COURT OF APPEALS
SECOND
DISTRICT OF TEXAS
FORT WORTH
NO. 2-02-321-CV
ALLSTATE TEXAS LLOYDS APPELLANT
V.
C. ROBERT MASON AND DEBORAH
MASON APPELLEE
------------
FROM THE 211TH
DISTRICT COURT OF DENTON COUNTY
OPINION
I. Introduction
This
suit involves a dispute over whether foundation damage to appellees C. Robert
Mason and Deborah Mason’s house is covered under appellant Allstate Texas
Lloyds’s homeowners insurance policy. The policy excludes coverage for loss
caused by “settling, cracking, bulging, shrinkage, or expansion of
foundations, walls, floors, ceilings.” Excepted from this exclusion is loss
caused by “Accidental Discharge, Leakage or Overflow of Water or Steam from
within a plumbing, heating or air conditioning system or household appliance.”
At issue is whether foundation and other related damages to the Masons’ house
were caused by a plumbing leak. Allstate denied coverage, and the Masons sued
for breach of contract, the breach of the duty of good faith and fair dealing,
unconscionable conduct, and unfair or deceptive acts or practices under the
Texas Deceptive Trade Practices Act and the Texas Insurance Code. Following a
jury trial, the trial court rendered judgment on the jury verdict, awarding the
Masons $163,159.76 in actual damages, $88,561.97 in statutory damages, $74,600
in attorney’s fees, $49,216.02 costs in pre- and post-judgment interest and
costs, and $3.5 million in exemplary damages.
In
six issues on appeal, Allstate challenges the award of exemplary damages, the
admission of the Masons’ expert testimony into evidence, the admission of
testimony into evidence regarding Allstate’s opposition to a pretrial
appraisal of the damages to the house, and the legal and factual sufficiency of
the evidence to support the judgment. We affirm in part and reverse and render
in part.
II. Factual Background
The
Masons’ house is located at 1108 Dentonshire in Carrollton, Texas. It was
built in the late 1980s along with two neighboring houses by the same builder.
Shortly after the three houses were built, each house suffered foundation
settlement with their low points at the southeast corners and their high points
at the northwest corners. The owners of the other two houses sued the builder
because the foundation damages were so severe. The owners of the house at 1108
Dentonshire did not join the suit.
The
house at 1108 Dentonshire was built on a sloping embankment with the back of the
house cut into the hill and the rest of the house founded on “fill.”
Apparently the builder did not compact the soil, and the foundation settled and
took the shape of the terrain’s slope before construction began. As a result,
the house’s southeast corner rested about five to seven inches below other
parts of the house. The settlement caused cracks in the house’s exterior and
interior walls, including a large crack in the west exterior wall.
Before
placing the house on the market, the owners’ realtor retained Greg Wilson, an
engineer, to inspect the house in January 1992. On the exterior of the house,
Wilson saw tension breaks in the west wall brick, a vertical crack in the west
wall mortar, a crack in the mortar over the front window, a separation at the
roof gable, a separation between the brick and the west garage door frame, and
heaving of the back patio and pool decking. Inside the house, Wilson saw heaving
of the east patio door threshold, a tension crack over the east living room
window, sheetrock damage in the living room ceiling, misalignment of the front
entrance door and a patio door, separation at the northwest corner in the dining
room, tension cracks over the master bedroom windows, sheetrock damage to the
breakfast room ceiling, and a separation between the wall and ceiling over the
stairs. Wilson concluded that subsurface water beneath the foundation caused the
foundation upheaval and particularly the upheaval in the house’s north
section.1
Following
his inspection, Wilson recommended that a French drain be installed to address
the problem of underground water damaging the foundation. After the French drain
was installed, Wilson visited the house again in September 1992 and saw that the
drain appeared to be working, the foundation appeared stable, and the interior
cracks had been repaired. The exterior damages, including the crack in the west
wall, however, had not been repaired. No repairs were made to the foundation
either.
In
1992, the Masons purchased the house and insured it with Allstate. Although
Robert Mason knew that the seller made some repairs to the home, such as
cosmetic repairs of hairline fractures and the installation of a French drain,
Mason claimed that the house was in “excellent condition” when they
purchased it. According to the Masons, the house remained in “pretty much
perfect condition” until 1998 when cracks in the walls and ceilings began to
appear.
In
1998, misalignment of doors and cracks in the bricks and sheetrock began to
appear, caused by heaving in the foundation. The damages appeared to be similar
to those sustained by the house after it was first built. For instance, new
cracks reopened in the entry hall and the den ceiling in the same places where
cracks had been previously repaired. There were large cracks in the pool deck
and a large separation in the patio, as well as a crack in the exterior west
wall. The house also continued to noticeably slope from its northwest corner to
its southeast corner.
The
Masons hired Hargrave Construction Company to repair the damage to their house,
which hired Vannier Engineering Company to inspect the house and make
recommendations for repairing the foundation. In August 1998, Vannier inspected
the house, and Hargrave recommended that a plumber check for plumbing leaks. The
Masons then made a claim under their Allstate policy after receiving a
foundation repair estimate from Hargrave.
On
December 29, 1998, Allstate assigned the claim to Glenn West, an adjuster who
specializes in foundation claims. West contacted the Masons and sent a
reservation of rights letter to them on January 12, 1999. The letter explained
that the policy covered the cost of assessing the plumbing leak and any physical
loss caused by it and did not cover the cost of repairing the plumbing leak and
any damage caused by settling or expansion of the foundation or earth movement.
