Insurance Law Section
ILS Events Calendar



19th Annual Insurance Law Institute

November 13-14, 2014, Dallas, TX (More)

Why Personal Injury Attorneys, Both Plaintiff And Defense, Should Read The U.C.C.
by Judith Ann Kostura

 On May 16, 2014, the Texas Supreme Court issued its opinion in McAllen Hosps., LP v. State Farm County Mut. Ins. Co., (Tex. 2014) No. 12-0983. The Court held that a release given to a liability insurer by an injured accident victim is invalid when that accident victim does not pay a hospital lien. The Court refused, however, to shed much light on the remedy available to the scorned hospital.

Two injured people, Jose Gil and Melinda Hernandez, settled with the tortfeasor, Carlos Benavidez, insured by State Farm, after a collision. Gil and Hernandez incurred hospital bills of $53,564 and $1,281, respectively, but settled for only $5,200 and $2,100. State Farm, aware of the hospital lien, named the injured plaintiff and McAllen Hospital on each of the settlement checks. The injured claimants endorsed and deposited the checks without obtaining the hospital’s endorsement and without paying the hospital bills. After the hospital was stiffed by each patient, the hospital sued State Farm to recover payment up to the amounts of the settlement checks; the carrier refused to pay again, arguing that it had already protected the hospital (and therefore itself) by naming the hospital as a payee.

The trial court sided with State Farm on summary judgment, which the appeals court affirmed, but the Supreme Court reversed and...(Continue)

TDI News
TDI Announces Top 10 Insurance Fraud Cases of 2013
More than $10.3 million in insurance fraud was identified in criminal cases referred for prosecution by the TDI Fraud Unit in 2013.
TDI Issues Bulletin Regarding Roofers and Insurance Adjusters
TDI has issued a bulletin to insurance companies, insurance adjusters, and roofers, reminding them of prohibitions related to public insurance adjusters.
Rule Aims to Assist Injured Employees Seeking Lifetime Income Benefits
The Division of Workers’ Compensation (DWC) is accepting public comment on a rule that will assist injured employees seeking Lifetime Income Benefits in the Texas workers’ compensation system.
Recent Decisions
Bad Faith Damages Affirmed With No Breach of Contract  
USAA Tex Lloyds Co v Menchaca Tx 13- Corpus/Edbrg 7/31/14—
A finding of no breach of contract does not preclude insurance code damages for failure to conduct a reasonable investigation.
Oil Storage Tank Leak Not Covered  
Superior Crude Gathering v Zurich Am Ins Co Tx 13- Corpus/Edbrg 7/30/14—
Trucker's policy with expanded pollution coverage still not applicable where there was no nexus between pollution and operation of covered vehicle.
Coverage Upheld in Alleged Stranger- Oriented Life Insurance Scheme  
Am Natl Ins Co v Conestoga Settlement Trust Tx 4-San Antonio 7/29/14—
Insurer barred from contesting policy after complex choice of law analysis results in application of New York law.
Claim Against Workers Comp Commissioner Tossed  
Hernandez v Tex Dept of Ins Tx 4-San Antonio 7/29/14—
Sovereign immunity bars workers comp claimant's claims against against TDI and Commissioner of Workers’ Compensation.
UM Coverage Precluded for Unscheduled Vehicle  
Anderson v Tex Farm Bureau Mut Ins Co Tx 11-Eastland 7/23/14—
No coverage for insured injured by unscheduled family-owned truck, even though injury allegedly caused by unrelated thief.
Insurer Finally Gets It Right  
Old Republic v San Antonio Piper WD Tx 7/20/14—
Court finds that per-passenger limit in aviation policy applies to survivor claims. Previous versions of the policy had been found to be ambiguous on issue.
Comp Carrier Did Not Waive Right To Contest Injury  
Zurich American Ins Co v Debose Tx 1-Houston 7/14/14—
Failure to contest compensability does not bar carrier from contesting the extent of an injury.
Landlord Denied Relief Under Tenant Policy  
Debes v General Star Indem Co Tx 9-Beaumont 7/9/14—
Landlord who is not named on a tenant's property policy cannot recover for a fire loss as a third-party beneficiary.
Fifth Circuit Sides with Insurer In Construction Defect Case  
Crownover v Mid-Continent Cas Co 5th Cir 6/26/14—
Court finds contractual liability exclusion applicable to breach of warranty claim.
Lien on Me? Not So Fast Says 14th Court  
Allstate Indem Co v Memorial Herman Health System Tx 14-Houston 6/25/14—
Court reverses trial court finding that insurer lacked standing to contest reasonableness of hospital lien.
More Recent Decisions
Section News
Welcome the 2014-2015 Insurance Law Section Council & Officers

Join us in welcoming the Insurance Law Section Officers and Council Members for 2014 - 2015. New officers were elected by the Council and Council members were elected by Section membe... (Continued)