Mealey's Texas Insurance
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August 14, 2025
Texas Says Lilly Violated State Law To Induce Providers To Prescribe Its Drugs
MARSHALL, Texas — Texas has sued Eli Lilly & Company Inc. in a state court, alleging that the pharmaceutical company violated the Texas Health Care Program Fraud Prevention Act (THFPA) through programs used to induce providers to prescribe its medications, including its GLP-1 medications Mounjaro and Zepbound.
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August 13, 2025
Extracontractual, Breach Of Contract Claims Barred By Statute Of Limitations
FORT WORTH, Texas — A Texas federal judge granted a homeowners insurer’s motion for summary judgment on breach of contract and extracontractual claims after determining that the claims are barred by the applicable two-year statute of limitations because the insureds filed suit more than two years after the claims accrued.
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August 13, 2025
Texas Panel: Insurer Has Justiciable Interest In Homeowner’s Storm Damage Suit
CORPUS CHRISTI, Texas —A Texas appeals panel conditionally granted in part an insurer and an adjuster’s petition for mandamus relief in a lawsuit arising from storm damage, directing a lower court to vacate its orders granting a homeowner’s amended motion to strike an insurer’s plea in intervention, denying the insurer’s motion to dismiss, denying the adjuster’s motion for reconsideration of its motion to dismiss and denying the insurer’s motion to compel appraisal.
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August 12, 2025
Suit Over Airline’s LTD Plan Is Voluntarily Dismissed After Resolution Report
FORT WORTH, Texas — A putative class complaint that a disabled pilot filed over a May 2024 plan revision that he alleged resulted in underpayment of long-term disability (LTD) benefits was voluntarily dismissed without prejudice on Aug. 11 after the defendants told the Texas federal court in a dismissal motion that the pilot’s union had already gotten the issues resolved through a Railway Labor Act (RLA) dispute-resolution process.
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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.