During
the investigation, the Masons used Allstate’s plumbing company, MCR Services,
to check for plumbing leaks and make any necessary repairs. MCR located and
repaired the plumbing leaks, including a leak underneath the west hall bathroom.
Allstate paid MCR for the cost of accessing the plumbing leaks but not for the
cost of fixing the broken pipes.
Allstate
also retained Owen Tolson, an engineer, to inspect the house and determine
whether the damage to the house was caused by a leak. Tolson inspected the house
on January 12 and 27, 1999. During these inspections, Tolson learned about the
history of the house, examined the failed pipe and plumbing diagnostics, and
obtained soil data. During his investigation, Tolson also reviewed Wilson’s
1992 report discussing the house’s subsurface drainage and foundation
problems.
Based
on his investigation, Tolson concluded that subsurface drainage caused the clay
soil under the house to swell, leading to the foundation upheaval, and that the
subsurface drainage combined with the soil expansion was alone sufficient to
damage the house. The swelling of the clay soil and resulting foundation
movement in turn damaged the house and broke the pipe in two. Tolson based his
conclusion on the fracture of the pipe and the fact that the grade elevation for
the west hall bathroom was lower and many feet away from the foundation’s high
point. Tolson concluded that the plumbing leak in the west hall bathroom did not
cause the damage to the house.2
West
reviewed Tolson’s report and the plumbing information and determined that
Allstate did not owe on the claim. On February 25, 1999, West wrote to the
Masons to inform them that Allstate was denying their claim based on the lack of
evidence that plumbing caused the damage.
The
Masons filed suit against Allstate for breach of contract and the duty of good
faith and fair dealing. The Masons requested a court order compelling Allstate
to participate in an appraisal of damages to the house, even though no liability
had yet been established. Over Allstate’s objection, the trial court ordered
an appraisal. The appraisers found that the repair costs to the house amounted
to $142,159.76 and that $21,000 in living expenses would also be needed.
After
hearing the evidence, the jury found that Allstate breached the insurance policy
and its duty of good faith and fair dealing; the jury found that it breached the
latter with malice. The jury also found that Allstate knowingly engaged in
unconscionable conduct and knowingly committed an unfair or deceptive act or
practice, violating the Texas Insurance Code and Texas Deceptive Trade Practices
Act (DTPA). The jury awarded the Masons $142,159.76 in repair costs and $21,000
in living expenses for the breach of contract claim. The jury also awarded the
same amounts for the breach of the duty of good faith and fair dealing and the
violations of the insurance code and DTPA. Finally, the jury awarded $3.5
million in exemplary damages.
The
Masons moved for judgment on the verdict, and Allstate moved for judgment
notwithstanding the verdict. The trial court entered a final judgment in favor
of the Masons, awarding them $163,159.76 in actual damages for breach of
contract, $88,561.97 for the violation of article 21.55 of the insurance code,
and $3.5 million in exemplary damages. The trial court also found that the
Masons were entitled to recover on the jury’s findings of unconscionable
conduct and breach of the duty of good faith and fair dealing, “whichever
remedy permits the greater recovery”; the judgment did not specify, however,
how much the Masons were entitled to recover for those claims. The Masons
elected to recover under “the DTPA ‘Unconscionable Action’ Cause of Action
and the Good Faith and Fair Dealing Cause of Action and 21.55 of the Texas
Insurance Code, in addition to the recovery under the Breach of Contract Cause
of Action.” The trial court further found that should those findings be
reversed on appeal, the Masons would be entitled to recover $489,479.28 for
“knowing” violations of the DTPA and article 21.21 of the insurance code.
Finally, the trial court awarded the Masons $74,600 in attorney’s fees, which
Allstate does not challenge on appeal.
III. Expert Testimony
In
Allstate’s fifth issue, it argues the trial court erred in admitting into
evidence Jim Linehan’s testimony. Linehan, the Masons’ engineering expert,
opined that all the damages to the Masons’ house were the result of a plumbing
leak under the west hall bathroom. Allstate contends that this expert testimony
was unreliable because Linehan did not rule out other plausible causes of the
damage to the house and exclude those causes with reasonable certainty.
Specifically, Allstate focuses on Linehan’s failure to determine the cause of
the plumbing leak under the house and to adequately address whether the
house’s pre-existing foundation problems were the true cause of the damage.
Whether
the trial court properly admitted expert testimony is subject to an abuse of
discretion standard of review. Helena Chem. Co. v. Wilkins, 47 S.W.3d
486, 499 (Tex. 2001); E.I. du Pont de Nemours & Co. v. Robinson, 923
S.W.2d 549, 558 (Tex. 1995). To determine whether a trial court abused its
discretion, we must decide whether the trial court acted without reference to
any guiding rules or principles; in other words, whether the act was arbitrary
or unreasonable. See Carpenter v. Cimarron Hydrocarbons Corp., 98 S.W.3d
682, 687 (Tex. 2002); Downer v. Aquamarine Operators, Inc., 701 S.W.2d
238, 241-42 (Tex. 1985), cert. denied, 476 U.S. 1159 (1986). Merely
because a trial court may decide a matter within its discretion in a different
manner than an appellate court would in a similar circumstance does not
demonstrate that an abuse of discretion has occurred. Downer, 701 S.W.2d
at 241-42.
