Recently, the Houston Merlin team has encountered several cases that turn on notice to policyholders, or rather, the lack thereof, when an insurer makes “material changes” to a policy renewal. A hypothetical example of this situation might be if a policyholder has a homeowners’ policy that did not exclude cosmetic damage to the policyholder’s roof and the next year, the renewal policy, unbeknownst to the policyholder, contains a cosmetic damage exclusion. Thinking the “renewal” policy was the same as the prior policy, except for coverage dates, the policyholder accepts it and pays his premium. Along comes the typical Texas hail/windstorm, and the policyholder’s metal roof suffers hundreds of unsightly dings. Policyholder files a claim with his insurance company only to find out that his current renewal policy has a new endorsement excluding what the insurance industry labels as “cosmetic” damage to his roof. His insurer denies the claim based on the “new” cosmetic damage exclusion in his renewal policy. Policyholder contacts Merlin Law Group for help. Given these facts, the information below regarding Texas law and renewal policies may be helpful to this hypothetical policyholder, and now Merlin client, and his case.
Continue Reading Upon Renewal of a Policy, Insurers Must Give Policyholders Advance Notice of “Material Changes”

Last week the Supreme Court of Texas weighed in on a longstanding dispute regarding the decision by Farmers Group Inc. (“Farmers”) to replace their HO-B homeowner policies with less comprehensive HO-A policies, back in 2001.1 Following an influx of mold claims in Texas, Farmers and other insurers decided to replace their HO-B policies, a broad “all-risk” policy, with narrower HO-A policies, or “named peril” policies.
Continue Reading The Insurance Coverage Gap Worsens—Farmers Policy Changes Approved

It is no secret that there are problems with the appraisal process. The ever-growing issues with appraisal include, but certainly are not limited to, exorbitant expenses pushed onto policyholders and insurance companies, gamesmanship, and the never-ending questions of:

In what sounds like a simple and obvious statement, an adjuster sent by the insurance company to perform an inspection and write an estimate of damages can be liable for violating the Texas Insurance Code. The Western District of Texas recently held that while an adjuster cannot be held liable as an insurer under the insurance code, the plaintiffs could have a valid claim against the insurance adjuster under Texas Insurance Code section 541.060.1
Continue Reading An Adjuster is not an Insurer But Can Violate the Texas Insurance Code

TFPA’s mission is to efficiently provide essential residential property insurance products and services for eligible Texas policyholders when no one else will.”

Purpose and Operation

The Texas Fair Plan Association (TFPA) was created by the Texas Legislature to address growing concerns of obtaining residential property insurance coverage in underserved areas. TFPA was implemented in 2002 following a mold crisis. Due to an increase in mold damage claims and water damage claims—fewer policies were being written and renewed through the private market. Lack of available residential property insurance policies through the private market sparked a surge in the number of TFPA policies being written.
Continue Reading Residential Property Insurance Coverage of Last Resort: Texas Fair Plan Association (TFPA) – Eligibility and Important Coverage Information

Texas Watch received more documents from their Freedom of Information Act request, which included internal documents and notes from a March 30, 2016, secret meeting between the Texas Department of Insurance (TDI), Texas Farm Bureau, and lobbyists for the insurance industry.

Continue Reading So-called Discount in Exchange for Mandatory Arbitration Clause is a Farce: There is No Discount

After a claim is filed, the insurance company is certainly entitled to receive from a policyholder reasonable information that the insurance company requires to decide whether to accept or reject the claim. Unfortunately, as a way to delay the claim and discourage the policyholder, many insurance companies create daunting laundry lists of items from the policyholder they say they require before they can make a decision to accept or deny the claim.

Continue Reading Carriers Can’t Hide Behind Laundry List of Requested Items and Avoid the Texas Prompt Payment Act

Yesterday’s post, Texas Insurance Lobbyists Support Bad Insurance Practices promised to show “how the insurance lobby uses ‘think tanks’ and the media – directly referencing yours truly – to manipulate our own elected representatives.” As a conservative supporter of people trying to help people rather than cheating insurance companies and believer that propagandists are a huge threat to America, I want to show you just one connection between the strategy of Texas insurer lobbyists and “for hire spin doctors” that are paid for by insurance companies to hurt policyholders.

Continue Reading Lobbying Spin Doctors Working for Texas Insurers against Policyholders

If organized criminals in Texas wanted to get off easier and pay less for their misdeeds, they would probably hire lobbyists to make up a propaganda campaign to change laws to go easier on crooks. This is similar to what the insurance industry and their trade groups plan to do in Texas this year – they want to lessen penalties and personal accountability for cheating, delaying, and wrongfully denying property insurance claims.

Continue Reading Texas Insurance Lobbyists Support Bad Insurance Practices