Dallas Fort Worth Insurance Lawyer Blog

Federal Law And Texas State Forfeiture Statute

March 31, 2019 | Mark S. Humphreys

How does Federal law work with the Texas Slayer Statute, Texas Insurance Code, Section 1103.151?

This question is answered in the 1992, Fifth Circuit opinion styled, Metropolitan Life Insurance Co. v. White.

This is a summary judgement case. Terri Yohey was the named insured under a group life insurance policy issued by Metropolitan under the Federal Employees Group Life Insurance Act (FEGLIA). At the time of her death she had not designated a beneficiary. Her widower, Leslie Yohey, was convicted of her murder.

Life Insurance And Murder – ERISA

March 30, 2019 | Mark S. Humphreys

What happens when the named beneficiary on a life insurance policy intentionally causes the death of the insured? That was the question in this case from the Western District of Texas, San Antonio Division, opinion styled, Garrett Bean and Aneila Bean v. Minerva Alcorta.

Plaintiff’s father,Garry, has a $130,000 life insurance policy under which Alcorta was named the primary beneficiary and Garrett and Aneila were secondary beneficiaries of 50% each of the policy.

Alcorta was charged with intentional first degree murder of Garry.

Press Release #5

March 28, 2019 | Mark S. Humphreys

The Law Office of Mark Humphreys, P.C., is pleased to announce the settlement of a life insurance case wherein the life insurance company recognized they owed the policy benefits but was unsure who was entitled to the money.

In this case, the deceased had named his wife as the primary beneficiary and his wife’s son, from a previous marriage, as the secondary beneficiary. The deceased had divorced his wife prior to his death without changing the beneficiaries under the policy.

By operation of Texas law and no exceptions applying, the divorce resulted in the ex-wife being automatically excluded as a beneficiary under the policy. This meant the claim went to the secondary beneficiary, the son of the ex-wife and Mark’s client.

Suing In Federal Court

March 27, 2019 | Mark S. Humphreys

Most insurance attorneys try to stay out of federal court. Here, a pro se plaintiff filed his case in federal court. The case is from the Eastern District of Texas, Sherman Division. It is styled, Marlon Green v. Covenant Transportation Group, Inc., et al. The case was dismissed because Green failed to properly plead his case.

Green does not enumerate any specific cause of action or claims, but rather broadly states that “administrative abuses are covered by The Civil Rights Act, and American with Disability Act Rights.” In the most recent amended complaint, Green alleges that the Court has subject matter jurisdiction over this matter pursuant to 28 U.S.C. Section 1332, but avers the claim is less than $75,000. Green also states “federal law violations include.” The Court finds, upon review, that Green’s claims should be dismissed for lack of subject matter jurisdiction, and for failing to provide addresses for the preparation of service of process on Defendants, as ordered by the Court.

Federal courts are courts of limited jurisdiction and must have statutory or constitutional power to adjudicate a claim. Federal courts have subject matter jurisdiction and are authorized to entertain a cause of action only where a question of federal law is involved or where there is diversity of citizenship between the parties and the amount in controversy exceeds $75,000.

Delay In Paying Claim – Texas

March 24, 2019 | Mark S. Humphreys

The Texas Prompt Payment of Claims Act was interpreted by the United States Fifth Circuit in this 2015 opinion. The opinion is styled, Cox Operating, L.L.C. v. St. Paul Surplus Lines Insurance Company.

The facts are kinda long ans somewhat confusing, plus there are other issues in the case. Of relevance here is the Court’s discussing of the Texas Prompt Pay statutes.

Texas Insurance Code, Section 542.054 says in order “to promote the prompt payment of claims,” the act provides for a series of deadlines to which insurers must adhere at each stage of the claim handling process.

Employer Health Plan That Is Governed By ERISA

March 23, 2019 | Mark S. Humphreys

The 5th Circuit Court of Appeals issued an opinion on January 31, 2019, in a case that is governed by the ERISA. The opinion is styled, Karen A. Rittinger v. Healthy Alliance Life Insurance Company.

Here, the beneficiary of a health plan governed by ERISA brought action against the plan administrator challenging the denial of coverage for her bariatric surgery and the follow-up surgery required after she developed complications. This Court ruled in favor of the plan administrator, ruling the administrator did not abuse its discretion when it treated e-mail from the plan beneficiary’s husband as a first-level appeal, and the administrator did not abuse its discretion in denying health plan beneficiary’s second level appeal.

Pursuant to 29 U.S.C.A., Sections 1001 et seq., the Court of Appeals reviews a district court’s grant of summary judgment in an ERISA case de novo.

Life Insurance – Missed Payments

March 20, 2019 | Mark S. Humphreys

Life insurance claims that are denied for missed payments of premiums is pretty common. This issue was discussed in a Southern District of Texas, Houston Division, opinion styled, Colonial Penn Life Insurance Company v. Ashley E. Parker, et al.

Robert Parker applied for a whole life policy with Colonial on October 30, 2014. Ashley Parker and Aden Barron were beneficiaries of the policy. The policy was issued on November 20, 2014.

On June 22, 2015, seven months later, Parker died in a car wreck. A claim for benefits were made on the life insurance policy.

Fort Worth Insurance Claim

March 17, 2019 | Mark S. Humphreys

Here is a Northern District of Texas, Fort Worth Division opinion issued by Justice Reed O’Conner. This opinion echoes similar opinions being issued in the Federal Courts in Texas. The style of this case is, Twanya Braden v. Allstate Vehicle and Property Insurance Company.

Braden reported a claim for hail and windstorm damage to her house to Allstate. A dispute arose as to the damages amount and appraisers set the amount of loss at $9,005.92. Allstate had made a previous payment and after taking into account the deductible, Allstate paid the balance.

Allstate moved for summary judgment based on the claim having been properly paid pursuant to the appraisal amount and thus, there were no other issues for the Court to decide.

Press Release # 4

March 16, 2019 | Mark S. Humphreys

The Law Office of Mark S. Humphreys, P.C., recently got a surprise for his client when contesting an ERISA life insurance claim.

The insured worked in Louisiana and had a life insurance policy through his employer. The insured was not married and did not have any children. Thus, the insured named his brother’s child as the beneficiary of his life insurance policy. The amount of the policy was $100,000. The insured was killed in a one vehicle accident. A claim was made for benefits. The plan administrator denied the claim benefit based on an exclusion if the deceased died as the result of intoxication. The toxicology report indicated proof of cocaine in the body of the insured at the time of the accident.

Mark hired a toxicology expert to write a report and contested the denial of benefits through the administrative process that has to be followed in ERISA claims. The report pointed out that the amount of cocaine in the system of the deceased was stated as being a “trace” amount. The toxicology expert report pointed out there was no way to prove intoxication had anything to do with the cause of death when the amount is just a “trace.”

When Delay In Paying A Claim Is Unpunished

March 16, 2019 | Mark S. Humphreys

The Texas Prompt Payment of Claims Act was not violated in this situation.

The case is from the Southern District of Texas, Laredo Division. It is styled, Jonnie Byrd v Liberty Insurance Corporation, et al.

Following a hail storm, Byrd made a claim against her homeowner’s policy with Liberty for damage to the roof and interior his home. Liberty’s adjuster found no hail damage to the roof but did find water damage of a little over $3,000, which was less than the deductible. Byrd then sent a demand letter seeking $55,731. Liberty closed the file and Byrd sued for various causes of action including violation of the Prompt Payment of Claims Act.