Dallas Fort Worth Insurance Lawyer Blog

Fraud In Insurance Cases

June 13, 2010 | Mark S. Humphreys

How does a person in Grand Prairie, Arlington, Mansfield, Aledo, Burleson, Bedford, Euless, Lancaster, Hurst, Fort Worth, or any other city in Texas know when their insurance company or agent is committing fraud? The problem with fraud is that a person usually does not know when it happens.

USLegal defines fraud as an intentional misrepresentation of material existing fact made by one person to another with knowledge of its falsity and for the purpose of inducing the other person to act, and upon which the other person relies with resulting injury or damage. Fraud may also be made by an omission or purposeful failure to state material facts, which nondisclosure makes other statements misleading.

The Texas Supreme Court, in 1977, defined fraud in the case, Stone v. Lawyers Title Insurance Corp., saying:

Insurance Companies And Agents And Negligence

June 12, 2010 | Mark S. Humphreys

How does a person in Grand Prairie, Arlington, Mansfield, Hurst, Euless, Bedford, Fort Worth, Burleson, or anywhere else in Texas know when their insurance agent or insurance company has committed an act of negligence? This is a fair question and maybe this article will give you something to think about.

Insurance companies and insurance agents do not have a general duty to obtain coverage or to make sure the coverge they get for you is adequate. On the other hand though, courts have found insurance companies and insurance agents liable for affirmative misrepresentations, and the courts have stated that an insurance agent who undertakes to procure insurance for someone owes a duty to a client to use reasonable diligence in attempting to place the requested insurance and to inform the client promptly if unable to do so. This was discussed in the Texas Supreme Court case, May v. United Services Association of America, in 1992. Also, this issue was discussed by the Court of Appeals in Houston, in the 1999 case, Frazer v. Texas Farm Bureau Mutual Insurance Company. In Frazier the court allowed Frazier to go forward with his claim against Texas Farm Bureau Insurance Company and his agent where it is alleged he asked his agent to raise his coverage limits and the agent failed to do so.

The Texas Supreme Court in the case, Kitching v. Zamora, in 1985, stated an agent has a duty to keep the customer informed about the insurance policy’s expiration date when the agent receives information pertaining to the expiration date that is intended for the customer. This was restated by the Texas Court of Appeals of Amarillo, in 1992, in the case Horn v. Hedgecoke Insurance Agency.

Mistake In A commercial Insurance Policy

June 10, 2010 | Mark S. Humphreys

Business people in Bedford, Colleyville, Grand Prairie, Arlington, Hurst, Euless, Fort Worth, or anywhere else in Texas will sometimes have mistakes in their commercial insurance policy. How do courts look at these situations?

The United States District Court, Northern District of Texas, Dallas Division, issued an opinion on a case May 26, 2010, where this was the issue. The opinion was issued by Judge Ed Kinkeade. The style of the case is Park Place Motorcars Mid Cities Ltd., and Park Place Motorcars of Texas, Inc. v. Affiliated FM Insurance Company.

The facts in this case are this: Park Place Motorcars Mid Cities Ltd. and Park Place Motorcars of Texas, Inc. (Park Place) operate a Mercedes dealership in Bedford, Texas, selling new and used vehicles. Park Place insured its motor vehicle inventory through two policies — a “dealer open lot” policy and a “floored” policy, both of which were provided by other insurance companies. Affiliated FM Insurance Company (FM) provided coverage to Park Place for physical loss or damage to insured property and for business interruption loss for such insured property, subject to all policy terms, conditions, limitations and exclusions (the “Policy”).

Lawsuit Against Homebuilders

June 8, 2010 | Mark S. Humphreys

What if your home is defective? If you live in Grand Prairie, Arlington, Sasche, Plano, De Soto, Azle, Aledo, or anywhere else in Texas and you have problems with your home, you may ask the same question.

The Miami Herald ran an article on May 28, 2010, reporting where a class-action lawsuit had been filed against numerous homebuilders for using Chinese drywall in the construction or remodeling of their homes. The title of this article is, Chinese Drywall Lawsuit Gets Class-action Status. As many as 152 families from three neighborhoods in Homestead, Florida, will be part of the first class-action lawsuit in the country over tainted drywall imported from China.

The drywall is made by Knauf Plasterboard Tianjin, and has been reported on extensively after it was used in repairs following hurricanes along the Gulf Coast region of the United States. These builders will be sued under the Deceptive Trade Practices Act and other causes of action including fraud and breach of contract.

Interpreting Policy Language In Texas

June 6, 2010 | Mark S. Humphreys

Commercial insurance policies are commonly issued to business people in the Dallas, Fort Worth area, and through out the state. Even business owners in Grand Praire, Arlington, or out in Weatherford, will have one of these policies. When a claim is made, there is often times a dispute as to the coverage provided in the policy.

The Court of Appeals of Texas, Houston (14th Dist.), decided a case on May 20, 2010, that does a pretty thorough job going thru an analysis of how these cases are looked at by the courts. The decision was handed down by Chief Justice, Adele Hedges. The style of the case is Essex Insurance Company v. Eldridge Land, L.L.C.

Some of the facts are that Eldridge Land L.L.C. (Eldridge) owned a vacant building. They had purchased a commercial property insurance policy from Essex Insurance Company (Essex). The policy contained a clause providing for damage “caused by or resulting from theft,” and an exception to the theft damage exclusion for “damage caused by the breaking in or exiting of burglars.” The relevant language was:

A Texas Commercial Policy Dispute

June 3, 2010 | Mark S. Humphreys

Let’s say a guy in Grand Prairie, Arlington, De Soto, Mansfield, Fort Worth, or any other place in Texas hires a contractor to reroof his property. Next, someone gets injured. Is there coverage for the injured person’s injuries?

