Homeowners in the Dallas, Fort Worth, Grand Prairie, Arlington, and Metroplex areas are not as affected by what appears to be a mass settlement for homeowners in the Gulf Coast area of Texas. But it is still a victory, and a victory for one should be considered a victory for all when the insurance company finally does the right thing by accepting responsibility for the homeowners policies it issues.

The Beaumont Enterprise, a newspaper published in Beaumont, Texas, recently ran an article disussing the above topic. The article is written by Mike D. Smith and was published on July 13, 2010. The title of the article is, Mass settlement offered in Ike windstorm cases.

The article tells how the wait could be over for countless Bolivar Peninsula property owners locked in a group stalemate with the Texas Windstorm Insurance Association over Hurricane Ike damages.

If someone in Dallas, Fort Worth, Arlington, Grand Prairie, Mansfield, Hurst, Euless, Bedford, Duncanville, or anywhere else in Texas gets involved in an accident and someone besides themselves are at fault, what happens when health insurance pays for the medical bills resulting from the accident? The answer is one you are going to hate. The answer is: It depends.

There are many variables that come into play, some of which have been discussed in previous blogs. Today we are going to discuss what happens when a person’s own personal health insurance company pays for the medical bills incurred as the result of someone else causing injury to you.

Typical health insurance companies are Blue Cross / Blue Shield, Humana, and other names you have heard about and often times this health insurance is provided as a benefit by your employer. The significance of employer provided health insurance is that many times the health insurance provided through employment is a federally regulated plan called Employers Retirement Income Security Act, otherwise known as an ERISA plan.

Am I paying too much for my insurance? Whether you live in Cedar Hill, Mansfield, Benbrook, Saginaw, Keller, Fort Worth, Dallas, Grand Prairie, Arlington, or some other place in Texas, that would be a question most people would ask at one time or another when thinking about their finances.

For a California woman, the answer to the above question seems to be, yes. She has sued Blue Shield of California, accusing the nonprofit health plan of overcharging thousands of policyholders who bought safety net insurance for peole who were sick or jobless.

This was reported by the Los Angeles Times in an article written by Duke Hefland and published on July 8, 2010.

Let us say you are a guy in Dallas, Fort Worth, Grand Prairie, Arlington, Irving, De Soto, Duncanville, Lancaster, Rowlett, Aledo, or anywhere else in Texas and you see an advertisement. How do you know whether the advertisement is being deceptive or misleading? The answer: You probably don’t know.

Travelers Insurance was recently running an advertisement that was deceptive. There was a story on this on Wednesday, July 7, 2010. The story ran in the Austin paper, American-Statesman and was written by Tim Eaton. The title of the story is, “Consumer group says Travelers ad is deceptive, wants it pulled.”

The Texas consumer advocacy group, Texas Watch, claims a television ad run by Travelers Companys, Inc. is deceptive in its content. The Executive Director of Texas Watch, Alex Winslow, has written to the Texas Attorney General, Greg Abbott, and to the Texas Insurance Commissioner, Mike Geeslin, seeking a cease-and-desist order to keep the ad off the air in Texas.

What is common to a lot of residents of Dallas, Fort Worth, Grand Prairie, Arlington, Mansfield, Benbrook, Burleson, Aledo, and other areas of Texas? One, there are a lot of veterans living in the state and two, there are a lot of people who are behind on their child support payments.

First of all, there is no correlation between the two, except they are easy and short discussions. Let’s talk about VA subrogation first.

When someone is injured as the result of a third person’s negligent activity and the Veterans Administration has paid benefits to the injured person, the VA is entitled to be repaid for the amount of money they spent on the veteran’s behalf. The reimbursement rights of the VA are written into law and are set out in the 1990 case, United States v. Maryland. This is a United States 4th Circuit case and in part says:

What do residents of Dallas, Fort Worth, Grand Prairie, Arlington, Mansfield, Weatherford, and other cities in Texas need to know about subrogation? The answer is, a lot, unless you get an experieinced Insurance Law Attorney helping you.

Another important and potentially risky area of subrogation is Medicaid. Medicaid is a Federal program which is administered by the State. For us Texans, the program is administered by the State of Texas. Anytime you are discussing Federal Government liens and subrogation claims, such as Medicaid, Medicare, Veterans Administration, and a laundry list of others, it is wise to assume that such liens attach to claims and are superior to other liens, even if you have no actual notice of their existence.