An
abuse of discretion does not occur where the trial court bases its decisions on
conflicting evidence. Davis v. Huey, 571 S.W.2d 859, 862 (Tex. 1978);
see also Goode v. Shoukfeh, 943 S.W.2d 441, 446 (Tex. 1997). Furthermore, an
abuse of discretion does not occur as long as some evidence of substantive and
probative character exists to support the trial court’s decision. Butnaru
v. Ford Motor Co., 84 S.W.3d 198, 211 (Tex. 2002); Holley v. Holley,
864 S.W.2d 703, 706 (Tex. App.—Houston [1st Dist.] 1993, writ
denied).
A
two-part test governs whether expert testimony is admissible: (1) the expert
must be qualified; and (2) the testimony must be relevant and based on a
reliable foundation. Helena Chem. Co., 47 S.W.3d at 499. A trial court
has the threshold responsibility of ensuring that an expert's testimony rests on
a reliable foundation and is relevant to the issues of the case. See Gammill
v. Jack Williams Chevrolet, Inc., 972 S.W.2d 713, 728 (Tex. 1998). In
meeting that responsibility, a trial court is not to determine whether an
expert's conclusions are correct, but only whether the analysis used to reach
those conclusions is reliable. See id.
To
guide trial courts in assessing reliability, the supreme court has crafted two
tests: the Robinson-factor analysis and the “analytical gap” test. Gammill,
972 S.W.2d at 727 (analytical gap test); Robinson, 923 S.W.2d at 556.
Further, the supreme court has determined that expert testimony is unreliable if
it fails to rule out other plausible causes. Merrell Dow Pharm., Inc. v.
Havner, 953 S.W.2d 706, 720 (Tex. 1997), cert. denied, 523 U.S. 1119
(1998); Robinson, 923 S.W.2d at 559; accord Martinez v. City of San
Antonio, 40 S.W.3d 587, 595 (Tex. App.—San Antonio 2001, pet. denied); Weiss
v. Mech. Associated Servs., Inc. 989 S.W.2d 120, 126 (Tex. App.—San
Antonio 1999, pet. denied). Accordingly, a trial court properly excludes expert
testimony as unreliable if: (1) the foundational data underlying the opinion is
unreliable; (2) the methodology used by the expert to interpret the underlying
data is flawed; (3) notwithstanding the validity of the underlying data and
methodology, there is an analytical gap in the expert evidence; or (4) the
expert fails to rule out other plausible causes. See Kimberly S. Keller, Bridging
the Analytical Gap: The Gammill Alternative to Overcoming Robinson & Havner
Challenges to Expert Testimony, 33 St.
Mary’s L.J. 277, 302-20 (2002).
During
the Daubert hearing, Allstate asked Linehan whether he knew what caused
the pipes under the bathroom to break. Although he conceded that pipes could
break due to soil movement (as well as other reasons), he stated that he did not
investigate why the pipes broke in this case. When asked if soil movement strong
enough to break pipes under the house would also be strong enough to damage the
foundation, Linehan again replied that he did not investigate why the pipes
under the bathroom broke.
Based
on this testimony, Allstate essentially seems to be arguing that Linehan’s
failure to determine what caused the pipes to break rendered his opinion that
leaks caused the damage to the house unreliable because he did not exclude with
reasonable certainty the possibility that the foundation damage occurred first
as a result of soil movement caused by subsurface drainage and that the soil
movement then caused the PVC pipe to break. Several problems exist with this
argument.
First,
Linehan had previously testified that he excluded the possibility that the
problems that caused the foundation damage in 1992, which included soil movement
resulting from subsurface drainage, were the cause of the damage in 1998.3 Linehan also testified that he did not believe that
seasonal moisture, which could cause soil movement, caused the 1998 foundation
damage.4 Incidentally, Allstate never
specifically asked Linehan whether he excluded the possibility that subsurface
drainage caused the soil under the house to move, which Allstate claimed at
trial was the cause of the house’s 1998 foundation problems. But the evidence
shows that he discounted the possibility.
Moreover,
Allstate’s questions to Linehan were based on hypothetical situations not
shown to the trial court, in the record before us, to be actual plausible causes
of the foundation damage that Linehan should have excluded in order for his
opinion to be reliable. For example, there was no evidence presented during the
hearing to show that soil movement was a plausible cause of the foundation
problems or that the hypothetical soil movement was strong enough to break
either PVC pipe or a concrete foundation. Moreover, because PVC pipe is not as
strong as concrete, it is entirely possible that the foundation could have
withstood a force that the pipe could not. Without evidence to support the
implications of Allstate’s hypothetical, we cannot say that the trial court
abused its discretion in not excluding the expert testimony because Allstate
came up with a hypothetical theory at the hearing that even Allstate did not
show was possible or provable until after trial began. Although Allstate’s
attorney told the trial court that it had photographs and expert testimony to
support its conclusion, it did not offer to admit the evidence at the hearing
and that evidence was not introduced until after trial began.
Based
on the evidence presented at the Daubert hearing, we hold the trial court
did not abuse its discretion in denying Allstate’s motion to strike
Linehan’s testimony. We overrule Allstate’s fifth issue with regard to the
trial court’s ruling on the admissibility of Linehan’s testimony.
IV. Legal and Factual Sufficiency of the Evidence
In
Allstate’s sixth issue, it challenges the legal and factual sufficiency of the
evidence to support the jury’s findings of a breach of contract, breach of the
duty of good faith and fair dealing, malice, unconscionable conduct, and knowing
violations of the DTPA and insurance code. We will address each finding
separately.
