If you get treated wrongly by your insurance company and you live in Grand Prairie, Arlington, Mansfield, Weatherford, Fort Worth, or Dallas, the first thing you should do is find an Insurance Law Attorney. He will tell you some of the following:
A plaintiff who prevails against an insurance company may obtain:
a) actual damages b) additional damages if the insurance company acted knowingly c) court costs d) attorney’s fees e) other monies depending on the wrongful act This article will deal just with one potential recovery, that being, the actual damages.
In a 1997, Supreme Court case, the court set out the following principles that govern recovery of “actual damages” under the similar language that existed under the Deceptive Trade Practices Act before 1995. This case was, Arthur Andersen & Company v. Perry Equipment Corporation. The same analysis in that case should apply to the Insurance Code, Section 541.152(a)(1).
The amount of actual damages recoverable is “the total loss sustained as a result of the deceptive trade practice.”
Actual damages are those damages recoverable under common law. At common law, actual damages are either “direct” or “consequential.” Direct damages are the necessary and usual result of the defendant’s wrongful act; they flow naturally and necessarily from the wrong. Direct damages compensate the plaintiff for the loss that is conclusively presumed to have been forseeable by the defendant from his wrongful act.
Consequential damages, on the other hand, result naturally, but not necessarily, from the defendant’s wrongful acts. Under the common law, consequential damages need not be the usual result of the wrong, but must be foreseeable, and must be directly traceable to the wrongful act and result from it. Of course, foreseeability is not an element of producing cause under the DTPA. Still, if damages are too remote, too uncertain, or purely conjectural, they cannot be recovered.
Under Texas common law, direct damages for misrepresentation are measured in two ways. Out-of-pocket damages measure the difference between the value the buyer has paid and the value of what he has received; benefit-of-the-bargain damages measure the difference between the value represented and the value received. Under the DTPA, a plaintiff may recover under the damage theory that provides the greater recovery. Both measure of damages are determined at the time of sale.
Here is just one example from the 1989 case, Paramount National Life Insurance Company v. Williams. This is a Houston, 14th District, Court of Appeals case.
An insured recovered actual damages for loss of credit or injury to credit reputation based on receiving notice letters from bill collectors arising from medical expenses the insurer misrepresented would be paid.
Each situation has to be looked at on an individual basis.