Dallas Fort Worth Insurance Lawyer Blog

Insurance Claims – Personal Jurisdiction & Subject Matter Jurisdiction

June 8, 2019 | Mark S. Humphreys

Most insurance lawyers understand the distinction between “personal jurisdiction” and “subject matter jurisdiction”. A recent case from the Northern District of Texas, Dallas Division, explained the difference. The case is styled, Yakimas Payne, Carmenisha Payne, and Mar’Keyona Ford v. Government Employees Insurance Company.

The Plaintiffs sued GEICO in State Court for uninsured motorist benefits. GEICO removed the case to Federal Court and the Plaintiffs filed a motion to remand, arguing that diversity jurisdiction existed but that GEICO had “continuous and systematic contacts with the state of Texas sufficient to establish general jurisdiction.

GEICO argued that Plaintiffs have confused personal jurisdiction with diversity jurisdiction. The Court set forth standards for the two types of jurisdiction.

Suing That Insurance Adjuster In A Homeowners Claim

June 5, 2019 | Mark S. Humphreys

Insurance lawyers got good news about a month earlier, on April 8, 2019. The case they got good news out of was from the Western District of Texas, Austin Division. The style of the opinion was River Of Life Assembly Of God v. Church Mutual Insurance Company and Jim Turner Harris.

The style of this case is still the same but the Court amended its order and the language added to the opinion does a good job of articulating the reasoning in the opinion. This new language and amended order is helpful for insurance lawyers helping insureds in similar situations.

This was a lawsuit about insurance coverage for storm damage. River of Life had sued Church and the adjuster, Harris, for the way the claim was handled. The suit was filed in State Court because Church is diverse and Harris is not. Pursuant to Texas Insurance Code, Section 542A.006(c), Church elected to accept responsibility for Harris and removed the case to Federal Court. The statute requires River of Life to dismiss its claims against Harris after this election to accept responsibility for Harris. So the issue here was whether it was proper to remand the case back to the State Court or to keep it in this Federal Court.

How Does Insurance Work In A Divorce?

June 2, 2019 | Mark S. Humphreys

Unfortunately, this is an issue that has to be addressed too often. An article was written in April 2019, in Forbes, that addresses this issue. The title of the article is “Insurance Issues To Consider In A Divorce.”

Most of the time and fighting and arguing in divorce situations is directed toward emotional, financial, and child custody issues. What can be lost in the mix is, what is going to happen regarding insurance policies. Usually the law of the state where the divorce is taking place deals with all these issues.

This Blog deals with Texas and when it comes to divorces and the issues surrounding divorces, the Texas Family Code is the source of information for how Texas Courts address these issues and also, insurance policies.

Prompt Notice Must Be Given When Insurance Company Plans To Deny A Claim Based On A Misrepresentation

June 1, 2019 | Mark S. Humphreys

With regards to life insurance policies, what if the insurance company denies a claim for benefits based on their assertion that a misrepresentation was made in the policy application?

This is covered by the Texas Insurance Code, Sections 705.001 to 705.005 and 705.101 to 705.105. This is also addressed by a San Antonio Court of Appeals opinion from 1969. The style of the San Antonio case is, The Prudential Insurance Company of America v. Ignacio Torres et ux.

The facts in Torres are substantially undisputed. Torres was an employee of Gonzaba, who had six employees. Gonzaba was considering purchasing group life and health insurance for his employees and their families when he eventually purchased a policy through a new employee, Avalone, of Prudential.

Life Insurance And The Application

May 29, 2019 | Mark S. Humphreys

Life insurance lawyers might know this law but most other people do not. The law is found in the Texas Insurance Code, Sections 705.101 thru 705.105.

These Insurance Code sections require that an application for insurance be attached to the policy when the policy is sent to the applicant.

This issue was before the Texas Supreme Court in a 1994 opinion styled, Fredonia State Bank v. General American Life Insurance.

