Dallas Fort Worth Insurance Lawyer Blog

Insurance Bad Faith And The Insurance Adjuster

November 20, 2023 | Mark S. Humphreys

When an insurance adjuster makes mistakes in handling a claim, it is usually necessary to sue the adjuster in addition to suing the insurance company. The trick is properly suing the adjuster.

A 2023 opinion from the Northern District of Texas, Dallas Division, dealt with properly suing the insurance company adjuster. The opinion is styled, Samurai Global, Inc., v. Rockford Kyle Brothers And Landmark American Insurance Company.

This case had a few legal issues going on at the same time but what is relevant here is the Court points out the proper way to make allegations against the insurance company adjuster.

Life Insurance Claims Denial Due To Fraud?

November 18, 2023 | Mark S. Humphreys

Many life insurance cases are fights between potential beneficiaries of the life insurance policy. That was the case in this 2023, opinion from the Southern District of Texas, Houston Division. The opinion is styled, Tommy Marion v. Principal Life Insurance Company and Nicky B. Thompson.

Marion sued Principal Life and Thompson alleging that Thompson fraudulently removed Marion as the beneficiary on a life insurance policy taken out by now-deceased John Thompson.

The facts of the case can be ciphered by reading the case. Thompson filed a motion to dismiss Marion’s claim. Here we will deal with the law regarding the alleged fraud.

Giving Notice And Attorney Fees

November 13, 2023 | Mark S. Humphreys

An insurance lawyer is frequently asked about whether or not attorney fees can be recovered by a successful claimant. The short answer is “yes.” But only if you give proper notice.

This issue is discussed in a 2023 opinion from the Southern District of Texas, Houston Division. The opinion is styled, Henry & Lydia Ansah v. Nationwide Property And Casualty Insurance Company.

The Ansah’s had property insurance through Nationwide. It is alleged the Ansah’s suffered storm damages and filed a claim with Nationwide that ultimately ended up in a lawsuit.

Must Give Proper Warning To Insurance Company Before Suing

November 11, 2023 | Mark S. Humphreys

Insurance lawyers know that they must give proper warning to an insurance company before suing the insurance company. Failure to do so puts a stop to a subsequent lawsuit.

This is illustrated in a 2023 opinion from the Southern District of Texas, McAllen Division. The opinion is styled, Laura Navarro v. State Farm Lloyds.

Navarro filed a claim with State Farm for hail and windstorm damage. Unhappy with State Farm’s response, Navarro sent a notice letter to State Farm pursuant to Texas Insurance Code, Section 542A.003. Among other things, the letter states that: (1) Navarro suffered damages caused by State Farm’s adjustment and investigation of Navarro’s claim: (2) the unpaid policy benefits were $21,157.31; and (3) the attorney fees were $8,000.

Insurance Claims Denial And Statute Of Limitations

November 6, 2023 | Mark S. Humphreys

When is the deadline for filing a law suit against an insurance company that refuses to fully pay on a claim?

This is usually a simple answer. It was the main issue in a 2023 opinion issued by the Fort

Worth Court of Appeals in a case styled, Kenneth Kessler v. Allstate Fire And Casualty Insurance Company.

Claim Denied (Attorney Fees)

November 4, 2023 | Mark S. Humphreys

Insurance lawyers who handle claims being denied are usually asked whether not their attorney fees can be recovered. The answer is usually a “Yes” but their are requirements to be met in order to recover those attorney fees. One of those requirements include giving a pre-suit notice letter in proper form.

In cases where the loss has resulted from an act of nature such as hail storms, tornadoes, hurricanes, freezes, etc. there is a further loop that must be followed involving the timing of the pre-suit notice letter.

Here is a 2023, opinion from the Eastern District of Texas, Tyler Division, that is worth reading. It is styled, Curt Adkisson v. Safeco Insurance Company Of Indiana.

Life Insurance Claim Denial – Who Can Be Sued?

October 30, 2023 | Mark S. Humphreys

Who can be sued when a life insurance claim is denied is an important consideration by strategic considerations. Here is some insight.

Chapter 541 of the Texas Insurance Code defines and prohibits unfair and deceptive insurance practices. Specifically, look at sections 541.001 to 541.061, 541.151 to 541.162, and 541.453.

