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Texas Insurance Bad Faith Questions & Answers
1 Answer | Asked in Insurance Bad Faith for Texas on
Q: I have health insurance claims that have been paid at different rates for the same services.

Insurance with a previous employers self insured plan.

Tim Akpinar
Tim Akpinar
answered on May 15, 2023

A Texas attorney could advise best, but your question remains open for two weeks. It's not necessarily a matter of insurance bad faith. It's more likely to be inconsistencies in the billing department. If the claims were processed by different people, they may have applied different... View More

2 Answers | Asked in Insurance Bad Faith, Small Claims and Car Accidents for Texas on
Q: Do you sue an individual or the insurance company, whereby an insurance company denies a claim / their insured at fault

In this case other party ran a red light resulting in collision accident, but claim was denied by at fault driver insurer in that there was no witness at the scene- but never deny the fact that the other driver ran a red light!

other party claimed couldn't speak English and Police... View More

John Michael Frick
John Michael Frick
answered on Apr 15, 2023

Texas does not allow a direct action against another driver’s insurance company. Sue the other driver directly. The other driver can then demand that his insurance company defend him and indemnify him from any judgment.

Our JP courts have jurisdiction up to $20,000. If the damage to...
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1 Answer | Asked in Family Law, Banking, Insurance Bad Faith and Small Claims for Texas on
Q: What to do if ex won’t endorse a two person signature check for an insurance claim where they were the co-signer on car

Ex lives on the opposite side of the country and is spiteful and won’t endorse a claims check made out in both our names cause they were on the car title as well unbeknownst to me. The check was sent to me but in both names and car insurance won’t change it. It’s my vehicle that I made all... View More

John Michael Frick
John Michael Frick
answered on Apr 3, 2023

Most divorce decrees contain a provision requiring each of the divorcing spouses to execute necessary instruments to effect the property division contained in the divorce decree.

You may be able to secure an order from your divorce court compelling your ex to endorse the check.

1 Answer | Asked in Insurance Bad Faith for Texas on
Q: Driver that hit us insurance company is paying all but $500 of a $35000 claim and want us-not atfault to pay diff-Legal?

We have a range rover and only 2 places are certified to fix it which means only Land Rover will sell parts to them- we went where the other guys insurance told us to go and after 8 weeks of trying to get an authorization they are refusing to pay the entire thing. Leaving our car hostage over... View More

John Michael Frick
John Michael Frick
answered on Mar 15, 2023

You can recover loss of use, which is how much it would take to rent a similar Land Rover from the date of the accident to the date repairs are complete

1 Answer | Asked in Insurance Bad Faith and Small Claims for Texas on
Q: Can I press charges on a insurance agent for stealing my $5600 premium down payment

And financing $3000 on my premium policy

John Michael Frick
John Michael Frick
answered on Mar 9, 2023

I suspect police will tell you this is a civil matter. Because such a small amount of money is involved, a civil claim for this amount falls within the jurisdiction of Texas justice of the peace courts. Such courts handle “small claims” where the amount in controversy is less than $20,000.... View More

1 Answer | Asked in Insurance Bad Faith for Texas on
Q: How do i sue an auto insurance company that is denying rightful claim?

My claim for auto insurance was denied by the perpetrator's insurance because their client "won't cooperate with the investigation. My car is still damaged. Do i have a claim?

John Michael Frick
John Michael Frick
answered on Mar 1, 2023

In Texas, you cannot sue another person’s insurance company directly.

Instead, you should contact a personal injury attorney to file suit against the other driver.

1 Answer | Asked in Car Accidents and Insurance Bad Faith for Texas on
Q: A vehicle hit my car and 2 others in the garage where I live. The apartment complex had my vehicle towed to a storage lo

The person who hit my car is underinsured and my insurance company is considering this a total loss. I can't replace the vehicle with one that has the same mileage and condition as mine. How can I recover enough to get a decent vehicle?

John Michael Frick
John Michael Frick
answered on Feb 9, 2023

You should make a claim on your uninsured/underinsured insurance coverage.

