Insurance cases in Federal Court require the pleadings to be substantive. This is seen in a 2019, decision from the Southern District of Texas, Corpus Christi Division. The decision is styled, Alvira Blue v. Allstate Vehicle and Property Insurance Company.
Allstate filed a motion with the Court requesting that Blue’s claims for misrepresentation under Texas Insurance Code, Section 541.060(a)(1), be dismissed.
This Court granted the motion and discussed.
Insurance property claims are a very big part of claims made against insurance companies. As part of those property claims that get denied, it is important to properly prove the property damages by attaching a dollar value to them. One way of proving the dollar value of these property damages is through the use of expert testimony. Proving property damages by way of expert was a recent topic in a 2019, opinion from the Eastern District of Texas, Sherman Division. This opinion is styled, Brandy Ventures, LLC v. Mesa Underwriters Specialty Insurance Company.
This case arises from alleged water damage resulting from a broken pipe on commercial property owed by Brandy Ventures and insured by Mesa. Brandy alleges Mesa unfairly denied the claim and filed this lawsuit.
Brandy appointed Roy Young of YPA Public Adjusters, LLC, to testify regarding water damage. Mesa filed a motion to strike any testimony of Young.
Insurance lawyers know that if a jury is convinced of the wrong an insurance company has committed that there is a chance to recover a trebling of the actual damages in the case. So how does that work? This is discussed in a 2019, opinion from the Texas First Court of Appeals. The opinion is styled, Certain Underwriters At Lloyd’s, London, Syndicate Numbers 2020, 1084, 2001, 457, 510, 2791, 2987, 3000, 1221, 5000 And Navigators Insurance Company UK v. Prime Natural Resources, Inc.
The facts of this case can be read by reading the opinion. The case was tried to a jury and the jury found in favor of Prime. The jury also awarded treble damages based on the conduct of the insurance companies. The focus here is on how the Court dealt with the issue of treble damages.
As a result, Underwriters argues that even if Prime were entitled to recover additional Policy benefits, it is not entitled to additional damages under Chapter 541 of the Insurance Code.
Here is another case wherein there was a failure to properly stipulate to the amount of damages involved in the case and thus, ended up having to litigate his case in Federal Court, rather than the State Court in which the lawsuit was filed.
The case is from the Southern District of Texas, Houston Division, and is styled, Olga Rodriguez v. State Farm Lloyds.
Olga filed her claim against State Farm in State District Court and State Farm timely removed the case to Federal Court.
As stated before, insurance companies prefer to litigate cases in federal court, whereas, lawyers suing insurance companies prefer to litigate in state court. The laws are such that the insurance companies get their way most of the time. However, one of the ways to keep a case in state court involves properly stipulating to the amount of damages at issue in the case.
This issue is discussed in the 2019, Southern District of Texas, Houston Division, opinion styled, Osiel Rubio v. State Farm Lloyds.
Rubio filed suit arising out of an insurance claim against State Farm in state court. State Farm timely removed the case to federal court. Rubio filed a Motion to Remand which was denied.
Employee Retirement Income Security Act (ERISA). These cases are tough even under the best of circumstances. Lawyers who handle ERISA cases do not spend time advertising their great results. The reason is the ERISA law prohibits “great” results. A win is just getting what you should have received in the first place. But wins are few and far between, especially in the United States Fifth Circuit.
Here is a case from the Northern District of Texas, Wichita Falls Division. It’s styled is, Edythe Koch v. Metropolitan Life Insurance Company.
In this case, the Court denied MetLife’s motion for summary judgment which is unusual in these cases, thus, at first blush one thinks a win is coming. But when the Judge conducted it’s own review of the record, the Court upheld the plan administrator’s denial of accidental life insurance benefits.
Most of the time, Personal Injury Protection (PIP) benefits are paid when a proper claim for them is made and then if a claim for Uninsured Motorist (UIM) benefits is made, the insurance company takes/gets an offset for the PIP benefits in any settlement that occurs. But what if the case is tried to a jury?
A case involving PIP and UIM benefits was tried to a jury in Jasper County and a Judgement was entered in favor of the insured. No offset was given for the PIP benefits that had been paid by the insurance company. How did this happen?
An appeal was taken to the Beaumont Court of Appeals and the case is styled, Allstate Fire And Casualty Insurance Company v. Andy Alfred.
Claims for violations of the Texas Insurance Code must be stated properly against an insurance company adjuster. One way of doing this is talked about in this Western District of Texas, San Antonio Division, opinion styled, Jeanette Kotzur, David Kotzur v. Metropolitan Lloyds Insurance Company of Texas, Bryant Tullous, Michael Esmay.
This case involves a claim for damages arising out of a wind and hailstorm that is alleged to have caused damages to property owned by the Kotzur’s. Metropolitan is the insurance company and the adjusters were Tullous and Esmay.
The Kotzur’s sued Metropolitan and the adjusters in State Court. Metropolitan removed the case to Federal Court asserting the amount in controversy exceeds $75,000, that the Kotzur’s are citizens of Texas and Metropolitan is a citizen of states other than Texas. Metropolitan also asserts that the adjusters should be disregarded for citizenship purposes because the adjusters were improperly joined in the lawsuit in an effort to defeat diversity of citizenship. Metropolitan asserts that the Kotzur’s have not properly asserted claims against the adjusters. The Kotzur’s assert that they have properly asserted claims against the adjusters.
As is acknowledged in the following case, the federal courts are mixed as to their rulings on the timing of when an insurance company adjuster is sued and how that affects diversity cases.
This case is from the Western District of Texas, San Antonio Division. It is styled, Bexar Diversified MF-1, LLC v. General Star Indemnity Company, Paul R. White And Company Inc.
Bexar had an insurance policy with General Star. Bexar suffered a weather related loss and reported it to General Star. General Star assigned White, a company, to adjust the claim. Bexar was dissatisfied with the way the claim was handled and sued General Star and White in state court for violations of the Texas Insurance Code, Sections 541 and 542.
Spring is coming soon and exclusions in homeowner policies for “surface and ground water damage” will be an issue an insurance lawyer must be able to discuss with client.
Here is a November 2019, opinion from the Southern District of Texas, Houston Division, that “kinda” addresses this issue. The opinion is styled, Robert Salcetti v. AIG Property Casualty Company.
Salcetti suffered damage to his home after the U.S. Army Corps of Engineers decided to release water from reservoirs and Salcetti alleges that water entered his home causing significant damage.
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