Case Notes


Determining the Reasonableness of Medical Charges – The Quest Continues

November 5th, 2018 By Sarah Scott

Texas Supreme Court Rules Government and Insurance Billing Rates are Discoverable for Determining “Reasonableness” of Hospital Charges to Individuals One of the biggest factors affecting the value of a personal-injury case is the amount of medical bills – hospital bills, in particular. To encourage hospitals to promptly and adequately treat accident victims who are uninsured, the Texas Legislature has granted hospitals a lien on any patient injured in “an accident that is attributed to the negligence of another person.” Tex.
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Adjuster in the UM/UIM Hot Seat? Houston Court of Appeals Says No

October 29th, 2018 By Sheila Tan

One of the more contentious battles in a UM/UIM case is the taking of the deposition of insurer’s corporate representative. The good news is that more and more Texas courts are acknowledging that the corporate representative’s deposition in a UM/UIM matter has no bearing on the issues of the tortfeasor’s liability and damages and “is not reasonably calculated to lead to the discovery of admissible evidence.” We suspect that Plaintiffs’ lawyers desire to get insurance carrier representatives in the hot
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Federal Courts Sketch Roadmap for Chapter 542A Removals

October 22nd, 2018 By Eric S. Peabody

As many commentators have noted, the addition of Texas Insurance Code Chapter 542A—the so-called “Hailstorm Bill”—has substantially reduced the volume of weather-related lawsuits against insurance companies since September 2017. In addition to imposing strict timelines for pre-suit notice and inspections and curbing potential penalties and attorneys’ fees awards, Chapter 542A affects the parties to, and potential venue of, a lawsuit by allowing the carrier to assume any liability an “agent” might have to the claimant (with certain exceptions) for the
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Pre-Suit Demands: Insured’s counsel must check all the boxes, but detail may still be vague.

September 26th, 2018 By Tara Mireur

Perrett v. Allstate Insurance Company, 2018 WL 2864132 (S.D. Tex. June 11, 2018) is the first case that scrutinizes whether or not a pre-suit notice properly complies with the new requirements of § 542A.003 of the Texas Insurance Code and therefore gives some guidance to attorneys about how strictly courts will enforce each statutory requirement. Section 542A.003 of the Texas Insurance Code provides that “not later than the 61st day before the date a claimant files an action to which
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Menchaca won’t save your vague pleadings

August 6th, 2018 By Sarah Scott

The Fifth Circuit Rejects a plaintiff’s attempts to use Menchaca to keep extra-contractual claims alive A recent ruling from the Fifth Circuit should serve as a warning to enterprising attorneys seeking to recover on extra-contractual claims under the Texas Insurance Code. In Moore v. Allstate Texas Lloyd’s, plaintiff Glen Moore sued Allstate, his homeowners’ insurer, for alleged damage to his home arising from a storm. No. 17-10904, 2018 WL 3492818 (5th Cir. July 19, 2018).  After two inspections by an
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A Premises Liability Primer

July 30th, 2018 By Eric S. Peabody

A person injured on another’s property may have either a negligence claim or a premises-liability claim against the property owner or occupier. When the injury is the result of a contemporaneous, negligent activity on the property, ordinary negligence principles apply; when the injury is the result of the property’s condition rather than an activity, premises liability principles apply. Occidental Chem. Corp. v. Jenkins, 478 S.W.3d 640, 644 (Tex. 2016).  Although they are related, the theories are not interchangeable, and “a
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Insured cannot lay down its burden and survive summary judgment.

July 23rd, 2018 By Sheila Tan

In Certain Underwriters at Lloyd’s of London v. Lowen Valley View, LLC, 892 F.3d 167 (5th Cir. June 6, 2018), the Fifth Circuit affirmed that in addition to establishing that the insured property sustained hail damage within a policy period, the policyholder must also provide some evidence of how much of the hail damage was attributable to the hail event within the policy period, and the failure to do so should lead to summary judgment against the policyholder. Insurance underwriter
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To err is human. To disagree on an appraisal award is not grounds to set it aside.

June 28th, 2018 By Catherine Hanna

In Abdalla v. Farmers Ins. Exchange, No. 07-17-00020-CV, 2018 WL 2220269 at * 1 (Tex. App.—Amarillo May 14, 2018, no pet. h.), the Amarillo Court of Appeals rejected an insured’s attempt to convert a disagreement among appraisers regarding the extent of damage into a reason to set aside a valid appraisal award. The court of appeals affirmed the trial court’s decision denying Abdalla’s motion to vacate the umpire’s award and granting summary judgment in favor of Farmers.   Abdalla sued Farmers alleging breach
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Appraisal Payments: Don’t be late for this very important date.

June 26th, 2018 By Todd Key

A recent opinion out of the Western District of Texas, Kezar v. State Farm Lloyds, 1:17-CV-389-RP, 2018 WL 2271380, at *1 (W.D. Tex. May 17, 2018), adds further support for post-appraisal summary judgments on extra-contractual claims, but also suggests a strict analysis of whether or not appraisal payments are timely. The Kezar plaintiffs filed their lawsuit against State Farm asserting causes of action for breach of the insurance policy, statutory and common law bad faith, unfair settlement practices, negligence and
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