Dallas Fort Worth Insurance Lawyer Blog

Policy Interpretation In Texas

August 11, 2010 | Mark S. Humphreys

No matter where you live, Weatherford, Aledo, Azle, Lake Worth, Mineral Wells, De Soto, Arlington, Grand Prairie, Dallas, Fort Worth, Mesquite, Garland, or anywhere else in Texas, the insurance companies are always looking for ways to deny a claim.

The Texas Supreme Court, in 2004, decided a case where the insurance company denied a claim for Personal Injury Protection (PIP) benefits under a policy. The style of the case is, Texas Farm Bureau Mutual Insurance Company v. Jeff A. Sturrock. Justice O’Neil delivered the opinion of the Court.

In this case, an insured, Sturrock, was injured when his foot became entangled with his truck’s raised door facing while he was exiting the vehicle. The issue here is whether or not his injury resulted from a “motor vehicle accident” for purposes of PIP coverage under his automobile policy with Texas Farm Bureau Mutual Insurance Company (Farm Bureau). The Court held that a “motor vehicle accident” occurs when (1) one or more vehicles are involved with another vehicle, an object, or a person, (2) the vehicle is being used, including exit and entry, as a motor vehicle, and (3) a casual connection exists between the vehicle’s use and the injury producing event.

Insurance Coverage – How Do You Interpret It?

August 10, 2010 | Mark S. Humphreys

I live in Dallas, or Fort Worth, Arlington, Grand Prairie, Flower Mound, Mansfield, Justin, De Soto, Duncanville, Azle, or anywhere else in Texas – How do I know how to interpret my insurance policy? Here is a bunch of answers. Consult with an experienced Insurance Law Attorney. Ask you insurance agent. Attend an insurance seminar. Go to law school. Ask your next door neighbor or your boss at work.

The above may seem rediculous but sometimes the answer is hard to get even when asking the professionals. Here is my suggestion. Talk to the lawyer.

Legal conclusions are sometimes easy to reach but too often they are not so easy. Here is a case that argued over what the work “you” means in the policy.

Insurance Companies Playing Games?

August 8, 2010 | Mark S. Humphreys

An insured in Dallas, Fort Worth, Grand Prairie, Arlington, Colleyville, Burleson, Benbrook, Grapevine, Irving, or anywhere else in Texas probably thinks they pay too much in health insurance rates. Well, the reality is they probably are paying too much.

The above is addressed in a USA Today article published on July 22, 2010. The author is Alison Young and the title of the article is, “Consumer group: Insurers kept surplus while hiking premiums.” The article focused on Blue Cross and Blue Shield health plans because the company covers one in three Americans with private insurance.

The article tells us that non-profit Blue Cross and Blue Shield health plans stockpiled billions of dollars during the past decade, yet continued to hit consumers with double digit premium increases. This was discovered by Consumers Union in an anaylsis of 10 of the plans’ finances.

Accused Of Cheating The Insurance Company

August 5, 2010 | Mark S. Humphreys

Insurance companies often times accuse policyholders of trying to cheat them. No matter if you are in Dallas, Fort Worth, Arlington, Grand Prairie, or somewhere else, if you make a claim the insurance company will assign an adjuster to investigate the claim. The adjusters job is to evaluate and settle the claim. Sometimes the adjuster finds things that make him suspicious of how legit the claim is. If the adjuster is ever questioning your honesty you should immediately get an experienced Insurance Law Attorney involved.

A big reason adjusters question the honesty of a claim is that occassionally they find something that is just not right. This is illustrated by an article that was published on July 19, 2010, in the Fresno Bee, a newspaper in California. The article is written by Barbara Anderson and is titled, “Valley doctors, chiropractors accused of fraud.”

The article tells us that Allstate Insurance Company is suing San Joaquin Valley doctors and several chiropractors in a multimillion-dollar lawsuit, alleging they falsely operated chiropractic clinics as medical groups to get insurance payments.

Deceptive Trade Practices Act Violation

August 4, 2010 | Mark S. Humphreys

Residents of Dallas, Fort Worth, Arlington, Grand Prairie, Weatherford, and other cities, beware. There are businesses out there that will cheat you.

Think about this for a second. There is a saying that says there are only two things in this world a person can be sure of; death and taxes. A person can be a little light hearted and joke by saying they are getting screwed by both of them.