1 Answer | Asked in Insurance Bad Faith for Texas on
Q: Do I have to answer Discovery for past criminal offenses in small claims court. I’m plaintiff suing for diminished value

Her insurance has already admitted she’s at fault and repaired my car. Lawyer is claiming she is not liable. Does this apply? Rule 404. Character Evidence; Crimes or Other Acts

(a) Character Evidence.

(1) Prohibited Uses. Evidence of a person’s character or character trait is... View More

John Michael Frick
John Michael Frick
answered on Jan 14, 2023

Rule 404 is a rule of evidence, not an exemption from discovery.

1 Answer | Asked in Insurance Bad Faith for Texas on
Q: In Texas, is there a statute of limitations for a homeowner's claim to be accepted or denied?
John Michael Frick
John Michael Frick
answered on Jan 7, 2023

The statute of limitations is the period of time within which the homeowner must file a lawsuit against the insurance company.

Separate and apart from the statute of limitations, the Prompt Payment Act requires an insurance company to respond within a specific time to a claim made by the...
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2 Answers | Asked in Insurance Bad Faith and Employment Law for Texas on
Q: After denial, Sedgwick isn’t responding to written reqs for Copies of Claim Files OR the STD Policy, what can I do?

Fortune 100 employer, ERISA policy. Sent written requests to Sedgwick 3x, 1st was 11/22. Will not return my calls. Employer states Sedgwick provides copy of policy/Summary Plan. Sedgwick advised STD policy exhausted from previous unrelated LOA; apply for LTD via Lincoln. Without policy & files,... View More

Damon Miller
Damon Miller
answered on Dec 28, 2022

Under ERISA, the plan administrator (usually your employer) is required to provide plan documents to you within 30 days of your request. With both your employer and the insurance company refusing to provide you anything, you may need to get an attorney involved. Feel free to contact my office and... View More

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1 Answer | Asked in Insurance Bad Faith, Appeals / Appellate Law and Civil Litigation for Texas on
Q: My insurance company made identification errors. Why do they expect me to fix the problem when they never notified me?

My medical records related to auto injuries keep 'disappearing'. Ive been denied medical treatment for auto related injuries and constantly undermineded without any explanation. Now that I know, my insurer is admitting they made identification errors during the claims process and is fully... View More

Tim Akpinar
Tim Akpinar
answered on Jan 5, 2023

A Texas attorney could advise best, but your question remains open for three weeks. It isn't clear why false allegations were made against you - unless you mean the matter was escalated to a SIU (Special Investigations Unit). It looks like there could be a number of issues to sort out here -... View More

1 Answer | Asked in Car Accidents, Insurance Bad Faith and Insurance Defense for Texas on
Q: Do insurance companies have the right to hire an attorney to defend the insured against liability claims?

If liability is disputed in intercompany arbitration will the insurance company notify the insured of the arbitrators decision?

John Michael Frick
John Michael Frick
answered on Dec 9, 2022

In a typical automobile liability insurance policy, the insurance company has both the right and the duty to defend the insured driver.

It is not typical in intercompany arbitration for the insured to be notified of the award

1 Answer | Asked in Insurance Bad Faith for Texas on
Q: Is there a law that allows health insurance to subvert themselves under other health insurance if you’re primary on both

I have two full time jobs and have full health insurance through both BCBS and United Healthcare. Both are refusing to pay because each claims i am primary on another policy. Each is trying to subvert themselves as secondary under ther other. This seems illegal

John Michael Frick
John Michael Frick
answered on Dec 9, 2022

There are rather complex rules called coordination of benefits which address the situation when a patient has coverage under two health separate health care plans. These rules resolve which one is primary and which one is secondary.

It is definitely legal. There are a number of...
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1 Answer | Asked in Insurance Bad Faith and Small Claims for Texas on
Q: Can I request that the auto insurance Company’s lawyer not represent a defendant in small claims court?

The insurance company denied my claim that’s why I am suing for an independent analysis of the accident.

