Skip to Navigation
The Collaborative Clearinghouse for Lawsuits and Other Claims Against ACE Group Insurance Companies

MATHEWS v. INDEMNITY INSURANCE CO. OF NORTH AMERICA

ATTENTION: It is possible that this information may no longer be current and therefore may be inaccurate. The index contains both open and closed cases and is not a complete list of cases in which an ACE Insurance Group company is involved. This information is provided to give interested persons an idea of the issues disputed in the indexed cases. For a full understanding of a case, one should read the rest of the court file, including the response. For the most up-to-date and complete information on a case, visit www.pacer.gov or contact the clerk of the relevant court.

Case Number: 
1:11-cv-00228 Search Pacer
Opposing Party: 
James Mathews
Court Type: 
Federal
US District Court: 
Western District of Texas
Date Filed: 
Mar 24 2011

"This suit is necessary to collect a legal debt and damages due and owing Mr. Mathews
because of Defendant's wrongful acts in handling of his claim for an on the job injury for which
workers' compensation benefits were disputed and later paid only after on order of the Texas
Department of Insurance-Division of Workers' Compensation, DWC."

"V. FIRST CAUSE OF ACTION--Violations of Texas Insurance Code

12. Plaintiff JAMES MATHEWS realleges and incorporates each allegation contained in
Paragraphs 1--15 of this Petition as if fully set forth herein.

13. INDEMNITY INSURANCE COMPANY OF NORTH AMERICA failed to attempt to
effectuate a prompt, fair, and equitable settlement of a claim with respect to which liability has
become reasonably clear, in violation of Texas Insurance Code Section 541.060 (a)(2)(A)
(formerly Art. 21.21 §4(l0)(ii».

14. INDEMNITY INSURANCE COMPANY OF NORTH AMERICA failed to adopt and
implement reasonable standards for prompt investigation of claims arising under its policies.

15. INDEMNITY INSURANCE COMPANY OF NORTH AMERICA failed to provide
Original Petition James Mathews
Case 1:11-cv-00228-SS Document 1-1 Filed 03/24/11 Page 5 of 28
promptly a reasonable explanation, in relation to the facts or applicable law, for the denial of a
claim, in violation of Texas Insurance Code Section 541.060 (a)(3) (formerly Art. 21.21
§4( 10)(iv)).

16. INDEMNITY INSURANCE COMPANY OF NORTH AMERICA refused to pay a claim
without conducting a reasonable investigation with respect to the claim, in violation of Texas
Insurance Code Section 54l.060(a)(7) (formerly Art. 2l.21 §4(10)(vii)).

17. INDEMNITY INSURANCE COMPANY OF NORTH AMERICA misrepresented the
insurance policy under which it affords workers' compensation coverage to Mr. Mathews, by
making an untrue statement of material fact, in violation of Texas Insurance Code Section
541.061 (l)(formerly Art. 2l.21 §4(11)(a».

18. INDEMNITY INSURANCE COMPANY OF NORTH AMERICA misrepresented the
insurance policy under which INDEMNITY INSURANCE COMPANY OF NORTH AMERICA
affords workers' compensation coverage to Mr. Mathews, by failing to state a material fact that is
necessary to make other statements made not misleading, in violation of Texas Insurance Code
Section 541.061(2) (formerly Art. 21.21 §4(1l)(b)).

19. INDEMNITY INSURANCE COMPANY OF NORTH AMERICA misrepresented the
insurance policy under which INDEMNITY INSURANCE COMPANY OF NORTH AMERICA
affords workers' compensation coverage to Mr. Mathews, by making a statement in such manner
as to mislead a reasonably prudent person to a false conclusion of material fact, and failing to
disclose a matter required by law to be disclosed, in violation of Texas Insurance Code Section
541.061(3) (formerly Art. 21.21 §4(11)(c) and Texas Insurance Code Section 541.002(1) (formerly
Art. 21.21 §4(11)(e)).

20. INDEMNITY INSURANCE COMPANY OF NORTH AMERICA knowingly committed the
4
Original Petition James Mathews
Case 1:11-cv-00228-SS Document 1-1 Filed 03/24/11 Page 6 of 28
foregoing acts, with actual knowledge of the falsity, unfairness, or deception of the foregoing acts
and practices, in violation of Texas Insurance Code Section 54l.002(1) (formerly Art. 2l.21
§2(c))."

The provided text is an excerpt from a document filed in this case. For a full understanding of the case, one should read the complete court file, including the response.

Javascript is required to view this map.