It is often times very difficult to answer the titled question.  When there us uncertainty as to who is entitled to life insurance proceeds there is a process by which the life insurance company can “interplead” the life insurance proceeds into the registry of the Court.  These are situation where the life insurance company knows they owe the life insurance money because the insured has died.  What they sometimes don’t know is, who is entitled to the money.  This interpleader process allows those who believe they may have an interest in the proceeds to litigate their respective interests.

This issue was presented in a 2022 opinion from the Northern District of Texas, Dallas Division.  The style of the case is Sun Life Insurance Company of Canada v. Elizabeth McKinney, Tisha Diante, and Teresa Morris.

Here, Sun Life knew they owed the life insurance proceeds to someone, but was not sure who.  After filing a lawsuits to interplead the money, the life insurance company must serve the potential beneficiaries with legal papers so that they may come to court and litigate between themselves as to who is entitled to the proceeds.  In this case, Sun Life was having difficulty locating McKinney to have her served with the legal papers.

Bad Faith insurance claims are common complaints when dealing with claims being denied.  When fighting these cases a common tactic is to sue the adjuster for the wrongs the adjuster did in causing the claim to be denied.  When suing an adjuster the insurance company is going to always claim that the adjuster is not a proper party to be sued in the case.  The relevance of whether the adjuster is sued or not often determines whether the case will be litigated in a State Court or in Federal Court.

Properly suing an adjuster was discussed in this 2022 opinion from the Northern District of Texas, Dallas Division.  The case is styled, Art Dallas, Inc. v. Federal Insurance Company and Derek Franks.

In this case, ADI made a claim for wind and hail damage.  The insurance company, Federal, sent it’s adjuster, Franks, to inspect the claim.  Franks determined the damage from wind and hail was minimum and that the roof damage was due to “wear and tear.”

Bad Faith Insurance Lawyers understand the law in Texas, at least as of the date of this post, requires that an insurer show that any misrepresentation made in an application for insurance be shown to have been made intentionally for the insurance company to be able to rescind the policy based on that misrepresentation.

This issue came up in a 2022, case from the Fort Worth Court of Appeals.  The case is styled, Maria Robles, J.S. and Jose Almaguer Vazquez v. Cox Insurance Group, LLC and Old American County Mutual.

This is an appeal from a summary judgment granted in favor of the insurer by the trial court.

Insurance claims lawyers are well aware that insurance companies prefer to litigate in Federal Court.  Proper pleading can often times prevent a case from being litigated in Federal Court.  Usually suing the adjuster who handled the claim will prevent removal to Federal Court.  The key is properly pleading claims against an adjuster.

This is discussed in a 2022, opinion from the Northern District of Texas, Dallas Division.  The style of the case is, Jackie Preston v. Nationwide Property & Casualty Insurance Company; Stevie Bruesewitz; and Matthew Vaughters.

Preston sustained damage to her property in 2019.  Nationwide was her property insurer and thus, Preston made a timely claim to Nationwide.  Preston became frustrated with Nationwide’s handling of her claim and sued Nationwide and the two adjusters, Stevie and Matthew.

Life Insurance Lawyers know that just as there may be disputes whether coverage took effect before the insured died, there may also be disagreements over whether coverage terminated before the insured’s death.  This is illustrated in a 1979, Fort Worth Court of Appeals opinion styled, Leach v. Eureka Life Ins. Co. of America.

This case is an appeal from a court ruling against Leach after she filed suit against Eureka.  The life insurance policy at issue was a Credit Life Insurance policy.  The policy was to pay the remaining balance of a loan in the event the insured died before the loan was paid or September 13, 1977.  The insured, Tommy Leach, was killed in a car accident at or around September 13, 1977.  There were no witnesses.  The death certificate for Tommy Leach shows the time of injury and death as 12:45 a.m., September 14, 1977.

The insurance company alleged that Leach was killed September 14, 1977.

Life insurance attorneys will run into a surprising amount of cases that are unique unto themselves.  This case is that way.  The Facts are long but need to be understood to understand how the Court ruled the way it did.  This is a 1959 opinion from the Texas Supreme Court.  It is styled, Republic Nat. Life Ins. Co. v. Hall.

Ms. Hall sued Republic after Republic denied her claim for life insurance benefits for the stated reason that the contract was never completed.