A. Standards of Review
In
determining a “no-evidence” or legal sufficiency issue, we are to consider
only the evidence and inferences that tend to support the finding and disregard
all evidence and inferences to the contrary. Bradford v. Vento, 48 S.W.3d
749, 754 (Tex. 2001); Cont’l Coffee Prods. Co. v. Cazarez, 937 S.W.2d
444, 450 (Tex. 1996); In re King's Estate, 150 Tex. 662, 244 S.W.2d 660,
661 (1951). Anything more than a scintilla of evidence is legally sufficient to
support the finding. Cazarez, 937 S.W.2d at 450; Leitch v. Hornsby,
935 S.W.2d 114, 118 (Tex. 1996). More than a scintilla of evidence exists if the
evidence furnishes some reasonable basis for differing conclusions by reasonable
minds about the existence of a vital fact. Rocor Int’l, Inc. v. Nat’l
Union Fire Ins. Co., 77 S.W.3d 253, 262 (Tex. 2002).
A
“no-evidence” issue may only be sustained when the record discloses one of
the following: (1) a complete absence of evidence of a vital fact; (2) the court
is barred by rules of law or evidence from giving weight to the only evidence
offered to prove a vital fact; (3) the evidence offered to prove a vital fact is
no more than a mere scintilla of evidence; or (4) the evidence establishes
conclusively the opposite of a vital fact. Uniroyal Goodrich Tire Co. v.
Martinez, 977 S.W.2d 328, 334 (Tex. 1998) (citing Robert W. Calvert, "No
Evidence" and "Insufficient Evidence" Points of Error,
38 TEX. L. REV.
361, 362-63 (1960)), cert. denied, 526 U.S. 1040 (1999).
An
assertion that the evidence is factually insufficient to support a fact finding
means that the evidence supporting the finding is so weak or the evidence to the
contrary is so overwhelming that the answer should be set aside and a new trial
ordered. Garza v. Alviar, 395 S.W.2d 821, 823 (Tex. 1965). We are
required to consider all of the evidence in the case in making this
determination. Mar. Overseas Corp. v. Ellis, 971 S.W.2d 402, 406-07
(Tex.), cert. denied, 525 U.S. 1017 (1998).
B. Breach of Contract
Allstate
contends that there is no evidence or insufficient evidence to show that the
plumbing leak under the west hall bathroom caused the foundation damage to the
house; thus, there is no evidence or insufficient evidence to show that Allstate
breached the insurance policy by denying the Masons’ claim. Although we have
concluded that the trial court did not abuse its discretion in admitting
Linehan’s testimony into evidence, this does not necessarily mean that
Linehan’s testimony at trial amounts to legally sufficient evidence that a
plumbing leak caused the foundation damage to the house. In conducting a legal
sufficiency review, we must also review the relevance and reliability of an
expert’s testimony in light of all the evidence admitted at trial. See
Havner, 953 S.W.2d at 713, 720; State Farm Lloyds v. Mireles, 63
S.W.3d 491, 493 (Tex. App.—San Antonio 2001, no pet.) (“The question of the
admissibility of expert testimony goes hand in hand with this court's analysis
under a legal sufficiency challenge.”). There is no question that Linehan’s
testimony was relevant to the issues at trial.
At
trial, Linehan testified that the plumbing leaks under the house at the west
hall bathroom caused 100% of the damage to the house. He negated the possibility
of other causes, including soil movement, being responsible for the foundation
damage because, according to Linehan, the damage in 1998 occurred suddenly,
which is not typical for foundation damage caused by soil movement, and there
was no evidence of soil movement from 1992 through 1998.
Linehan
testified at trial:
Q. Okay. Have you--have you
checked with Mr. Mason to determine if the French drain has continued to work?
A. Mr. Mason has told me that
every time it rains, the water keeps pouring out the French drain wonderfully.
He has noticed no time at which it has plugged up or anything else. So a lot of
work was done in 1992 prior to Mr. Mason buying the house and when they went in
the house and repaired the sheetrock cracks, fixed the house up.
Mr. Mason came to the
house--and his wife bought the house. And he told me, he says, if the house was
a mess in 1992, he wouldn't have bought the house. It was fine in 1992. Did it
have prior problems? Yes, it did. Were they corrected? Yes, they were. And then
Mason comes by and buys himself a nice house in 1992.
Q. What is the next thing that
historically is important to you in--regarding this house?
A. Well, the next thing that
was important to me was how about 1993, Mr. Mason? Was the house fine then? Yes,
it was. How about 1994? Yes, it was. Well in 1995? Yes, it was. '96? Yes. '97?
The house is fine. What about 1998? Oh, things started happening in 1998. But
the important thing to me is to not only write down 1998 but to tell me that he
had six years in there the house wasn't moving substantially to cause any
damage.
And he tells me--and I have
it--
Q. Let me interrupt. If the
drainage or the trees or the settlement or anything was wrong with this house,
what would it have been doing during those six years?
A. It would have--it would--it
would have continued to show movement, and sheetrock cracking would have got
progressively worse between '92 and '98.
Q. And that didn't happen?
A. That didn't happen.
Q. Okay. What happened in '98?
A. The house began to tear
itself apart. And we have some good photographs of that.
.
. . .
