies expressly state the “effective date” of coverage. This date may be earlier than, or later than, the date the first premium is paid or the dates the policy is issued or delivered. Often, an insurance policy may have an effective date, an issue date, and a policy date — and they may all be different, causing confusion or misunderstanding. If the dates differ, disputes may arise over when the policy actually took effect or terminated. The effective date can be important in setting the due date for subsequent premiums and thus the date of any lapse for failure to pay a premium.

An example to think about is found in the case, Life Insurance Company of the Southwest v. Overstreet. This is a Texas Supreme Court case decided in 1980. Here is a brief summary of the case: