For Insurance Lawyers handling claims caused by “Mother Nature” it is important to understand Texas Insurance Code, Section 542A.  This is a specific section for claims related to hail damage, tornados, hurricane’s, etc.  As it relates to attorney fees on this type of claim the Southern District of Texas, Houston Division, issued an opinion in June 2024, that needs to be read and understood.  The opinion is styled, Carole Baker v. American Economy Insurance Company.

In January 2023, Carole Baker’s home and contents suffered storm damage.  She filed an insurance claim with American, which had issued her homeowner’s policy, to recover her covered losses.  American sent two independent companies to inspect the residence and analyze mitigation and buildback costs.  Following these inspections and the reports on the estimated costs, American paid Baker in accordance with these estimates.

In a series of emails from May to July 2023, Baker contacted American with her own estimates of mitigation and buildback costs based on quotes from a different inspector.  Baker asked American to supplement its preceding payment based on the estimates from her own inspector.  Baker also asked American to reopen her claim for damage to her roof, which had previously been denied.   American sent Baker a revised repair estimate and made an additional payment based on the estimate she submitted.

Life insurance and a subsequent divorce will present problems, one of which was addressed by the United States 5th Circuit Court of Appeals.  This is a June 2024, opinion styled, Transamerica Life Insurance Company v. Holly L. Moore versus Jeffrey H. Simpson.

Texas Family Code, section 9.301 generally operates to strip “the insured’s spouse” of beneficiary interests in insurance policies once a divorce decree renders the policy beneficiary an ex-spouse.  This case turns on whether “the insured’s spouse” includes someone who was named a policy beneficiary before she became the insured’s spouse: Ian Simpson took out a life insurance policy and named his fiancée Holly Moore primary beneficiary and his father Jeffrey Simpson contingent beneficiary.  The couple then married, then divorced, and then Ian died without ever changing the policy beneficiaries.

The district court held that section 9.301 comes into play only if the insured and the beneficiary were married when the insurance policy was purchased.  The court reasoned that because a policy purchased prior to marriage did not name “the insured’s spouse,” a later divorce decree would not divest the beneficiary of insurance proceeds.  But section 9.301’s text indicates that “the insured’s spouse” centers on an individual’s status at the time a divorce decree is rendered, regardless of when a policy was first obtained.  Therefore, the Court reversed the district court’s judgment awarding Ian’s policy proceeds to Holly and rendering judgment in favor of Jeffrey Simpson.

he question presented here is in the title.  If the named beneficiary of a life insurance policy causes the death of the insured, does the beneficiary still get the life insurance proceeds.
The Texas Slayer’s Rule is found in the Texas Insurance Code, Section 1103.151.  It says:
Sec. 1103.151. FORFEITURE. A beneficiary of a life insurance policy or contract forfeits the beneficiary’s interest in the policy or contract if the beneficiary is a principal or an accomplice in wilfully bringing about the death of the insured.

There are situations where the person named as a beneficiary under a life insurance is responsible for the death of the named insured.  It doesn’t seem right that the person who kills an insured should be able to recover the life insurance benefits.  Well, it isn’t fight and there is a law to prevent that from happening.
The Slayer’s Rule is found in the Texas Insurance Code, Section 1103.151.  It says:
Sec. 1103.151. FORFEITURE. A beneficiary of a life insurance policy or contract forfeits the beneficiary’s interest in the policy or contract if the beneficiary is a principal or an accomplice in wilfully bringing about the death of the insured.

In the previous post, Texas Family Code, Section 9.301 is cited for the way Texas, and most other states, handles how an ex-spouse beneficiary are treated regarding a designation of beneficiary in a life insurance policy.  It important to know that when the life insurance policy is a policy governed by the Employee Retirement Income Security Act of 1974 (ERISA) that ERISA pre-empts state law rules regarding life insurance polices and divorce.  This is pointed out in the 2001, United States Supreme Court opinion styled, Egelhoff v. Egelhoff.  Note, that while this opinion discusses Washington State law, that the results would be the same for Texas.
While David A. Egelhoff was married to petitioner, he designated her as the beneficiary of a life insurance policy and pension plan provided by his employer and governed by ERISA.  Shortly after petitioner and Mr. Egelhoff divorced, Mr. Egelhoff died.  Respondents, Mr. Egelhoff’s children by a previous marriage, filed separate suits against petitioner in state court to recover the insurance proceeds and pension plan benefits.  They relied on a Washington statute that provides that the designation of a spouse as the beneficiary of a nonprobate asset-defined to include a life insurance policy or employee benefit plan-is revoked automatically upon divorce.  Respondents argued that in the absence of a qualified named beneficiary, the proceeds would pass to them as Mr. Egelhoff’s statutory heirs under state law.  The trial courts concluded that both the insurance policy and the pension plan should be administered in accordance with ERISA, and granted petitioner summary judgment in both cases.  The Washington Court of Appeals consolidated the cases and reversed, concluding that the statute was not pre-empted by ERISA.  The State Supreme Court affirmed, holding that the statute, although applicable to employee benefit plans, does not “refer to” or have a “connection with” an ERISA plan that would compel pre-emption under that statute.
ERISA’s pre-emption section, 29 U. S. C. section 1144(a), states that ERISA “shall supersede any and all State laws insofar as they may now or hereafter relate to any employee benefit plan” covered by ERISA.  A state law relates to an ERISA plan “if it has a connection with or reference to such a plan.”  To determine whether there is a forbidden connection, the Court looks both to ERISA’s objectives as a guide to the scope of the state law that Congress understood would survive, as well as to the nature of the state law’s effect on ERISA plans.  Applying this framework, the state statute has an impermissible connection with ERISA plans, as it binds plan administrators to a particular choice of rules for determining beneficiary status.  Administrators must pay benefits to the beneficiaries chosen by state law, rather than to those identified in the plan documents. The statute thus implicates an area of core ERISA concern, running counter to ERISA’s commands that a plan shall “specify the basis on which payments are made to and from the plan,” section 1102(b)(4), and that the fiduciary shall administer the plan “in accordance with the documents and instruments governing the plan,” section 1104(a)(1)(D).  The state statute also has a prohibited connection with ERISA plans because it interferes with nationally uniform plan administration.  Administrators cannot make payments simply by identifying the beneficiary specified in the plan documents, but must familiarize themselves with state statutes so that they can determine whether the named beneficiary’s status has been “revoked” by operation of law.  The burden is exacerbated by the choice-of-Iaw problems that may confront an administrator when the employer, the plan participant, and the participant’s former spouse live in different States.  Although the Washington statute provides protection for administrators who have no actual knowledge of a divorce, they still face the risk that a court might later find that they did have such knowledge.  If they instead decide to await the results of litigation among putative beneficiaries before paying benefits, they will simply transfer to the beneficiaries the costs of delay and uncertainty.  Requiring administrators to master the relevant laws of 50 States and to contend with litigation would undermine the congressional goal of minimizing their administrative and financial burdens.  Differing state regulations affecting an ERISA plan’s system for processing claims and paying benefits impose precisely the burden that ERISA pre-emption was intended to avoid.

What if a spouse is the beneficiary of the other’s life insurance and they get a divorce?  People to often, find out the hard way what happens.  What happens is the spouse named spouse in the life insurance policy is automatically divulged of any interest in the life insurance proceeds.  This is discussed in a 1987 opinion from the 14th District Court of Appeals.  The opinion is styled, Novotny v. Wittner.
In the cited case, the divorced spouse appealed an adverse decision regarding her rights to the life insurance proceeds.
A divorced spouse is eligible as a beneficiary of a life insurance policy on the life of the ex-spouse.  Termination of the ownership interest in a policy does not necessarily destroy the right to receive the policy proceeds as the designated beneficiary.  However, the beneficial interest may also be terminated by the divorce decree where it clearly appears from the decree that it was intended not only to segregate the property of the spouses, but also to deprive either spouse of the right to take as beneficiary under an insurance policy on the life of the other.

It is not uncommon first a life insurance lawyer to run across a situation where the issue is, Did the insured change the beneficiary of the life insurance policy.
Here is a 1953, Texas Supreme Court opinion dealing with this issue.  It is styled, Creighton v. Barnes.
Petitioners, the mother, daughter and a sister of B. B. Barnes, as the named beneficiaries of the two Jefferson Standard Life Insurance Company policies, filed this suit against the Insurance Company for the proceeds of the two policies.  The Insurance Company answered with an interpleader suit, wherein it impleaded respondent, the third wife and surviving widow of B. B. Barnes, and said that all of the petitioners and the respondent were claiming the right to the proceeds of both policies, and tendered the money into court, and asked the court to decide which of the claimants were entitled to receive the funds, and asked that it be discharged with its costs and attorneys’ fees.  Respondent answered claiming the proceeds by virtue of the will of B. B. Barnes.

A vacancy exclusion is common in most policies insuring structures unless it is a type of policy that specifically provides that type of coverage.  Here is a 2024 opinion wherein the insurer denied coverage under a renters policy due to the insured not living in or occupying the property.  The opinion is from the Eastern District of Texas, Lufkin Division.  It is styled, Crystal Childers and Bradley Childers v. Allstate Indemnity Company.
The Childers bought a second home as an investment rental property in 2021.  The home required repairs and remodeling before it could be rented.  While the home was being worked on and through March 29, 2022, no one lived there.
The Allstate policy contained the two coverage exceptions:

It is one thing to sue your insurance company for doing you wrong.  It is another thing to prove the costs of what they should have done for you.  Here is a 2024 opinion from the Northern District of Texas, Dallas Division, that discusses this issue.  It is styled, Brian and Shannon Hart v. State Farm Lloyds.
The Harts suffered a loss to their home and their insurer is State Farm.  The Harts made a claim and a lengthy dispute arose between them and State Farm as to the costs of repairs.  A relevant fact in this case is that the repairs were not performed.  A lawsuit resulted.
After time for discovery had passed, State Farm filed a motion for summary judgment asserting the Harts were unable to prove their claim.
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