Category archive: Texas

No Pay for Delay Today: Insurer’s Joint Check Satisfied Prompt Payment Statute

Summary: Property Gusma Properties owned and insured was damaged in Hurricane Ike. When the insurer demanded an appraisal, Gusma hired an attorney to assist. Following the appraisal award, the insurer tendered a check to the attorney for the full amount, all of which the attorney retained. Gusma sued the attorney and the insurer to recover…

Texas Law Firm’s Coverage and EC Awards Properly Reduced from $33M to $28M

Summary: OneBeacon Insurance Company (OneBeacon) provided professional liability insurance to T. Wade Welch & Associates (Welch Firm) and firm attorneys, including Ross Wooten (Wooten). After a legal malpractice award against the Welch Firm which OneBeacon refused to settle, the Welch Firm filed common law and statutory bad faith claims against OneBeacon on which it prevailed….

Prejudicially Delayed Loss Reporting Barred All Claims, Contract and Extra-Contractual

Summary: Hamilton Properties owned the Dallas Plaza Hotel, which was insured by American Insurance Company (“AIC”) when a hail storm struck Dallas in July 2009. Hail damage was covered by the policy, but losses were to be reported promptly. The District Court found that the hail loss first reported at least 19 months after the…

Insurer Not Liable For Bad Faith Where No Payment Was Obligated Under The Terms Of The Insurance Contract

Summary:  In Davis, the Texas Court of Appeals affirmed that no breach occurred when the insurer denied a claim that the jury ultimately found did not exceed the insured’s deductible. Without a breach, no “extra-contractual claims” could exist, including for bad faith. Davis v National Lloyds Insurance Company Davis, the insured, purchased a building in…

Texas Healthcare Insurance Administrator Not Subject to Statutory Penalties for Alleged Delayed Claims Payments

Summary:  The plaintiff healthcare insurance administrator acts in various roles including administering some plans that expressly assume the risk of medical costs and establish their own benefit plans, including employer self-funded plans, state government plans, and claims arising under the BlueCard program allowing out-of-state patients to obtain care in Texas. Plaintiff also services benefit plans…

Failure To Timely Decide Claim Leads to Large Interest Penalty Under Texas Prompt Payment Statute When Insurer Knew That The Insured Had In Fact Suffered A Loss

The insured, Weiser-Brown, had a loss of control oil well insurance policy with St. Paul. Under this policy, St. Paul is required to pay if insured suffers a subsurface loss of control on one of its oil wells. Weiser-Brown made a claim under the policy in March 2009 and St. Paul’s claims representative requested seventeen…

Insurer Did Not Commit Bad Faith in Denying Worker’s Comp Claim

Summary: Worker’s compensation insurer filed dispute as to whether claimant’s compensable injury included right carpal tunnel syndrome, a wrist sprain/strain, and tendonitis. Following a contested case hearing with the Department of Worker’s Compensation, it was found that evidence of causation was insufficient to establish claimant’s injuries were work related. Claimant filed a bad faith action…

Court Finds No Bad Faith Due to Bona Fide Dispute Over Coverage for Wind Damaged Roof

Summary: The District Court granted partial summary judgment in favor of insurer on bad faith claim regarding roof damage. The District Court found there was a bona fide dispute whether coverage applied, but that the insurer had not acted in bad faith by relying on its experts’ reports which concluded that the damage was not…


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