Dallas Fort Worth Insurance Lawyer Blog

Fort Worth Insurance Denial Case

November 6, 2021 | Mark S. Humphreys

Here is a case that originated in a Fort Worth State District Court that insurance attorneys need to read. The opinion is from the Northern District of Texas, Fort Worth Division. It is styled, Yolonda Carney v. Allstate Vehicle And Property Insurance Company et al.

The facts of the case are undisputed. This is claim by a homeowner, Yolonda, against her insurance company, Allstate, for hail damage. Yolonda sued Allstate and the adjuster, after Allstate failed to respond to respond to a demand letter. Yolonda filed a lawsuit against both of them in the Fort Worth State Court. Allstate removed the case to this Federal Court and simultaneously elected to assume the adjuster’s liability in connection with insurance code claims against him. Allstate contends that the adjuster is improperly joined due to Allstate accepting liability for the adjuster.

Title 28 U.S.C. Section 1441(a) permits the removal of “any civil action brought in a state court of which the district courts of the United States have original jurisdiction.”

Insurance Claims Denial – Federal Court

November 1, 2021 | Mark S. Humphreys

Insurance lawyers learn real quick the difference between a case being litigated in Federal Court versus State Court. This is illustrated in a 2021 opinion from the Western District of Texas, San Antonio Division. It is styled, Craig Janssen v. Allstate Vehicle & Property Insurance Company.

This is a claim for damages to Janssen’s property caused by a hailstorm. Janssen asserts that he suffered damages, that Allstate is his insurer, and that after filing a claim, Allstate failed to properly inspect, investigate, and assess damages and wrongfully denied and underpaid the covered damages. Janssen filed a lawsuit in State Court for various violations, including damages under the Texas Insurance Code, Section 541.060 and Section 542. Allstate had the lawsuit removed to Federal Court.

Federal Rule of Civil Procedure 8, requires that a Defendant be given fair notice of the claim and the grounds upon which the plaintiff relies. To satisfy this pleading requirement, at a minimum, a plaintiff must provide a short and plain statement of each cause of action asserted to show entitlement to relief under Rule 8(a)(2). This pleading standard does not require detailed factual allegations but does demand more than conclusory allegations of wrongdoing.

Life Insurance Denial – Incontestability

October 30, 2021 | Mark S. Humphreys

Life Insurance Lawyers have many potential clients where in the basis for denial of the claim is that insured made a misrepresentation in the policy application within two years of making the application. This two years is called the contestability period. After two years the policy is supposed to be incontestible. The Southern District of Texas, Houston Division, issued an opinion in September 2021, wherein one of the issues dealt with the incontestability period. The style of the opinion is, Pruco Life Insurance Company v. Blanca Monica Villarreal and Transamerica LIfe Insurance Company v. Blanca Monica Villarreal.

In this case, the insured had purchased two very large life insurance policies from the Pruco and Transamerica. The details of the case can be read in the opinion as can the other issues presented. Discussed here is the issue of Incontestability.

Villarreal moved for partial summary judgment on this issue that the policies are incontestable on that basis that under Texas law, insurance policies cannot be contested after remaining in effect for two years during the insured’s life. Villarreal argues that even if Texas law permits insurers to raise a material and intentional misrepresentation defense after the two years, that challenge would not apply here because the life insurance policies did not contain the language reserving the right to raise the challenge. Additionally, Villarreal argues that the defense would apply only if the insured (Rosendi) was residing in Texas “during the term of his life insurance policies.” The insurers oppose on the basis that an exception to incontestability exists when an insurer can prove material and intentional misrepresentations and that the exception applies to Rosendi’s life insurance policies because he was “in” Texas when he contracted for the policies
and when the policies were delivered to him.

Life Insurance Claim Denial – Rescission

October 25, 2021 | Mark S. Humphreys

Here is a life insurance case wherein the insurance company attempts to have the Court agree to rescission of the policy. It is a 2021, opinion from the Southern District of Texas, Houston Division. The opinion is styled, Pruco Insurance Company v. Blanca Monica Villarreal – Transamerica Life Insurance Company v. Blanca Monica Villarreal.

This opinion regards both sides filing motion for summary judgement. The case involves millions of dollars of life insurance. The facts of the case are long and detailed and the opinion should be read to understand the facts. The case also deals with many issues. The issue discussed here has to do with rescission.

The insurer claim there are undisputed facts that show material, intentional misrepresentations made in the application for insurance, warranting rescission as a matter of law. A material fact is one that might affect the outcome of the suit
under governing law,” and “a fact issue is genuine if the evidence is such that a reasonable jury could return a verdict for the non-moving party.

