Dallas Fort Worth Insurance Lawyer Blog

Insurance Lawsuits – Cooperation

January 20, 2019 | Mark S. Humphreys

Insurance lawsuits, as all lawsuits, require the parties involved to cooperate with each other in the discovery process and to abide by the Rules of Procedure. The results of failure to do so are illustrated in the 2018, Dallas Court of Appeals opinion styled, Farbod Ayati-Ghaffari v. Farmers Insurance Exchange.

The issue in this appeal is whether the trial court abused its discretion in imposing death penalty sanctions against Ayati for his abuse of the discovery process.

This opinion makes a long list of the abuses of occurred over the course of this lawsuit including Orders made by the Court that were not followed and numerous chances given by the Court to correct wrongs being committed by Ayati.

Subrogation And Statute Of Limitations

January 19, 2019 | Mark S. Humphreys

Here is an insurance subrogation case from the U.S. Southern District of Texas, Houston Division. It is a 2018, opinion styled, AXA Insurance Company a/s/o The Museum Of Printing History v. Yoau Electric Co. Ltd., LG Electronics U.S.A., Inc., and Chocolates El Rey Inc.

The museum leased a portion of the place of business to El Rey. A fire occurred at the subject premises on or about May 10, 2016, resulting in extensive smoke, fire, and water damage to Chocolates’s historical collection and the premises. AXA, as subrogee, made payments on the loss. Investigators determined the fire resulted from faulty wiring of an LG air conditioning unit used by El Rey at the premises. The air conditioning unit was designed and manufactured by LG and Yoau. AXA as subrogee, asserts that defendants LG and Yoau and Chocolates are responsible for the fire loss sustained by AXA due to breach of express and implied warranties, negligence, and strict products liability.

This is a Rule 12(b)(6) motion to dismiss opinion. In considering a Rule 12(b)(6) motion, courts generally must accept the factual allegations contained in the complaint as true. While a complaint attacked by a Rule 12 (b)(6) motion does not need detailed factual allegations, a plaintiff’s obligation to provide the grounds of his entitlement to relief requires more than labels and conclusions, and a formulaic recitation of the elements of a cause of action will not do. The factual allegations must be enough to raise a right to relief above the speculative level. The supporting facts must be plausible enough to raise a reasonable expectation that discovery will reveal further supporting evidence.

Suing Insurance Adjusters

January 16, 2019 | Mark S. Humphreys

Suing Adjusters in federal court is often times difficult. The reason is that an adjuster is usually sued in state court in an effort to defeat diversity jurisdiction thus, keeping the case in state court. When an insurance company believes the adjuster has been sued solely to defeat diversity jurisdiction, the insurance company will remove the case to federal court and ask the Judge to dismiss the adjuster.

This is what happened in this 2018, 5th Circuit opinion styled, William Mauldin v. Allstate Insurance Company; Mayella Gonzales; Theresa Hernandez.

Pursuant to 28 U.S.C., Section 1441 and 1446, Allstate removed this case to federal court where the Judge allowed the removal. Mauldin appealed this issue to this Court.

ERISA Case Review

January 13, 2019 | Mark S. Humphreys

Employee Retirement Income Security Act (ERISA) cases have their own set of rules. Two things stand out about ERISA cases. One is that a person is not entitled to a jury trial in an ERISA case, rather a Judge reviews the administrative record in the case when deciding who is going to prevail in the case. Two is that there is very little to no discovery in the case.

This is illustrated in the 1998, 5th Circuit Court of Appeals opinion, Vega v. National Life Ins. Services, Inc.

Vega is a summary judgement case where Vega is appealing the decision rendered against hit. Part of his appeal addresses how the Court ruled as it relates to discovery in the case.

Unfair Settlement Practices By Insurance Companies

January 12, 2019 | Mark S. Humphreys

Insurance company unfair settlement practices is dealt with in a specific section of the Texas Insurance Code. Look at Texas Insurance Code, Section 541.060.

The statute prohibits engaging in any of the following settlement practices with respect to a claim by an insured or beneficiary:

(1) misrepresenting to a claimant a material fact or policy provision relating to coverage at issue;

Life Insurance – ERISA

January 9, 2019 | Mark S. Humphreys

Here is a life insurance case that involves a plan under the Employee Retirement Income Security Act (ERISA). It is a 2018, 5th Circuit Court of Appeals case styled, Jason Crawford v. Metropolitan Life Insurance Company.

This is a summary judgment case granted in favor of MetLife. This Court sustained the ruling in favor of MetLife.

The deceased, Tracy Crawford, worked as a flight attendant for Southwest Airlines. Tracy enrolled in the company offered life insurance benefit plan in 2008, and submitted a paper document naming her great-nephew as the primary beneficiary.

Storm Damage And New Law

January 6, 2019 | Mark S. Humphreys

A new law, Texas Insurance Code, Section 542A.006(a) matters in this case.

The case is from the Western District of Texas, Austin Division. It is styled, Yan Qing Jiang v. The Travelers Home and Marine Insurance Company and Dana Ellen Pustka.

Jiang filed this action in state district court alleging her home was damaged in a storm and that Travelers is the insurer and the adjuster was Pustka. Jiang asserted causes of action for violations of the Texas Insurance Code and the Texas Deceptive Trade Practices Act (DTPA). Travelers and Pustka had the case removed to federal court based on diversity jurisdiction, 28 U.S.C., Section 1332(a), and argue that Pustka was improperly joined in an effort to defeat diversity jurisdiction.

Insurance Policy Anti-Assignment Clauses

January 5, 2019 | Mark S. Humphreys

Most people do not know what an anti-assignment clause in an insurance policy means. This issue is discussed in a 2018, opinion from the 14th Court of Appeals. The opinion is styled, Safeco Insurance Company of America v. Clear Vision Windshield Repair, LLC.

This case concerns anti-assignment clauses in insurance policies. Clear Vision repaired chips in the windshields of Safeco’s insureds. Safeco recently refused to pay invoices for the windshield repairs on four of Safeco’s insureds. The insureds had assigned the claim to Clear Vision for payment and Safeco denied the payments relying on the anti-assignment clause in the policies at issue.

The trial court ruled in favor of Clear Vision and that ruing was upheld on appeal by this Court.

Life Insurance – Interpleader

January 2, 2019 | Mark S. Humphreys

Life Insurance cases can have a surprising number of twists to them. Readers of the DallasFortWorthInsuranceBlog have seen some of these various twists.

The U.S. District Court, Eastern District of Texas, Sherman Division, issued an opinion in a case styled, Reliastar Life Insurance v. Trina R. Wiemer, Laura R. Weimer, and Roderich W. Weimer, Jr., which is interesting.

This case is an interpleader action. Reliastar issued a life insurance policy on the life of Vincent H. Weimer, who died on August 19, 2017. The policy was for $3,000,000.00 and this amount is claimed by competing persons. Because of these competing persons, Reliastar filed this interpleader action pursuant to Federal Rule of Civil Procedure 22 and 28 U.S.C. Section 1335.

Homeowners Claim And Policy Language

December 30, 2018 | Mark S. Humphreys

The U.S. District Court, Western District, Austin Division, issued an opinion on November 16, 2018, that is worth reading. It is styled, Thomas G. Kezar and Sylva Shroyer Kezar v. State Farm Lloyds.

This is an appeal from a partial motion for summary judgement as to one issue in the case. The issue is whether Kezars still had a claim against State Farm for breach of contract and extra-contractual damages under the dwelling coverage aspect of the claim when State Farm had already properly and timely paid that aspect of the claim after an appraisal award. This Court ruled in favor of State Farm.

The policy language at issue states: