Source: https://www.dallasfortworthinsurancelawyerblog.com/category/delay-in-paying-claim/page/2/
Timestamp: 2019-07-16 02:52:04
Document Index: 187947035

Matched Legal Cases: ['§542', '§542', '§542', '§542', '§542', '§542', '§542']

Delay in Paying Claim Category Archives — Page 2 of 9 — Dallas Fort Worth Insurance Lawyer Blog Published by Weatherford Insurance Attorney — Grand Prairie Denied Insurance Claims Lawyer — Mark S. Humphreys, P.C.
Articles Posted in Delay in Paying Claim
Penalties For Delay In Paying Claim
Benbrook insurance attorneys can discuss the penalties for delays in paying a claim. These penalties are spelled out in the Texas Prompt Payment of Claims Act (TPPCL) and are found in the Texas Insurance Code.
The amount of an insured’s claim (and/or the amount for which an insurer is liable) is often based on third-party invoices that the insured has not incurred, in amounts the insured cannot necessarily predict, at the time the insured submits its notice of claim to the insurer. Consider duty to defend or environmental clean-up coverage, where the amount of the claim can increase every month.
Naturally, there are questions regarding when the 18% penalty begins to accrue on such claims. The TPPCA language does not provide specific guidance on these calculations, but courts in the Fifth Circuit have recently indicated the methodology is based on the date of the TPPCA violation and not necessarily the date the cost was incurred.
Updated: September 18, 2016 7:42 am
Burleson insurance lawyers know that when an insurance company is slow to pay a claim that there are possible consequences to the insurance company under the Texas Prompt Payment of Claims Act (TPPCA).
Historically, one area of contention in TPPCA disputes has been the calculation of the penalty when an insurer violates an early claims-handling deadline and later denies a covered claim. Insurers have pointed out that §542.058 is the only subsection that references the enforcement provision (§542.060), and thus argue that only a violation of §542.058 triggers the penalty. The Fifth Circuit recently rejected this argument and ruled any violation of §§542.055-542.058 triggers the penalty, while the Texas Supreme Court has not addressed the issue.
Because courts have previously calculated the penalty interest when only a violation of §542.058 is pleaded and proved, there has been a dearth of guidance regarding when the penalty begins to accrue when an insurer violates §§542.055 or 542.056.
Updated: September 17, 2016 7:47 am
Prompt Payment Of Claims Act In Texas
It is important for Dallas and Fort Worth Attorneys to understand how the Texas Prompt Payment of Claims Act (TPPCA) works.
The deadlines imposed by the TPPCA are presented chronologically in terms of the claims-handling process.
First, §542.055 states the insurer shall acknowledge receipt of the claim, request information the insurer believes it requires, and begin investigation of the claim, within 15 days [or 30 days, for surplus lines insurers] of receiving notice of the claim;
Updated: September 15, 2016 8:05 am
Prompt Pay Act – Insurance Company Duties
Texas insurance lawyers need to be able to tell their clients the responsibility the insurance company has under the Texas Prompt Pay Act.
To start with, no deadlines are triggered until the insurance company receives all items, statements, and forms reasonably required by the insurance company. Once the insurance company receives this information, seven new duties arise that were not mentioned in the previous post.
(5) Accept or reject the claim. – By the 15th “business day,” the insurer, pursuant to Section 542.056(a), must notify the claimant that it accepts or rejects the claim. This deadline extends to 30 “days” if the insurance company reasonably expects arson. Also, the insurance company can get a 45 day extension of these deadlines.
Updated: June 26, 2016 8:06 am
Prompt Payment Act – Duties Of Insurance Company
Texas lawyers handling insurance claims need to know the following.
Once an insurance company receives notice of a claim, four duties are triggered:
(1) Acknowledge the claim. Texas Insurance Code, Section 542.055(a)(1) says the insurer must acknowledge receipt of the claim.
Updated: June 25, 2016 7:42 am
Insurance lawyers need to be aware of the Prompt Payment of Claims Act
Insurance lawyers need to be aware of the Prompt Payment of Claims Act found in Texas Insurance Code, Section 542.051. When suing for violation of this Act, an attorney must know that at the same time, he must sue for breach of contract. This is illustrated in the 2005, Waco Court of Appeals opinion styled, United States Fire insurance Company v. Tammy Fugate.
Fugate and her family were injured in a motor vehicle collision with a vehicle operated by William Heintz. After filing suit against Heintz, Fugate settled with him for his remaining policy limits of $15,200.
Fugate had an automobile insurance policy with US Fire, and that policy provided underinsured and uninsured motorist (UIM) coverage for her.
Updated: August 31, 2016 4:28 pm
Delay In Paying Claim After An Appraisal
Insurance lawyers in Mansfield and elsewhere should be able to explain to clients when payment is due under a claim. There are many situations and the situation determines when the claim should be paid and if a penalty applies.
The U.S. Western District Court of Texas, Waco Division issued an opinion in Cater v. State Auto Property & Casualty Insurance that needs to be read.
This is a case that was decided on two dueling motions for summary judgment.
Posted in: Delay in Paying Claim and Hail Claims
Updated: March 1, 2016 8:20 am
Insurance Company Delay In Payment
Fort Worth insurance lawyers need to read this 5th Circuit opinion. The case is styled, Cox Operating, L.L.C. v. St. Paul Surplus Lines Insurance Co.
In this Katrina pollution clean-up coverage case, the 5th Circuit sheds a bit more light on the proper method for calculating an insurer’s delay penalty under Texas’ Prompt
Payment of Claims Act (the “Act”). Along the way, the court also determines whether a one-year cost-reporting requirement was an absolute, unwaivable condition precedent under a policy, or whether the insurer could, and did, waive it by anticipatorily denying the claim. The principal issue regarding the Act is whether, under a first-party property-damage policy, the 18% penalty begins to accrue multiple times as each new cost invoice is submitted to the insurer, as is probably the case with defense invoices under a liability policy, or whether the insurer’s first violation of a deadline under the Act starts the clock for the total amount of the claim ultimately determined. As discussed below, the insurer lost on all issues.
Updated: February 20, 2016 8:24 am
Prompt Pay And Auto Insurance
Mansfield insurance lawyers need to read the Houston Court of Appeals [14th Dist.] opinion styled, Daugherty v. American Motorists Insurance Company. It was issued in 1998.
Daugherty filed suit against American for refusing to pay his claim. The trial court ruled in favor of American. Daugherty appealed.
The record reflects that Daugherty purchased a BMW on January 12, 1994. The sales price of the vehicle was $58,148.88. With the addition of taxes and fees, Daugherty paid a total of $64,678.97 for the automobile. The car was stolen on February 15, 1994. Daugherty promptly reported the theft to American. On February 25, 1994, Daugherty submitted an affidavit of vehicle theft to American in which he claimed a loss of $68,895.42.
Posted in: Delay in Paying Claim and Interpreting An Insurance Policy
Updated: July 28, 2015 8:04 am