Insurance Lawyers And The Texas Insurance Code

October 23, 2021 | Mark S. Humphreys

Insurance lawyers need to be keeping up with the way courts are interpreting the new Texas Insurance Code, Section 542A. This is discussed in this 2021 opinion from the Northern District of Texas, Amarillo Division. The opinion is styled, Ashlee Green v. Allstate Vehicle and Property Insurance Co.

Here, Plaintiff had a property coverage policy with Allstate and alleges she suffered damage caused by a severe storm. The adjuster, Steven Buchert, found $4,005.17 of damages while Plaintiff seeks damages that totals to $46,472.15. A lawsuit was filed in State Court suing Allstate and Buchert for various violations of the Texas Insurance Code, Chapters 541 and 542.

Allstate filed its Written Notice of Election of Legal Responsibility for Agent pursuant to Section 542A.006, accepting liability for Buchert’s actions or omissions related to the case. The state court dismissed Buchert with prejudice and Allstate filed it’s notice of removal.

Insurance Lawsuits – Extending Deadlines

October 18, 2021 | Mark S. Humphreys

Here is a 2021, opinion from the Northern District of Texas, Dallas Division, wherein the insurance company missed a deadline and tried to excuse the mistake. The styled of the opinion is, Aldo Cueller v. Safeco Insurance Company of Indiana.

Aldo sued Safeco in state court for breach of contract and various violations of the Texas Insurance Code after Safeco denied Also’s claim for water damage to is property. After the deadline for removal passed, Safeco filed a Notice of Removal and Aldo responded with a Motion to Remand arguing the removal was untimely.

Aldo filed the suit on May 25, 2021, and served Safeco’s registered agent in Texas on June 4, 2021.

Insurance Lawsuits – What Can You Learn?

October 16, 2021 | Mark S. Humphreys

Insurance lawyers can listen to a client’s perspective on what happened in a claim but often times will not understand the extent of wrong doings by an insurer until a lawsuit has been filed and the discovery process completed. In this regard, exactly what is discoverable in a lawsuit?

The areas and information that can be discovered in a lawsuit will vary with each situation. The Beaumont Court of Appeals issued an opinion in 2021, that touches on this issue of “what is discoverable.” The opinion is styled, In Re Liberty Insurance Corporation.

In the lawsuit, the insureds, Michael and John Young, sued their insurer, Liberty Insurance Corporation, for various violations of the Texas Insurance Code arising out of a pipe burst that caused damage to their home.

Insurance Trial Lawyer

October 11, 2021 | Mark S. Humphreys

Insurance lawyers can read this opinion to find out, exactly what Not to do in a trial. This 2021, opinion is from the San Antonio Court of Appeals. The opinion is styled, Sarah Friend Neutze v. Texas Farmers Insurance Company and James ‘Doug’ Wasson, II.

What this case teaches is what Not to do. That is, do not waive the right you to have a record made of the proceeding.

Neutze sued Farmers on a homeowners claim concerning tornado damage to to her property. Farmers is alleged to have delayed in making payments and refused to make some payments. Neutze eventually sued alleging breach of contract, violations of the Texas Insurance Code and violations of the Texas Deceptive Trade Practices Act.

Appraisal And Delays In Paying A Claim

October 9, 2021 | Mark S. Humphreys

The United States 5th Circuit Court of Appeals issued an opinion on August 12, 2021, that is noteworthy for Insurance Law attorneys. The opinion is styled, Randy Randel; Debra Randel v. Travelers Lloyds of Texas Insurance Company.

After a fire at their home, the Randels filed a claim for benefits from their home insurance company, Travelers. Eventually the parties agreed to an appraisal and the appraisal award was closer to the Randel’s view of the damages. Travelers had already paid an amount they thought was proper. After the appraisal Travelers paid the full appraisal amount.

The Randels brought suit against Travelers for breach of contract and violation of the Texas Prompt Payment of Claims Act. The breach of contract claim was denied by the Court but the Texas Prompt Payment of Claims violation went forward in the lawsuit.

Hail Damage Claims – You Have To Prove The Damages

October 2, 2021 | Mark S. Humphreys

Here is a 2021, opinion from the Western District of Texas, San Antonio Division, where the insured made a claim for hail damage against its insurer but did virtually nothing to prove the damage was caused by hail. The style of the case is, 343 West Sunset, LLC v. Seneca Insurance Company, Inc.

In this case, 343 made a claim for hail damages. The date listed for the hail damage was the last date for which there was coverage and it was undisputed that there was no hail storm on that date.

The Court spells out the problems with this claim and why the court is granted summary judgment in favor of Seneca.