Having said the above, it is important to realize that Medicaid and Medicare liens are very different creatures. This is expecially true in light of a recent United States Supreme Court case appealed from the State of Arkansas. This 2006 case is styled, Arkansas Department of Health and Human Services v. Ahlborn. A copy of the July 3, 2006 memo setting forth the Federal Government’s position on Ahlborn’s impact on Medicaid reimbursement / subrogation is available to the public on the Internet at:

No matter where you live – Grand Prairie, Dallas, Fort Worth, Arlington, Mansfield, De Soto, Duncanville, or anywhere else in Texas, you have to keep your eye on insurance companies. If you don’t, they will cheat and try to get away with doing people wrong.

A few weeks ago on this blog there was an article talking about the Texas Windstorm Insurance Association. Well, they are back in the news.

One of our favorite reporters, Purva Patel, with the Houston Chronicle, did a follow up story on the Texas Windstorm Insurance Association. This article was published on July 7, 2010, and is titled, “State criticizes windstorm insurer.” Purva Patel has had a number of articles describing wrongs committed by insurance companies. In the article published on July 7, about the Texas Windstorm Insurance Association, he writes about poor record keeping procedures that Texas Winstorm evidently does not have. Of course, this is wrong. The Texas Insurance Code, Section 542.005(b), says:

A large part of the population in Dallas, Fort Worth, Arlington, Grand Prairie, Weatherford, and most all other cities in Texas receive some form of government benefits. So what happens when someone receiving Medicare benefits gets a settlement in an injury case from an insurance company?

The answer to the above question is, “it depends.”

It should be obvious that if the benefits received by someone on Medicare are unrelated to the claim being made, then there is nothing to worry about. However, if the person receives a settlement based on injuries and medical bills that were paid for by Medicare, then Medicare is entitled to be paid back for any monies they paid for the benefit of the person receiving the benefits.

What if someone in Fort Worth, Arlington, Mansfield, Mesquite, Garland, Irving, Grand Prairie, Dallas, or anywhere else in Texas, is involved in an accident and goes to the hospital for treatment? Are there any special laws that apply?

The answer is yes. It depends on the circumstances, but often times, what is called a “hospital lien” comes into play. If this hospital lien is not properly dealt with it could cost a lot of money and heartache.

Texas public policy strongly supports hospital liens, and it is important to understand that these liens are not just applicable to hospitals; they may also operate for the benefit of EMS providers and doctors at teaching hospitals whose bills are not already included in the bill. The rights of hospitals and certain other medical providers to be paid from settlement proceeds or a judgment begins with the Hospital Lien Statute. This is found in the Texas Property Code, Chapter 55. It says, in relevent part, that a lien attaches to “any cause of action, judgment, or settlement” received as a result of an accident for which the person was admitted to a hospital within 72 hours of the injury, as well as any hospital to which the injured person is subsequently transferred for the same injuries. This is found in Texas Property Code, Section 55.002. These hopital liens must be filed prior to settlement in order to be valid, and hospital liens are limited to “reasonable and regular” charges within the first 100 days following the injury. Even the attorney representing the injured person may have to wrestle with the hospital for first priority, as seen in the Texas Supreme Court case styled, Bashara v. Baptist Memorial Hospital System, decided in 1985.

Most every person in Grand Prairie, Arlington, Mansfield, Fort Worth, Bedford, Mesquite, De Soto, Duncanville, Weatherford, or anywhere else in the State of Texas, has at one time or another purchased something on credit. Many times when a credit purchase is made a person will have the opportunity to purchase some sort of insurance that will pay the debt in the event that you become disabled or killed before the debt is repaid.

Almost all credit card companies will offer credit life and disability for a few extra dollars each month and charged a fee based on the total amount of the debt due on your credit card. The payment for this insurance is going to be charged and included in your credit card payment. Another place most people will see this type of insurance being offered is with a home purchase. If you do not purchase this option when you purchase the home, you will receive numerous solicitations in the mail offering this insurance to you. Another time a person is almost always requested to purchase this type of insurance is when an automobile purchase is made on credit. If this type of insurance is purchased in a car transaction it is going to be at the point of sale and is usually a lump sum and rolled into the loan for the vehicle.

Texas laws exist to regulate credit life and disability policies in Texas. The chapter of the law dealing with this is cited as the Act for the Regulation of Credit Life Insurance and Credit accident and Health Insurance.

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