Dallas Fort Worth Insurance Lawyer Blog

Insurance Claim Denial And Attorney Fees

February 5, 2022 | Mark S. Humphreys

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 Claim Denial And Amount In Controversy

January 31, 2022 | Mark S. Humphreys

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.

Life Insurance Claim Denial – Pham IV

January 29, 2022 | Mark S. Humphreys

Here is a life insurance claim denial that is interesting factually and legally, and a must read for lawyers handling life insurance claims. This is a case handled by the Law Office of Mark S. Humphreys.

The opinion is a December 10, 2021, summary judgment ruling from the Northern District of Texas, Dallas Division. It is styled, Pham v. TransAmerica Premier Life Insurance Company. Johnny Pham sues in his own right and Kim Van Bui sues on behalf of minor children SKB and BDB.

This case has been presented in multiple blogs with this being the last.

Life Insurance Claim Denial – Pham III

January 24, 2022 | Mark S. Humphreys

Here is a life insurance claim denial that is interesting factually and legally, and a must read for lawyers handling life insurance claims. This is a case handled by the Law Office of Mark S. Humphreys.

The opinion is a December 10, 2021, summary judgment ruling from the Northern District of Texas, Dallas Division. It is styled, Pham v. TransAmerica Premier Life Insurance Company. Johnny Pham sues in his own right and Kim Van Bui sues on behalf of minor children SKB and BDB.

This case will be presented in multiple blogs.

Life Insurance Claim Denial – Pham II

January 22, 2022 | Mark S. Humphreys

Here is a life insurance claim denial that is interesting factually and legally, and a must read for lawyers handling life insurance claims. This is a case handled by the Law Office of Mark S. Humphreys.

The opinion is a December 10, 2021, summary judgment ruling from the Northern District of Texas, Dallas Division. It is styled, Pham v. TransAmerica Premier Life Insurance Company. Johnny Pham sues in his own right and Kim Van Bui sues on behalf of minor children SKB and BDB.

This case will be presented in multiple blogs.

Life Insurance Claim Denial – Pham I

January 17, 2022 | Mark S. Humphreys

Here is a life insurance claim denial that is interesting factually and legally, and a must read for attorneys handling life insurance claims. This is a case handled by the Law Office of Mark S. Humphreys.

This is a December 10, 2021, opinion from the Northern District of Texas, Dallas Division. It is styled, Pham v. TransAmerica Premier Life Insurance Company. Johnny Pham sues in his own right and Kim Van Bui sues on behalf of minor children SKB and BDB.

This case will be presented in multiple blogs.

ERISA And Promissory Estoppel

January 15, 2022 | Mark S. Humphreys

The Employee Retirement Income Security Act of 1974 (ERISA) applies to a lot of employer benefit plans. Each of these cases need to be examined by looking at the wording of the plan and the facts of the case.

A 2021 opinion from the Northern District of Texas, Dallas Division, is a good opinion to look at when there is a cause of action for Promissory Estoppel. The style of the case is, Medarc, LLC vs. Meritain Health, Inc.

Promissory Estoppel is the legal principle that a promise is enforceable by law, even if made without formal consideration when a promisor has made a promise to a promisee who then relies on that promise to his subsequent detriment.

ERISA And Abuse Of Discretion

January 10, 2022 | Mark S. Humphreys

ERISA stands for Employee Retirement Income Security Act of 1974. The way ERISA cases are handled is unique from a legal perspective. This is illustrated in a 2021, opinion from the Eastern District of Texas, Sherman Division. The opinion is styled, Carol Sue Allen, Et Al. v. Sherman Operating Company, LLC.

This is an appeal from a Magistrate’s summary judgment ruling in favor of Sherman.

Allen was injured at work. She made a claim for disability benefits under a plan provided by her employer, which is an ERISA plan. Her claim for benefits was denied by the plan administrator. She filed suit alleging various causes of action. The cause of action discussed here has to do with her assertion there were violations of the ERISA plan. She claims the plan administrator abused its discretion when her clam for benefits.

Life Insurance Claims Denied Based On A Misrepresentation

January 8, 2022 | Mark S. Humphreys

Life Insurance lawyers have to know this case. It is an opinion that has been discussed here recently. The opinion was issued on November 10, 2021, by the United States Fifth Circuit and is styled, Mirna Guzman v. Allstate Assurance Company.

Saul Guzman died after suffering a seizure at age 28. Mirna, his wife and beneficiary file to collect on a life insurance policy issued by Allstate. Allstate denied the claim. A lawsuit was filed and the local district court granted summary judgment in favor of Allstate. This Court reverses that decision.

When applying for the insurance policy, Saul disclosed his history of seizures but denied using tobacco or nicotine products.

Bad Faith Insurance – How Do You Get There

January 3, 2022 | Mark S. Humphreys

Lawyers handling insurance claims that have been denied frequently have a conversations with clients about “bad faith” insurance. Bad faith, generally speaking, often times centers around whether or not an insurance company has committed a fraud.

If allegations of fraud are going to be alleged, insurance lawyers need to understand that those claims that end up in a Federal Court are subjected to a higher pleading standard than those claims that are litigated in State or County Courts. This is illustrated in a 2021, opinion from the Southern District of Texas, Galveston Division. The opinion is styled, Smiley Team II, Inc. v. General Star Insurance Company.

Smiley made a claim against General Star after a vehicle was alleged to have crashed into Smiley’s building. A lawsuit was eventually filed containing allegations that General Star failed to properly adjust the claim which resulted in an alleged underpayment of the claim.