Mealey's Texas Insurance
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August 11, 2025
5th Circuit Mostly Vacates, Remands Row Over Assignment Of Health Care Claims
NEW ORLEANS — Concluding in part that the lower court “ignored the Physician Groups’ arguments about ambiguities in contract language and applied the wrong legal standard in determining whether assignments to the Physician Groups were valid,” the Fifth Circuit U.S. Court of Appeals on Aug. 8 mostly vacated and remanded summary judgment against health insurance plans in a reimbursement dispute over out-of-network care.
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August 11, 2025
Judge Refuses To Dismiss Chemical Company’s Coverage Suit Arising From Explosion
BEAUMONT, Texas — A federal judge in Texas denied an insurer’s motion to dismiss a sustainable chemical company’s breach of contract and declaratory judgment lawsuit seeking to obtain coverage for the full value of its business interruption loss caused by an explosion at a Texas plant, finding that the company sufficiently pleaded a right to sue the insurer “based on an implied agreement outside the Reinsurance Agreement.”
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August 11, 2025
Insureds Failed To Show Coverage Decision In Storm Damage Dispute Was Unreasonable
SAN ANTONIO — A Texas federal magistrate judge granted a homeowners insurer’s motion for summary judgment on extracontractual claims alleged by insureds seeking additional coverage for storm damage to their home after determining that the insureds failed to offer evidence showing that the insurer’s coverage decision was unreasonable.
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August 06, 2025
Texas Panel: Court Erred In Setting Aside Appraisal Award In Storm Damage Suit
EDINBURG, Texas — A Texas appeals panel determined that an insured failed to meet his burden to set aside an appraisal award in a coverage dispute over storm damage and, therefore, that the lower court abused its discretion in granting the insured’s motion to set the award aside, vacating the lower court’s order.
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August 05, 2025
Bifurcation Of Extracontractual Claims In Storm Damage Dispute Not Warranted
SHERMAN, Texas — Bifurcation of an insured’s breach of contract claim from the insured’s extracontractual claims is not warranted because the property insurer failed to meet its burden of showing that bifurcation would be economical or that the insurer would be prejudiced if the claims are tried together, a Texas federal magistrate judge said in denying the insurer’s motion.
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August 05, 2025
Builder Seeks Reconsideration Of Ruling For Insurer On Defects Arbitration Award
HOUSTON — A homebuilder seeks reconsideration of a Texas federal judge’s ruling granting summary judgment in favor of its commercial general liability insurer in the builder’s suit seeking indemnification for a $213,000 arbitration award for damages caused by construction defects in a home it built, arguing that the judge erred in finding that the appraisal process discharged the insurer’s obligations as there was no appraisal or appraisal award in the case.
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August 05, 2025
Insured’s Counterclaim In Dispute Over Defective Pool Shells Dismissed
AUSTIN, Texas — A Texas federal judge adopted a magistrate judge’s recommendation to dismiss an insured’s counterclaim for promissory estoppel in a dispute over coverage for defective pool shells damaged by a chemical reaction between alkalis in the cement and silica, overruling the insured’s objection that the magistrate judge misapplied the legal standard governing promissory estoppel claims.
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