Q. Okay. What does it tell you
then when you have this extensive damage around the location of the leak?
A. Well, we had the foundation
uplift at the leak. We knew we had expansive clay soils. We knew we had a
plumbing leak right here (Indicating). We had major damage all around here that
suddenly began to occur over a short period of time. And once the leaks got
fixed, it hasn’t occurred again.
We also know at the rest of
the house there is no damage. So why did the damage occur here and not over
here? Because the leaks affected the foundation here, but they did not affect
the foundation over here (Indicating).
Q. On this area of the house
where it is heaved up, how close is the French drain to that area?
A. It is several feet away.
Q. So the French drain would
have prevented any--any--any rainwater from causing this heave?
A. That’s right.
. . . .
Q. Assume that the pipe broke
because of the movement of the soil. If the soil is moving enough to break that
pipe, it is going to be moving enough to damage that foundation, isn’t it?
A. Not necessarily, because
pipe is not as strong as what the concrete is. So it--it could have broke the
pipe first, released water underneath the house and really got the soils swelled
that then uplifted and broke the foundation, and that--that could have also
hypothetically happened that way.
Linehan
also relied on Wilson’s 1992 report, which concluded that after the French
drain was installed, the problem of subsurface drainage had been eliminated.
While Linehan did not himself investigate whether the French drain was working
properly in 1998, Mr. Mason informed him that it was working. Finally, Linehan
testified that unlike the foundation damage to the house in 1992 that covered
several parts of the house, the damage in 1998 was limited to areas near the
leak and that after the leak was repaired, the foundation stabilized. Thus,
according to Linehan, the 1998 damage was caused by the leak and not by the same
factors that caused the damage in 1992.
Although
at trial Linehan again testified that he did not investigate why the pipes
broke, he stated that while soil movement might be enough to break the pipes it
would not necessarily be enough to damage the foundation. Because PVC pipe is
not as strong as concrete, the pressure from soil movement might not have been
strong enough to damage the foundation, but could have broken the pipe, which in
turn could have increased the swelling in the soil causing it to uplift further
and then damage the foundation. Thus, according to Linehan, it was possible that
the pipe broke and caused a leak and only as a result of the leak did the soil
swell enough to cause the uplift.
Based
on the above evidence, we conclude that Linehan’s testimony was reliable
because it sufficiently dispelled other possible causes of the 1998 foundation
damage. Accordingly, we also hold that Linehan’s testimony amounted to legally
sufficient evidence for the jury to conclude that the pipe leak caused the
foundation damage, which in turn supported the jury’s finding that Allstate
breached the insurance policy by denying the Masons’ claim.
With
regard to the factual sufficiency of the evidence, the jury was faced with two
competing theories supported by expert testimony as to what caused the
foundation damage. Allstate’s theory was that soil movement caused the
foundation damage, and the Masons’ theory was that the plumbing leak under the
west hall bathroom did. As previously discussed, in support of the theory that
the plumbing leak under the west hall bathroom caused the foundation damage, the
jury heard Linehan’s testimony.
To
support the theory that soil movement caused the damage, Allstate introduced the
testimony of three witnesses. First, Owen Tolson testified that in his
professional opinion, subsurface water from seasonal moisture made its way under
the house and caused the uplift in the foundation. Tolson based this opinion on
the history of the house, an examination of the French drain, the elevations in
the foundation, and an examination of the nature of the break of the pipes that
were removed from under the house. Tolson testified that the pipe leaks did not
cause the foundation damage and that the only explanation for the leak in the
PVC pipe was that it snapped due to soil movement caused by subsurface drainage
moving underneath the house. According to Tolson, the nature of the fracture in
the pipe indicated that the pipe broke after the foundation.
Gregory
Wilson testified about his inspection of the damage to the house in 1992 and
that his recommendation was to eliminate the drainage problem by installing a
French drain. Wilson testified that he reinspected the house later in 1992 after
the French drain had been installed to see if it was working properly. He noted
that the damages to the interior had been repaired but that the exterior damages
had not; the foundation, however, appeared stable. Further, Wilson testified
that French drains need to be checked every five years for maintenance and to
make sure they are not clogged. If they get clogged, they will not function
properly. Finally, Wilson testified that while French drains will usually fix
subsurface drainage problems, sometimes the drains do not solve the problem.
Tim
Slider, an Allstate engineering expert, testified that he inspected the home in
2000. During his inspection, Slider noticed that the home sloped toward the
street, there was distress around the house, the pool separated from the
perimeter of the foundation, and there was a large crack in the exterior veneer.
The sloping originally occurred because the house had been constructed on a
fairly steep sloping embankment without being properly placed, resulting in the
house settling and assuming the shape of the slope over time. As a result of the
open joint between the pool deck paving and the house, Slider opined that water
collected at the crack and was absorbed into the soil, which led to moisture
collecting in the soil under the house and causing the house to heave. Slider
also testified that although the plumbing leak was not the primary cause of
damage to the house, it could have “potentially” contributed to some heaving
in the house.
With
competing contentions supported by expert witnesses on both sides, the burden
fell on the jury to determine which contention was more credible. Turner v.
KTRK Television, Inc., 38 S.W.3d 103, 134 (Tex. 2000) (“Under established
Texas jurisprudence, a reviewing court must defer to the fact-finder's
credibility determinations because the jury is the exclusive judge of the facts,
the witnesses' credibility, and the weight given to their testimony.”). We
will not second-guess the fact-finder’s determination.