There has not been any material dispute about the facts, which in substance are as follows: The deceased, who resided in California but was President of Weatherford Manufacturing Co., of Weatherford, Texas, made application at Weatherford in the latter part of March 1949, for a twenty-year-payment type of policy in the amount of $20,000 through a Mr. Coder, the local soliciting agent of petitioner, on petitioner’s usual printed form, which Mr. Hall, of course, signed.  At that time, Mr. Hall was 36 years old, and was evidently understood by himself and the soliciting agent to be in some undetermined degree “overweight” from a life-underwriting standpoint, so as probably to require of him a premium higher in some unknown amount than that of approximately $640 per year, which was normal for an applicant of his age.  The agent testified that he told Mr. Hall, “I didn’t know what the rate would be; that it would have to be a special rate case.” At the same time he testified as follows:  “Q. What did George (Mr. Hall) tell you in response to that; he told you he wanted the insurance?  A. Yes; I told him that was what we could get.”  Mr. Hall’s secretary was allowed to testify that on the date of the application and in the presence of the agent, Mr. Hall told her that he was going on a trip to the West, wanted insurance and that “when these policies came in I was to put them in the safe.”  (A “group” policy was also involved in the negotiations but not in this suit.)  Previously to these transactions, Mr. Hall had been negotiating with another company than petitioner and had been quoted an annual premium rate of $40 per $1,000 of insurance but had evidently gone no further with these negotiations, and told petitioner’s agent, “I want you to beat that other man’s premium.”  It was also understood between Mr. Hall and the petitioner’s agent that, Hall being a licensed airplane pilot, accustomed to fly the plane of his company on business trips, the insurance would include coverage for death suffered in any such flight, the additional premium for such coverage being an amount evidently not subject to variation and Hall having executed contemporaneously with his application the usual company form questionnaire describing his flying activities.

Insurance agent misrepresentations are not always held against the insurance company, but most the time the agents misrepresentations are held against the insurance company.  A 1979 opinion from the Texas Supreme Court is a good illustration of the company being liable for the misrepresentations of the agent.  The opinion is styled, Royal Globe Ins. Co. v. Bar Consultants, Inc.

Bar Consultants operated a bar near the University of Texas known as “The Bucket.”  The president of Bar Consultants, John Barber, testified that he purchased a policy of insurance from Tully Embrey, an agent of Royal Globe.  The policy contained a vandalism and malicious mischief endorsement.  Barber testified that he had a lengthy discussion with Embrey about the problem of vandalism at which time Embrey assured him that he was “totally covered” from losses caused by vandalism.  This testimony was uncontradicted.

After extensive damage to an area of the bar, a claim was filed and Royal Globe eventually denied the claim.  A lawsuit was filed and a trial found in favor of Bar Consultants.

Insurance agent liability is an issue for Insurance Law Attorneys to be know about when investigating a case.  A 2004, opinion from the United States 5th Circuit provides some input on how to look at cases that might involve wrongs by the insurance agent.  The opinion is styled, Hornbuckle v. State Farm Lloyds.

This is a claim on a homeowners policy wherein a claim was made for benefits and the adjuster assigned to the claim, Kirkpatrick, along with State Farm was sued for mishandling the claim.  The case was filed in State Court and removed to Federal Court by State Farm, after which Hornbuckle filed a Motion to Remand.  State Farm claimed Kirkpatrick was sued for the sole purpose of defeating diversity jurisdiction and asserted that no independent causes of action were viable against Kirkpatrick.  The facts are worth reading, however the focus here is how the Court viewed the case.

In the opinion the Court states that Hornbuckle fails to bring forward any substantial evidence to support a claim against Kirkpatrick.  Contrastingly, with their notice of removal and in their response to the motion to remand, the Hornbuckle’s attach, among other things, the entire Hornbuckle deposition and other summary judgment type evidence, and assert that removal was proper because Kirkpatrick was fraudulently joined in that there was no arguably reasonable basis for predicting Hornbuckle could recover against him, and that in any event, removal was objectively reasonable.

Insurance claims that are denied caused the insured to incur attorney fees unless they are going to accept the denial.  So, how do Judges look at attorney fees?  This is answered in a 2021 opinion from the Northern District of Texas, Dallas Division.  The opinion is styled, Linda Veach v. State Farm Lloyds.

Veach sued State Farm under her homeowner’s property insurance policy, claiming she suffered damage to her roof after a storm.  State Farm sent out an adjuster who decided Veach had only suffered minimal damage to her roof.

Veach sued State Farm for breach of contract and numerous violations of the Texas Insurance Code, the Texas DTPA, and breach of the duty of good faith and fair dealing.

Insurance lawyers try to evaluate the value of a claim when talking with a prospective new client.  Guess what?  Federal Judges do the same with cases removed to their Court from the State and County Courts.  This is seen in a 2021 opinion from the Southern District of Texas, McAllen Division.  The opinion is styled, Macario Saenz v. State Farm Lloyds.

This is a dispute over the amount of damage resulting from a hurricane claim between Saenz and State Farm.

A lawsuit was filed in State Court and State Farm removed the case to Federal Court pursuant to 28 U.S.C., Section 1332, based on the amount in controversy exceeding $75,000.  Saenz filed a motion to remand.

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