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PRACTICE AREA : Trial & Litigation

Consumer Protection Litigation : Representative Cases

HMO vs. The State of Texas and the Texas Department of Insurance

This is an insurance regulatory matter that began when the Attorney General’s Office issued several civil investigative demands to an HMO. The HMO filed a declaratory judgment action challenging the civil investigative demands, as well as the constitutionality of various provisions of the Texas Insurance Code. The State of Texas and the Texas Department of Insurance asserted a plea in abatement and a plea to the jurisdiction, both of which were denied by the trial court. Over a period of time, over 400 other private individuals and entities intervened in the case against the HMO.

With regard to the intervenors, upon motion by the HMO, the court ruled they have no private right of action against the HMO for alleged violations of the delegation oversight statute. Further, the court ruled that the Texas Attorney General and the Texas Department of Insurance can not seek to impose civil penalties against the HMO under the prompt pay law in the state court litigation. The HMO ultimately reached an agreement with the State of Texas and the Department of Insurance.

Michael Klein and Lisa Michaux Magids were the lead attorneys for the plaintiff HMO.

Individual vs. Insurance Company

 The case was filed as a nation-wide class action. The plaintiffs alleged that the defendants misled their insureds into believing certain insurance coverage was included for free, when in fact it was not. Plaintiffs further alleged that the defendants' renewal practices were improper because they did not account for the depreciated value of the insured property. The plaintiffs alleged that these acts constituted fraud, fraudulent misrepresentation, breach of contract, and violations of the insurance codes of all 50 states. The plaintiffs sought punitive damages in an unspecified amount. In the civil cover sheet, the plaintiffs listed their damages demand as $100,000,000.

No class was ever certified, and the claims of the individual class representatives were settled.

Self-Move Company vs. The State of Texas and the Texas Department of Insurance

This was an insurance regulatory case in which a self-move company was accused by the Texas Department of Insurance of selling insurance and damage waivers without a proper license. The self-move company filed a declaratory judgment action seeking a declaration of its rights. With regard to the damage waiver, the self-move company obtained a summary judgment that damage waiver was not insurance, and therefore did not require a license. The other issues in the case were resolved through settlement.

Michael Klein was the lead attorney for the plaintiff self-move company.

Individuals vs. Insurance Company

This was a private class action arising out of the same factual allegations as the insurance regulatory lawsuit involving a self-move company and its insurance carrier. In this case, three individuals filed suit on behalf of themselves and all Texas residents who purchased certain products in the previous four years, excluding those who filed a claim under any of the purchased products. The plaintiffs claimed violations of Article 1.14-1 and Article 21.21 of the Texas Insurance Code, as well as Section 17.46(b) of the Texas Deceptive Trade Practices Act. The suit also sought a refund of all insurance premiums paid by the class members, as well as exemplary damages and attorneys' fees.

The trial court granted defendant’s motion for partial summary judgment on the issue of restitution, ruling that the class members were not entitled to a return of any amounts paid to defendant. As a result, no class was ever certified, and the case was settled for a nominal amount.

Michael Klein was the lead attorney for the defendants.

Individuals vs. Self-Move Company

This was a private class action arising out of the same factual allegations as the insurance regulatory lawsuit directly above. In this case, plaintiffs filed suit on behalf of herself and all Texas residents who purchased certain products in the last four years, excluding those who filed a claim under any of the purchased products. The plaintiffs claimed violations of Article 1.14-1 and Article 21.21 of the Texas Insurance Code, as well as Section 17.46(b) of the Texas Deceptive Trade Practices Act. The suit sought a refund of all insurance premiums paid by the class members, as well as exemplary damages and attorneys' fees.

No class was ever certified, and the case was eventually non-suited.

Michael Klein was the lead attorney for the defendants.

Individual vs. Insurance Company

This case was filed as a state-wide class action. The plaintiff alleged that the defendants allowed insureds to be overinsured for property damage coverage on policies covering travel trailers, mobile home, motor homes and manufactured homes. The plaintiff also requested injunctive relief and an unspecified amount of damages.

No class was ever certified, and the claim of the individual class representative was settled.

Michael Klein was one of the two lead attorneys for the defendants.

For more information, please contact any of the attorneys listed below, or send an e-mail to info@smith-robertson.com.

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