Having
reviewed all the evidence in support of both theories, we conclude that evidence
supporting the finding that a plumbing leak caused the foundation damage is not
so weak or the evidence to the contrary so overwhelming as to require that the
jury’s verdict on the breach of contract claim be set aside. Thus, we hold
there was factually sufficient evidence for the jury to conclude that Allstate
breached the insurance policy. We overrule Allstate’s legal and factual
sufficiency challenges to the jury’s finding of breach of contract.
C. Breach of the Duty of Good Faith and Fair Dealing
The
jury determined that Allstate failed to attempt in good faith to effectuate a
prompt, fair, and equitable settlement of a claim when its liability had become
reasonably clear and refused to pay a claim without conducting a reasonable
investigation of the claim. Allstate contends that there is legally and
factually insufficient evidence to support the jury’s finding.
An
insurer has a duty to deal fairly and in good faith with its insured in the
processing and payment of claims. Republic Ins. Co. v. Stoker, 903 S.W.2d
338, 340 (Tex. 1995); Arnold v. Nat’l County Mut. Fire Ins. Co., 725
S.W.2d 165, 167 (Tex. 1987). A breach of the duty of good faith and fair dealing
is established when: (1) there is an absence of a reasonable basis for denying
or delaying payment of benefits under the policy and (2) the carrier knew or
should have known that there was not a reasonable basis for denying the claim or
delaying payment of the claim. Republic Ins. Co., 903 S.W.2d at 340.
“The first element of this test requires an objective determination of whether
a reasonable insurer under similar circumstances would have delayed or denied
the claimant’s benefits.” Aranda v. Ins. Co. of N. Am., 748 S.W.2d
210, 213 (Tex. 1988). This assures that a carrier “will not be subject to
liability for an erroneous denial of a claim” as long as a reasonable basis
for denial of the claim exists. Id.; see Lyons v. Millers Cas. Ins.
Co. of Tex., 866 S.W.2d 597, 600 (Tex. 1993).
Evidence
that merely shows a bona fide dispute about the insurer's liability on the
contract does not rise to the level of bad faith. Transp. Ins. Co. v. Moriel,
879 S.W.2d 10, 17 (Tex. 1994); Nat’l Union Fire Ins. Co. v. Dominguez,
873 S.W.2d 373, 376-77 (Tex. 1994). Nor is bad faith established if the evidence
shows the insurer was merely incorrect about the factual basis for its denial of
the claim or about the proper construction of the policy. Lyons v. Millers
Cas. Ins. Co., 866 S.W.2d 597, 601 (Tex. 1993) (“[T]he issue of bad faith
focuses not on whether the claim was valid, but on the reasonableness of the
insurer's conduct in rejecting the claim.”). A simple disagreement among
experts about whether the cause of the loss is one covered by the policy will
not support a judgment for bad faith. Id. To the contrary, an insured
claiming bad faith must prove that the insurer had no reasonable basis for
denying or delaying payment of the claim and that it knew or should have known
that fact. Transp. Ins. Co., 879 S.W.2d at 18.
An
insurer's reliance upon an expert's report, standing alone, will not necessarily
shield the carrier if there is evidence that the report was not objectively
prepared or the insurer's reliance on the report was unreasonable. State Farm
Lloyds v. Nicolau, 951 S.W.2d 444, 448 (Tex. 1997). Evidence casting doubt
on the reliability of the insurer's expert's opinions may support a bad-faith
finding. Id.
Allstate
claims that the evidence is legally insufficient to support the finding that it
breached its duty of good faith and fair dealing because it reasonably relied on
Tolson’s report that the plumbing leak did not cause the foundation damage in
denying the claim. The Masons raise several factors that they claim call into
question the reliability of Tolson’s report and the reasonableness of
Allstate’s reliance on it and, as a result, shows sufficient evidence of bad
faith.
First,
the Masons claim that because Wilson testified that the engineer, i.e., Tolson,
was supposed to tell him what tests were needed and Tolson said he did not have
authority to recommend testing, Tolson’s investigation of the damage to the
house was somehow improper. We fail to see how this misunderstanding provides
any proof that Allstate acted in bad faith.
The
Masons claim that Tolson was not present at the house when the plumbing repairs
were done, implying that he could not exclude plumbing as the cause of the
damage without being present. The record shows that after the plumbers removed
the broken pipes from underneath the house, they laid them out on the ground and
“talked [Tolson] through them . . . and [told him] the configuration of the
pipe . . . matches up 100 percent with the configuration of the elevations.”
There is no evidence that it was necessary for Tolson to be at the house when
the plumbing repairs were conducted in order to exclude a plumbing leak as the
cause of the foundation damage. Incidentally, Linehan was also not present
during the repairs, yet he was able to determine that the plumbing leak caused
the foundation damage.
The
Masons also claim that even though Tolson testified that “it was customary to
take soil tests and to make flow tests in situations such as these,” Tolson
did not conduct those tests. Tolson also testified that while the flow tests
would have been helpful, they were not available and were not necessary and that
only sometimes does he request soil tests. According to the Masons, the tests
would have revealed how much the pipe was leaking and whether the soil under the
west hall bathroom was saturated by rainwater, which would have confirmed
Tolson’s theory, or fecal matter and chlorine, which would have shown that a
plumbing leak had saturated the soil and caused the foundation damage. There was
no dispute, however, that a plumbing leak existed under the west hall bathroom.