John Michael Frick
John Michael Frick
answered on Dec 3, 2022

In a typical automobile liability insurance policy, the insurance company has both the right and the duty to defend its insured in any lawsuit triggering coverage under the policy.

In those cases where the insured fails to notify the insurance company of a lawsuit and a judgment is entered...
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1 Answer | Asked in Insurance Bad Faith and Car Accidents for Texas on
Q: Can an auto insurance agency deny a claim because I would not provide cell phone records unreasonably?

My two adult sons were in an accident with each other. They're covered under my policy. Fault is clear, 1 rear-ended the other. Police came. No tickets. No injuries. Straight forward.

I was not involved nor did I know about the accident for a few days. I told the insurance that when I... View More

Tim Akpinar
Tim Akpinar
answered on Dec 8, 2022

A Texas attorney could advise best, but your question remains open for two weeks. It's possible that both vehicles in the accident being from the same family raised red flags. You could consult with an attorney to review the file. The carrier could be building evidence for a denial, they could... View More

1 Answer | Asked in Insurance Bad Faith, Estate Planning and Probate for Texas on
Q: My husband son passed away who named his insurance agent has beneficiary is that legal

My husband's son passed away at 50 years old after days ago and we found out that he had named his insurance agent his beneficiary is that legal

John Michael Frick
John Michael Frick
answered on Oct 27, 2022

It’s legal but it sure looks suspicious.

1 Answer | Asked in Insurance Bad Faith for Texas on
Q: My insurance company has denied my claim for water damage from a broken sewer line under my house

They have denied the claim based on a line in the contract that says they will not cover water damage resulting from the release "from within any portion of a plumbing or automatic fire protective sprinkler system that is either: below the surface of the ground, or within or below the slab or... View More

John Michael Frick
John Michael Frick
answered on Oct 12, 2022

What is covered by your particular homeowners policy depends on the language of the policy. There are a few different forms of HO insurance available and approved for use in Texas.

The ISO HO 00 03 policy as amended by the Special Provisions-Texas endorsement does not include coverage for...
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1 Answer | Asked in Insurance Bad Faith, Personal Injury and Car Accidents for Texas on
Q: My lawyers filed a lawsuit for UIM claim and the insurance company is passed the deadline by 15 days to respond.

What should my lawyer be doing to resolve this matter. The para legal said they did receive an email from the defense attorney to discuss the lawsuit before the deadline but she said she is working with my lawyers to figure out what is going on. Are my lawyers just being negligent, shouldnt they... View More

Tim Akpinar
Tim Akpinar
answered on Aug 25, 2022

A Texas attorney could advise best, but your question remains open for two weeks. In all fairness to your attorney, they may be working toward trying to discuss the claim. You mention the paralegal receiving an email from defense attorney. Based on these brief facts, no one here could say and no... View More

1 Answer | Asked in Insurance Bad Faith and Probate for Texas on
Q: Life Insur: Insured died in Oct 2021. One of the beneficiaries started the claim process in Jan 2022, but didn't finish

before passing away in Feb 2022. Prudential is telling me (her Executrix) that even though she started a claim and outlived her father, her estate is not eligible for the proceeds because the 1992 policy had an "automatic mode of settlement" that paid only the 3 living persons.

Ross F. Tew
Ross F. Tew
answered on Jul 25, 2022

I expect the answer to your question lies within the language of the insurance policy itself. You would need to meet with an attorney and have him or her review the documents in question. If you are on good footing and the insurance company is in the wrong, then you will probably need to open an... View More

1 Answer | Asked in Consumer Law, Car Accidents and Insurance Bad Faith for Texas on
Q: Do statues begin the day liabilty is determined or the day you're notified?

Does someone need to be notified of their right to file a claim & what the deadlines are before statues can begin?

Tim Akpinar
Tim Akpinar
answered on May 21, 2022

A Texas attorney should advise here, since statutes of limitations are governed by state law. But your question remains open for two weeks. In virtually all jurisdictions, statutes of limitations usually use the day of the accident as a reference point. A local attorney could provide specific... View More

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