But here is a different twist. According to a Houston Chronicle news story that was published on July 19, 2010, the tax man, or in this case “TaxMasters” is screwing you over also. The author of the article, Mike Tolson, titled the article, “TaxMasters target of state AG, customers.” The article tells how the tax assistance company, TaxMasters, appears to be in violation of the Texas Deceptive Trade Practices Act and the Texas Debt Collection Act.

Life Insurance Policies In Texas

August 3, 2010 | Mark S. Humphreys

What do people in Dallas, Fort Worth, Arlington, Grand Prairie, Azle, Irving, Burleson, Mansfield, Duncanville, and other cities in Texas know about life insurance? Answer: not much, except what it costs each time they make a payment.

Life insurance in Texas is regulated by the Texas Department of Insurance. Laws governing life insurance can be found in the Texas Insurance Code. Insurance Law Attorneys can answer a lot of questions whenever someone thinks they are not being treated properly by their agent or the insurance company.

Life insurance policies, by law, must contain several prescribed provisions. This is stated in Section 1101.002(a) of the Insurance Code. The exception to this statute is a single premium life insurance policy. This is stated in Section 1101.002(b), but these single premium policies are not seen very often and the vast majority of people do not have these types of policies.

First Party Insurance Claims

August 1, 2010 | Mark S. Humphreys

Someone in Dallas, Fort Worth, Grand Prairie, Arlington, Mansfield, De Soto, Aledo, Weatherford, Azle, Burleson, or anywhere else in Texas may ask, What is a “First Party” Insurance Claim?

“First party” insurance claims are claims that an insured makes against their own insurance policy. Most of the time a person making a claim against someone else’s insurance policy is considered a “third party” claimant. However, sometimes a person making a claim against someone else’s policy is still considered a “first party” claimant when the person making the claim is a beneficiary of the insurance policy.

A “first party” policy typically involves insurance that provides policy benefits directly to the insured or beneficiary in the event of a loss. This is further set out in the Texas Insurance Code, Section 542.051(2). In that section, “first party claim” is defined as a claim “by an insured or a policyholder under an insurance policy or contract or by a beneficiary named in the policy or contract that must be paid by the insurer directly to the insured or beneficiary.” These types of policies generally include health insurance, life insurance, disability insurance, workers’ compensation insurance, auto property insurance, homeowner’s property insurance, and commercial property insurance. The Texas Supreme Court, in 1997, described the difference between first party and third party insurance in the case styled, Universal Life Insurance Company v. Giles.

What Does My Insurance Policy Cover?

July 29, 2010 | Mark S. Humphreys

The above question could be asked by someone in Grand Prairie, Hurst, Euless, Bedford, Grapevine, Colleyville, Keller, Dallas, Fort Worth, or anywhere in Texas. So what is the answer? The answer is what all lawyers say in response to all questions put to them: It depends!

It depends on whether or not the insurance policy is ambiguous. If it is ambiguous, then it is open to more than one interpretation. Or if it is doubtful or uncertain, the court must find in favor of coverage.

Experienced Insurance Law Attorneys look at and rely on what courts have done in the past with similar cases when advising a client what may be the outcome to any particular set of facts in a case.

Interpretation Of A Texas Insurance Policy

July 28, 2010 | Mark S. Humphreys

Someone in Dallas, Fort Worth, Grand Prairie, Arlington, Carrollton, Garland, Mesquite, De Soto,Duncanville, Burleson, Benbrook, or anywhere else in Texas may ask: How do I know what my insurance policy says?

Insurance companies spend lots of money paying lawyers to draft and write insurance policies that they issue to their insureds. And the insurance company knows what they are trying to write. The problem is, what they mean to write and what the insured person reads it to mean can often times be very different. So what happens?

What happens depends on whether or not the insurance policy is ambiguous.

Uninsured Drivers In Dallas And Fort Worth

July 27, 2010 | Mark S. Humphreys

It just makes you mad! Most drivers in Dallas, Fort Worth, Grand Prairie, Arlington, Mansfield, De Soto, Duncanville, Weatherford, Azle, Aledo, and throughout Texas do the right thing by maintaining liability coverage on their automobiles. But, way too many drivers are on the road without insurance.

The Dallas Morning News ran an article on Saturday, July 17, 2010, addressing this subject. The article is written by Terrence Stutz. The title of the article is, TexasSure program finds about 25 percent of vehicles uninsured in Dallas County.

This article points to a scary statistic. This stastistic is that 25 percent of all vehicles in Dallas County, according to records, 429,478 cars and trucks, remain without liability insurance. This statistic comes from the Texas Department of Insurance.