Press Release #12

May 27, 2019 | Mark S. Humphreys

The Law Office of Mark S. Humphreys, P.C. is pleased to announce the settlement of a life insurance denial case. Mark’s client was the daughter of a lady who had applied for a small life insurance policy about a year and a half before the mother’s death. Her death was within the two year look-back period allowed to life insurers in the State of Texas. This “look-back”allows an insurance company to investigate for misrepresentations made in a life insurance policy if the insured’s death occurred within two years of the application date.
The lady had severe mental issues but also she had significant health issues that were not disclosed in the insurance application. The plus for Mark’s client is that the insurance company agent who took the application information would have been aware of the health problems of the insured because the agent was present in the house of the lady and actually would have seen the insured’s oxygen machine and medications, yet these were not disclosed in answers to relevant questions on the application for life insurance. Mark’s argument was that the agent is who made the misrepresentations, not the mother. The agent had financial incentive to make the misrepresentations because the only way the agent received commissions for the sell of the life insurance policy was if the sell was made.

Life Insurance And Suicide Exclusion

May 26, 2019 | Mark S. Humphreys

An often seen reason for denying a claim for life insurance benefits is the accusation by the insurance company that the insured committed suicide.

As is pointed out in the 1982, 14th District Court of Appeals opinion, Parchman v. United Liberty Life Ins. Co., life insurance policies typically exclude suicide as an assumed risk. However, this exclusion is virtually always limited to a suicide that takes place within two years of the inception date of the policy.

In the Parchman case, the policy excluded suicide as an assumed risk for two years from the policy date and provided a reduced benefit of the return of all premiums paid if death resulted from suicide within that period.

Insurance Agent Representations

May 25, 2019 | Mark S. Humphreys

As most insurance law attorneys can tell a prospective client: An insurance agent does not have a responsibility to explain the terms of the policy.

As in most laws, there are exceptions based on the facts of each given situation. The Western District of Texas, Austin Division, issued an opinion in 2019 worth reading. It is styled, Riojas v. Nationwide General Insurance Company, et al.

While in the process of selling the Riojases a home loan in 2015, DHI, through its employee Brittany Present, allegedly told the Riojases that DHI would secure homeowners’ insurance for their home. Brittany asked Lezam to obtain a policy, which he did through Nationwide. All of the defendants in this case, allegedly told the Riojases that the policy provided full coverage for their home including water damage.

Covered And Non-Covered Causes Of Loss

May 22, 2019 | Mark S. Humphreys

Insurance attorney need to stay current on the ways the Judges interpret the law and how that law is applied to the facts in a case.

When dealing with insurance contracts and the “covered and non-covered cause of loss” issue, this 2019, Northern District of Texas, Dallas Division opinion is worth reading. It is styled, 2223 Lombardy Warehouse, LLC, et al. v. Mount Vernon Fire Insurance Company.

The policy language at issue in this case read:

Press Release #11

May 20, 2019 | Mark S. Humphreys

The law office of Mark S. Humphreys, P.C. is pleased to announce the settlement of a case involving a Credit Life & Disability policy.

Mark’s client was the wife of a man who had died and she was the beneficiary named on the policy. The policy, a Credit Life & Disability policy, had been purchased when the husband bought a new vehicle. After his death, she made a claim for benefits which was denied due to the insurance company claim that her husband had misrepresented his health in his application for the policy. The problem for the insurance company was that the client had a copy of the application which did not have the misrepresentations. It appeared that the finance manager for the car dealership had altered the application in order to get commissions for selling the policy. In the end the insurance company paid more than three times the actual benefits.

Automobile dealerships are a source for a lot of Credit Life & Disability policies being sold. The salesman and finance manager handling the sale are incentivized to sell these policies and often times have quotas they have to meet. As a result, there is often times a lot of information on the application for these policies that is not entirely accurate. Some rules governing these policies are found in the Texas Insurance Code, Sections 1153.151 through 1153.161.