The answer is the typical “it depends.” In the case, Atlantice Casualty Insurance Company v. PV Roofing Corp., et al. Horatio Gonzalez (Horatio) was injured when a ladder he was moving hit an electrical line. This case was decided by Stephen Wm. Smith, United States Magistrate Judge, U.S. District Court, S.D. Texas, Houston Division, on May 20, 2010.

In this case, PV Roofing was the roofing contractor on the job site. PV hired an independent contractor, Bernardo Mejia, to complete the roofing job. On the day of the incident, Mejia went to the job site to do a final inspection and took Horatio with him. Horatio was not paid by either PV or Mejia for any servies in connection with the roofing job.

Underinsured Motorist Coverage In Texas Commercial Policies

June 2, 2010 | Mark S. Humphreys

What if someone in Grand Prairie, Arlington, Duncanville, Mansfield, Burleson, Weatherford, Fort Worth, or some other city in Texas is involved in an accident, as an employee, with an underinsured driver? Does the employers underinsured portion of their insurance policy provide coverage?

This was the issue in a May 12, 2010 case decided by District Judge, T. John Ward, of the United States District Court, E.D. Texas, Marshall Division. The style of the case is, Dean and Parwana Amanzoui, Individually and as next friends of Fahim Amanzoui and Sabrina Amanzoui v. Universal Underwriters Insurance Company.

In this case, Parwana Amanzoui (Parwana) was riding in an automobile driven by her husband, Dean Amanzoui, and owned by her husband’s employer, the Huffines Automotive Group (Huffines). At the time of the accident, Huffines carried its insurance with Universal Underwriters Insurance Group (Universal) pursuant to a multiple coverage policy. Coverage under the policy for underinsured motorist (UIM) was limited. “Insureds” for purposes of UIM coverage was expressly limited to three categories of persons: (1) persons designated on the declarations as subject to the UIM policy, (2) family members of persons designated in the UIM policy, and (3) persons occupying vehicles driven by someone falling within category no. 1 or no. 2. It was uncontested that Parwana was not included in this list.

Texas Policies And Out Of State Policies?

May 31, 2010 | Mark S. Humphreys

Policyholders in Arlington, Aledo, Farmers Branch, Grand Prairie, De Soto, Lancaster, Fort Worth, Mansfield, Weatherford, or any other town in Texas might have the following question. What happens if I am in an accident when I am out of state? Or they might ask, what happens when someone from out of state has an accident with me in Texas when they are at fault?

Let’s consider the last question first. What happens when someone from out of state has an accident in Texas when that out of state person is at fault in the accident? The only part of an extensive answer to this question that is relevant is this:

In a state like Oklahoma, who has minimum policy limits that are less than the minimum limits in Texas, what happens. The Texas Transportation Code, Section 601.001 et seq. sets the minimum liability limits in Texas at $25,000 per person or $50,000 per incident on the bodily injury portion of an automobile policy. The State of Oklahoma has limits as low as $15,000 per person. When someone is driving in Texas with an automobile insurance policy issued from some state other than Texas, the minimum limits in Texas apply. This is the case regardless of the fact that the Oklahoma policy clearly says the minimum limits are $15,000. Other differences are not relevant or, are not going to arise very often.

Lawsuits Involving Underinsured/Uninsured Coverage And The Responsible Third Party

May 30, 2010 | Mark S. Humphreys

A policyholder in Weatherford, Fort Worth, Grand Prairie, Arlington, Mansfield, Colleyville, Newark, or any other city in Texas could find themselves in a position where they are having to sue their underinsured/uninsured (UIM) insurance company. And at the same time, they might be having to sue the person with whom they had the accident with.

When the other driver, who caused an accident, has to be sued and that person does not have insurance or does not have enough insurance to cover the damages you have sustained, most experienced Insurance Law Attorneys will tell you to sue both the driver and your own insurance company at the same time rather than having to incur the time and expense of two separate lawsuits. When this becomes necessary there are usually several options about where the lawsuit can be filed. Choosing the best county to file a lawsuit can often times make a big difference as to the value of the case.

The Texas Civil Practice & Remedies Code, Section 15.002, cites the general rules governing where a lawsuit can be filed. Sometimes the options are limited, but other times there are many options and when a lawsuit is filed the attorney filing the lawsuit will want to file in a county where the best results are possible. In contrast, the person being sued will make efforts to get the lawsuit transferred or moved to a county they believe is more favorable to themselves, or as it relates to insurance, a county more favorable to the position the insurance company will be taking.

Personal Injury Protection (PIP) And Liability Coverage In Texas Automobile Insurance Policies

May 29, 2010 | Mark S. Humphreys

Policyholders in Grand Prairie, Arlington, Mansfield, Fort Worth, Weatherford, Aledo, Azle, or any other city in Texas who have one of the coverages listed above would want to know how those coverages work if they are in a situation where the coverages may apply. A case decided by the Texas Supreme Court in 1999, gives some insight into how these types of claims are handled.

The court actually decided two cases together. They are Mid-Century Insurance Company of Texas v. Jack Kidd, and the other is Nationwide Mutual Insurance Company v. Catherine Gerlich.

The issue in both cases revolved around how PIP benefits were paid when a claim was being made against the liability portion of the same policy.