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 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.

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.

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.

A Federal Court for the Western District of Texas, Midland/Odessa Division issued an opinion in 2021, that deals with the Texas Prompt Payment of Claims Act (TPPCA).  The style of the opinion is long.  We will call it Woodcrest Capital, LLC, et al v. Zurich American Insurance Company.

The TPPCA is found in Chapter 542 of the Texas Insurance Code.  Chapter 542 of the TIC does not contain a statute of limitations.  District courts in the Fifth Circuit are split on whether a twoyear or fouryear statute of limitations applies to claims brought under Chapter 542, and the Fifth Circuit has not considered the issue.  The dispute is whether the two-year statute of limitations included in Chapter 541 of the TIC or the four-year statute of limitations in Section 16.051 applies to claims arising under Chapter 542.

Plaintiffs contend Defendant violated Section 542.058 when it failed to pay Plaintiffs’ insurance claims within sixty (60) days after receiving all items, statements, and forms requested.  Plaintiffs conclude that their TPPCA claim arises under the statute, not under the Policies; therefore, the contractual limitation does not apply to their TPPCA claim Additionally, Plaintiffs argue the contractual limitation in the Policies does not apply to the TPPCA claim because the language in the Policies suggests that it only applies to claims for breach of duties imposed by the Policies.  The Court agrees with Plaintiffs.

Hee is a 2021, opinion dealing with bad faith claims by an insured and the insurance company efforts to dispose of the bad faith claim via summary judgement.  The opinion is from the Southern District of Texas, Houston Division, and is styled, GeoVera Specialty Insurance Company v. Sam Walker.

The insured is Walker.  The insurance company is GeoVera.  Walker suffered wind damage and a subsequent theft claim.  There are other issues in the case, but only the bad-faith / extra=contractual issues will be looked at here.

Geovera denied the claim and then sued Walker seeking a declaratory judgment that it did not owe any damages to Walker.

The question asked in the title is a good question.  However, it is a hard question to answer.  A 2021, opinion from the Northern District of Texas, Fort Worth Division, lends some insight into how bad faith is analyzed by the courts.  The opinion is styled, Cocanougher Asset No. 3, LLC v. Twin City Fire Insurance Company.

The facts of the case can be read in the opinion and will not be rehashed here.

Twin City filed a motion for summary judgement on the bad faith allegations of the plaintiff.  In deciding the motion in favor of the plaintiff, the court explained how these situations are analyzed.

Life Insurance Claim Denials are getting more and more common.  But, the insurance companies are beginning to jump ahead of the denials and starting to rescind the policies based on their assertion that there were/are misrepresentations in the insurance application.

Statutory Requirements – In addition to common law standards, several statutory provisions regulate an insurer’s ability to avoid coverage based on a misrepresentation by the insured.  These are found in the Texas Insurance Code, Chapter 705.

The statutes provide:

Insurance lawyers are frequently asked, “Can you make the insurance company pay my attorney fees?”

Here is a case from the Southern District of Texas, Houston Division.  The case is styled, Shane and Shannon Richardson v. Liberty Insurance Co.

Most case, over 98%, get resolved short of a trial.  Some cases get dismissed for legal reasons soon after the lawsuit is filed or at the Motion for Summary Judgment stage of the case.  The others reach a settlement.  When a case is settled, the insurance company really doesn’t care how the settlement money is applied.  They are going to pay a certain sum of money and how that money gets distributed, i.e., actual damages, exemplary damages, interest, court costs, or attorney fees is not really important to them.

Life Insurance Lawyers who handle claims denied due to the claim that a misrepresentation was made in the life insurance application must read this 2021, opinion from the Amarillo Court of Appeals.  It is styled, Bertha Arce, Individually And As Representative Of All Others Similarly Situated v. American National Insurance Company.

The deceased insured, Sergio Arce, Jr. took out a policy of life insurance with American.  Within days, Sergio was killed in a car accident and a claim for benefits was made by Bertha Arce (Arce).  American denied the claim based on the assertion that Sergio misrepresented his health condition in the application for the life insurance.

American filed a motion for summary judgment in the trial court which was granted and this appeal followed.

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