Allstate Vehicle and Property Insurance Company v. Peter Reininger

Court of Appeals of Texas·Decided November 25, 2020·No. 04-19-00443-CV·Published

Opinion

Fourth Court of Appeals San Antonio, Texas MEMORANDUM OPINION

No. 04-19-00443-CV

ALLSTATE VEHICLE AND PROPERTY INSURANCE COMPANY, Appellant

v.

Peter REININGER, Appellee

From the 288th Judicial District Court, Bexar County, Texas Trial Court No. 2016-CI-21617 Honorable Cynthia Marie Chapa, Judge Presiding

Opinion by: Beth Watkins, Justice

Sitting: Luz Elena D. Chapa, Justice Beth Watkins, Justice Liza A. Rodriguez, Justice

Delivered and Filed: November 25, 2020

AFFIRMED IN PART; REVERSED AND RENDERED IN PART; REVERSED AND REMANDED IN PART

Appellant Allstate Vehicle and Property Insurance Company appeals a judgment in favor

of its insured, appellee Peter Reininger. We affirm the judgment in part, reverse and render

judgment for Allstate in part, and remand this cause for a new trial on attorney’s fees.

BACKGROUND

Before 2015, Reininger’s home was insured under a Liberty Mutual policy that covered

cosmetic hail damage to his metal roof. When Reininger began looking for a new policy in 2015,

he contacted Justin Losoya, an Allstate agent. Reininger told Losoya he wanted a policy that was 04-19-00443-CV

“apples to apples” with his Liberty Mutual policy, and Losoya stated Allstate could provide that.

Reininger also asked Losoya, “[I]f I have any bad weather, hail or any type of hail and it damaged

my roof, am I covered?” Losoya answered, “Yes, sir, Mr. Reininger, you are. You pay [a] 1 percent

[deductible].” Losoya did not mention any exclusions on coverage for the roof, and Reininger did

not make any further inquiries about exclusions.

Reininger agreed to purchase automobile and homeowners’ policies from Allstate. On June

26, 2015, Losoya sent Reininger an email with the subject line “Allstate Insurance Policies.” In

the email, Losoya stated he had “attached a copy of both policies for your records.” The

attachments were titled “Reininger Peter_Auto Policy” and “Reininger Peter_Home Policy.” The

“Reininger Peter_Home Policy” attachment was a six-page document that contained a policy

number and listed coverage amounts, deductibles, discounts to be applied to Reininger’s policy,

and information about Reininger’s property. Other than specifying the monetary limits of the

coverage, it did not identify any coverage exclusions. However, it stated, “Any insurance bound

hereunder shall otherwise be subject in all respects to the terms and conditions of the regular policy

forms of the Company at present in use and to the statements in this application.” It also contained

a “Binder Provision” providing that Allstate, “[i]n reliance on the statements in this application

and subject to the terms and conditions of the policy authorized for [Allstate’s] issuance to the

applicant, binds the insurance applied for[.]” Allstate internally refers to a document like this one

as a “binder.”

Reininger believed the “Reininger Peter_Home Policy” attachment was his homeowners’

insurance policy, and he paid his premium after he reviewed that document. After Reininger paid

his premium, Allstate created the policy. In contrast to the six-page binder, the policy was a

document of approximately sixty pages. Unlike the Liberty Mutual policy, the Allstate policy

contained a “metal roof surfaces cosmetic damage exclusion endorsement” providing the policy

-2- 04-19-00443-CV

did not cover “[c]osmetic damage caused by hail to a metal roof surface, including but not limited

to, indentations, dents, distortions, scratches, or marks, that change the appearance of a metal roof

surface.” The policy also explained, “We will not apply this exclusion to sudden and accidental

direct physical damage to a metal roof surface caused by hail that results in water leaking through

the metal roof surface.” Both Reininger and his wife, Nancy, contend the only homeowners’ policy

document they ever received from Allstate was the six-page binder.

On April 12, 2016, a hailstorm struck Reininger’s home. After the storm, Reininger

reported to Losoya that the roof and other parts of his home had been damaged, and Allstate opened

a claim. On May 2, 2016, a claims adjustor, Kevin Phillips, inspected Reininger’s property on

Allstate’s behalf. 1 Reininger reported to Phillips that there was no interior damage, and Phillips

did not inspect the home’s interior. After surveying the roof, Phillips told Reininger the storm had

caused only cosmetic damage that was not covered by the policy. Both Reininger and Nancy

testified that this was the first time they learned about the cosmetic damage exclusion, and both

testified that they would not have purchased the policy if they had known about that exclusion.

Shortly after Phillips’s inspection, Reininger and Nancy noticed water leaks inside their

home. Because they had not experienced any interior leaks before the hailstorm, they requested a

further inspection of their roof, and Allstate scheduled a second inspection with a different claims

adjustor. However, Reininger cancelled it after the second adjustor told him, without first

inspecting the property, that “he didn’t think he was going to find anything worse than Mr. Phillips

did.” Although Allstate’s claim file indicated Reininger had stated he wanted to reschedule the

second inspection, Allstate closed the file two days later.

1 While Phillips is not an Allstate employee, Allstate does not dispute that it would be liable for his wrongful actions, if any.

-3- 04-19-00443-CV

Reininger sued Allstate and Phillips for breach of contract, fraud, and violations of the

Texas Insurance Code and the Deceptive Trade Practices Act. He claimed, inter alia, that Allstate

had misrepresented the terms of his policy, both before he purchased it and during the adjustment

of his hail damage claim; denied his claim without performing a reasonable inspection of his roof;

and refused to pay his claim after liability became reasonably clear. After an eight-day trial, the

jury found in Reininger’s favor on his breach of contract, fraud, and statutory claims against

Allstate. 2 It also found Allstate had knowingly engaged in unfair or deceptive acts or practices and

assessed additional damages as a result of that finding. Finally, the jury awarded Reininger

attorney’s fees. Reininger elected to recover on his statutory claims, and the trial court signed a

judgment consistent with the jury’s verdict on Reininger’s claims under the Insurance Code,

including its finding that Allstate had acted knowingly.

Allstate filed a motion for judgment notwithstanding the verdict and alternative motion for

new trial. Both motions were denied by operation of law. Allstate appealed.

ANALYSIS

Legal and Factual Sufficiency of Liability Findings

In its fourth issue, Allstate contends the evidence is legally and factually insufficient to

support the jury’s liability findings on Reininger’s Insurance Code claims. Because Allstate’s legal

sufficiency complaint would, if meritorious, require rendition of judgment in Allstate’s favor, we

will consider this issue first. See Maynard v. Booth, 421 S.W.3d 182, 183 (Tex. App.—San

Antonio 2013, pet. denied).

2 Reininger nonsuited his claims against Phillips during the trial.

-4- 04-19-00443-CV

Standard of Review and Applicable Law

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