The statute allows a private cause of action by any person who has sustained actual damages caused by another’s engaging in any act or practice that is defined as an unfair method of competition or unfair or deceptive act or practice in the business of insurance, or defined as an unlawful deceptive trade practice. This is found in Section 541.151. The definitions of unfair and deceptive practices are found in two places: (1) Texas Insurance Code, Sections 541.051 to 541.061, and (2) Section 17.46(b) of the Business & Commerce Code, the Texas Deceptive Trade Practices — Consumer Protection Act (DTPA). See Texas Insurance Code, Section 541.051.

Life Insurance Claims Denial – Agents And Ratification

October 28, 2023 | Mark S. Humphreys

What if a life insurance agent does something he is not supposed to do when he sells a life insurance policy? What if the insurance company ratifies what the agent did?

An insurance company may be liable for unauthorized conduct of an agent or other person, if the insurance company ratifies the conduct. Ratification may occur when the insurance company, though having no knowledge of the unauthorized act, retains the benefits of the transaction after acquiring full knowledge of it. The critical factor is the insurance company’s knowledge of the transaction and it actions in light of that knowledge. Ratification extends to the entire transaction. This is discussed in the 1980, Texas Supreme Court opinion styled, Land Title Co. of Dallas, Inc. v. F. M. Stigler, Inc.

Here is an example. In the 1989, Fourteenth District Court of Appeals opinion styled, Paramount National Life Insurance Co. v. Williams, the insurance company issued a hospitalization policy, without further investigation, despite having an application indicating the insured’s advanced age and poor health, and despite having knowledge of the agent’s inexperience. By nevertheless accepting premiums, the insurance company ratified the agent’s misrepresentations made in the sale of the policy.

Life Insurance Claim Denial – Recording Agent or Soliciting Agent?

October 23, 2023 | Mark S. Humphreys

What is the difference between a “recording” agent and a “soliciting” agent? Does it make a difference?

The law is this area can be confusing, despite the relatively straightforward principles. Historically, there was a distinction between “recording” agents and “soliciting” agents. A recording agent had authority co-extensive with that of the company, so there was no question of the agent’s actual or apparent authority. This was stated in the 1979, Texas Supreme Court opinion styled, Royal Globe Insurance Company v. Bar Consultants, Inc. The court noted that the authority of a soliciting agent was much more limited that the actual authority of a recording agent. The court went on to hold that the insurance company was liable for the agent’s misrepresentation of coverage.

This led some courts to conclude mistakenly that an insurance company could be liable for misrepresentations by a recording agent, but not by a soliciting agent. This can be seen in the 1984, First District Court of Appeals opinion styled, Guthrie v. Republic National Insurance Co. This analysis was wrong, which was made clear when the Texas Supreme Court decided the 1994 opinion styled, Celtic Life Insurance Company v. Coats.

Life Insurance Claim Denial Because Of The Agent’s Conduct

October 21, 2023 | Mark S. Humphreys

What if the life insurance agent varied the life insurance contract terms? What is your recourse?

There are Insurance Code statutes dealing with this. An agent is not authorized by the statutes to alter or waive a term or condition of an insurance policy or an application for an insurance policy. The statutes governing this are section 4001.051(c), and 4001.053. Nevertheless, an insurance company will be liable “for purposes of the liabilities, duties, and penalties provided by” certain statutes pursuant to Texas Insurance Code, Section 4001.051(b). The referenced statutes include the prohibitions found in Chapter 21 and now found in the new codification, sections 4001.051 and 4001.009. The Texas Supreme Court explained the interaction between these provisions under the older statutes as follows in the 1979 opinion styled, Royal Globe Insurance Company v. Bar Consultants, Inc.:

We are not to be understood as holding that the statutory authority granted an agent under Article 21.02 authorizes that agent to misrepresent policy coverage and bind the company to terms contrary to those of the written policy; that question was decided by us in International Sec. Life In. Co. v. Finch, 496 S.W.2d 544 (Tex. 1973). However, an insurance company that authorizes an agent to sell its policies may not escape liability for the misrepresentations made by that agent which violate article 21.21 or section 17.46 merely by establishing that the agent had no actual authority to make such misrepresentations.