Thus, the soil tests would have revealed sewage and chlorine regardless of the
cause of the uplift. Further, Tolson testified that he did not need the soil
tests because he already knew the soil under the house was expanding from
moisture.
The
Masons also claim that Tolson ignored Wilson’s report that the French drain
was working in making his determination that subsurface drainage caused the
upheaval. There is no evidence that Tolson ignored Wilson’s report. As a
matter of fact, Tolson testified that he examined Wilson’s report as part of
his investigation. Although Wilson determined in 1992 that the French drain was
working, Tolson concluded that subsurface drainage was still getting past the
drain and under the house. There is no evidence that this conclusion was not
made objectively.
The
Masons also claim that the jury heard evidence that Allstate’s “witnesses
had avoided subpoenas, failed to bring documents to court, and that Allstate had
failed to produce pipe for inspection that had been removed from the front
yard.” The Masons have failed to cite to where in the record there is evidence
that any witness avoided service. See Tex. R. App. P. 38.1(h). While the Masons’ trial
attorney accused Tolson during cross-examination of avoiding service, there is
no evidence that he in fact avoided service. There is also no evidence that
Tolson intentionally failed to bring documents to court, and the Masons refer us
to no evidence in the record showing that any other Allstate witness
intentionally failed to bring documents to court. See id. Finally, the
Masons provide no record reference for their contention that Allstate failed to
produce the pipe that had been removed from the front yard. See id.
The
Masons also attempt to discredit Tolson based on the fact that he has worked for
insurance companies in the past in conducting investigations. Although Tolson
testified that he received a significant amount of his income from insurers, he
testified that he also works for homeowners and that he does not believe that
plumbing leaks can never cause foundation damage. As a matter of fact, before
the trial in this case, Tolson had concluded that a plumbing leak had caused
foundation damage while working for another insurance company. He also made a
similar conclusion while working for Allstate on a different claim. The fact
that Tolson wants to obtain more business from Allstate, by itself and in
conjunction with the above, however, does not show that Tolson was necessarily
biased against insureds.
The
evidence showed that Tolson conducted an adequate investigation of the house and
surrounding property, that he took a history of the house, and that he examined
reports regarding the house’s prior foundation problems. Although Tolson did
not determine whether the French drain was working, that fact alone does not
indicate that his conclusions were unreliable or that he did not arrive at them
objectively. Tolson testified that in his opinion subsurface drainage could
still be moving under the French drain. Based on the evidence available to
Allstate at the time it denied the Masons’ claim, we hold that there is no
evidence suggesting that Tolson’s investigation was unreliable and that
Allstate acted unreasonably in its reliance on his investigation in denying the
Masons’ claim. Accordingly, we conclude that there is no evidence that
Allstate acted in bad faith when it denied the Masons’ claim. Thus, there is
no evidence to support the jury’s verdict that Allstate breached its duty of
good faith and fair dealing. We sustain Allstate’s legal sufficiency challenge
to the jury’s finding of breach of the duty of good faith and fair dealing.
Because we conclude that there is no evidence of bad faith, the jury’s finding
of malice and punitive damages resulting from bad faith can no longer stand.
D. Unconscionable Conduct
The
jury also found that Allstate engaged in unconscionable conduct.
“‘Unconscionable action or course of action’ means an act or practice
which, to a consumer's detriment, takes advantage of the lack of knowledge,
ability, experience, or capacity of the consumer to a grossly unfair degree.” Tex. Bus. & Com. Code Ann. § 17.45(5) (Vernon 2003). Allstate
challenges the legal and factual sufficiency of the evidence to support the
jury’s finding.
As
proof of unconscionable conduct, the Masons point to the letter Allstate sent to
them that stated it would attempt to give the Masons “every advantage of your
policy.” The Masons state that the evidence showed at trial that Allstate had
no interest in seeing that they received the benefits due to them under the
policy. Instead, the Masons claim that Allstate was interested in performing a
sham investigation and denying their claim no matter what the consequences. We
have already held that Allstate did not perform an unreasonable investigation
and did not violate its duty of good faith and fair dealing. Allstate’s letter
to the Masons does not show that Allstate attempted to take advantage of the
Masons. Instead, the evidence shows that Allstate paid for the plumbing repairs
as required under the insurance policy and investigated the claim that the
plumbing leaks caused the damage to the home. After determining that the policy
did not cover the damage, Allstate denied the claim based on Tolson’s report.
The evidence does not show any unconscionable conduct on Allstate’s part. We
sustain Allstate’s no evidence challenge to the jury’s finding of
unconscionable conduct.
E. Knowing Violation of the DTPA and Insurance Code
In
response to charge question 3, the jury found that Allstate engaged in an
“[u]nfair or deceptive act or practice” by making “misrepresentations
relating to insurance” that included “[f]ailing to attempt in good faith to
effectuate a prompt, fair, and equitable settlement of a claim when [its]
liability has become reasonably clear” or “[r]efusing to pay a claim without
conducting a reasonable investigation of the claim.” In response to charge
question 5, the jury found Allstate committed such conduct knowingly. Although
Allstate and the Masons address on appeal whether there is legally and factually
sufficient evidence to find that Allstate committed an unfair or deceptive act
or practice knowingly, we must first determine whether Allstate even
committed such an act at all. Neither party concedes that it did.
The
question the jury was asked to decide with regard to whether Allstate committed
an unfair or deceptive act or practice is the same as the one it was asked to
decide with regard to whether Allstate breached its duty of good faith and fair
dealing.5 Having already determined that
Allstate did not breach its duty of good faith and fair dealing, we see no
reason to readdress the same evidence here that we examined with regard to that
issue. Based on the charge to the jury, a review of the same evidence would
arrive at the same conclusion: There is no evidence to support the jury’s
finding that Allstate “[failed] to attempt in good faith to effectuate a
prompt, fair, and equitable settlement of a claim when [its] liability has
become reasonably clear” or “[refused] to pay a claim without conducting a
reasonable investigation of the claim.” Thus, we sustain Allstate’s
challenge to the jury’s finding that it knowingly engaged in an unfair or
deceptive act or practice.
In
light of our determination that there is no evidence that Allstate engaged in
unconscionable conduct or committed an unfair or deceptive act or practice, the
jury’s findings that Allstate acted knowingly in committing such acts and its
award of actual and punitive damages for those causes of action can no longer
stand. Furthermore, because we conclude that no evidence exists to support the
jury’s findings that Allstate breached the duty of good faith and fair
dealing, engaged in unconscionable conduct, or committed an unfair or deceptive
act or practice, it is not necessary for us to address whether the trial court
erred in admitting into evidence testimony showing that Allstate did not want to
participate in the pretrial appraisal. See Tex. R. App. P. 47.1.
V. Conclusion
Having
held that legally and factually sufficient evidence exists to support the
jury’s finding of breach of contract, and that no evidence exists to support
the other complained of findings, we reverse the trial court’s award of
exemplary damages and render judgment that the Masons take nothing on their
claims for breach of the duty of good faith and fair dealing, unconscionable
conduct, and unfair or deceptive act or practice. We affirm the trial court's
judgment of $163,159.76 for breach of contract, $88,561.97 for statutory damages
under article 21.55 of the Texas Insurance Code, $74,600 for attorney’s fees,
and $49,216.02 for pre- and post-judgment interest.
SAM
J. DAY
JUSTICE
PANEL A: CAYCE,
C.J.; HOLMAN, J.; and SAM J. DAY, J. (Retired, Sitting by Assignment).
DELIVERED: November 26, 2003
NOTES
1. Wilson also
observed during his inspection that a neighboring house had window separations,
brick cracks, and a barrier around it with a sign that said “danger,
structure.” Other homes on the same street were having similar foundation
problems.
2. Although
there were several plumbing leaks, the Masons contend only that the leak in the
west hall bathroom was responsible for the damage to the house.
3. Linehan
testified:
Q. Now, in this case, did you
do any work to see whether the foundation had deformed because of soil movement?
A. I read--I measured the
foundation elevations and observed the structural distresses and the timing of
such, combined with Mr. Mason, to form my opinion that there was soil movement
caused by the plumbing leak that uplifted the foundation at that location at the
bathroom.
Q. So you will agree with me,
won't you, that if you have got a foundation that has experienced upheaval to
the point that it has deformed the foundation, that the foundation can be
subject to seasonal moisture changes, correct?
A. No, I will not agree with
that at all.
Q. Now, what did you do to
rule out the possibility that any damage to this occurred--that occurred in 1998
wasn't attributable to the same things that were happening back in January of
'92?
A. There was no evidence that
the failure that occurred in 1992 was present again in 1998, but in 1998, there
was a plumbing leak at the hall bathroom. There was an uplift at the hall
bathroom. There was substantial damage that occurred outside the house in 1998
by Mr. Mason's testimony. And it also occurred inside the house in 1998, all
confined to this area right in here (Indicating). All the prior problems had
been at the rear of the garage, and there is no substantial movement at the
rear--rear of the garage in 1998.
4. Linehan
testified:
Q. And I had asked you this
earlier about the foundation being damaged and needing to be repaired. Isn't it
possible that when you have that occur, the foundation no longer resists
movement so it may continue to move during its life during periods of wet or dry
weather? Isn't that true?
A. If it has been fractured
and damaged, it may continue to move due to seasonal moisture changes. That's
right.
Q. And, for instance, if it is
extremely dry, it could start to settle a little, go down lower?
A.
It could.
Q. Or during periods of heavy
rain, go up?
A. That is correct. It could
rock and roll or it could not move at all.
Q. Now in this case, with the
upheaval that Mr. Wilson mentioned in his January '92 report, you didn't do any
kind of investigation, did you, to see if the foundation had been damaged at
that point in time to where it could no longer resist movement, did you?
A. There was no information
available to me, sir.
Q. So you--the answer is you
did nothing on that?
A. No. I did talk to Mr.
Mason, and he hadn't had any signs of foundation movement between 1992 and 1998
when it suddenly began to fall apart. If you are having foundation movement, you
would have seen a series of cracking and breaking occurring between '92 and
1998. The fact that for six years his house was spotless inside but with maybe
one or two minor things and substantially suddenly it began to tear itself apart
in 1998, there is very good evidence that it has not been moving due to seasonal
moisture changes and was not broken in 1992.
5. In the
charge, the jury was instructed that it should find Allstate breached its duty
of good faith and fair dealing and committed an unfair or deceptive act or
practice if evidence existed that Allstate either (1) failed to attempt in good
faith to effectuate a prompt, fair, and equitable settlement of a claim when its
liability had become reasonably clear or (2) refused to pay a claim without
conducting a reasonable investigation of the claim.