in Re State Farm Mutual Automobile Insurance Company and Todd Joseph Dauper

CourtTexas Supreme Court
DecidedMarch 19, 2021
Docket19-0792
StatusPublished

This text of in Re State Farm Mutual Automobile Insurance Company and Todd Joseph Dauper (in Re State Farm Mutual Automobile Insurance Company and Todd Joseph Dauper) is published on Counsel Stack Legal Research, covering Texas Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
in Re State Farm Mutual Automobile Insurance Company and Todd Joseph Dauper, (Tex. 2021).

Opinion

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IN THE SUPREME COURT OF TEXAS ════════════ NO. 19-0791 ════════════

IN RE STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY AND TERECINA SHAHAN, RELATORS ════════════════════════════════════════════════════ ON PETITION FOR WRIT OF MANDAMUS ════════════════════════════════════════════════════

~ consolidated for oral argument with ~

════════════ NO. 19-0792 ════════════

IN RE STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY AND TODD JOSEPH DAUPER, RELATORS ════════════════════════════════════════════════════ ON PETITION FOR WRIT OF MANDAMUS ════════════════════════════════════════════════════

Argued December 2, 2020

JUSTICE BLACKLOCK delivered the opinion of the Court.

These original proceedings arise from suits by holders of underinsured motorist (“UIM”)

insurance seeking recovery against their insurers following traffic accidents. Plaintiffs in such

cases often bring claims for breach of their insurance policies as well as statutory, extracontractual

claims authorized by the Insurance Code. The common practice has been to sever and abate the

Insurance Code claims while an initial trial is conducted on the breach-of-contract claim to determine whether the underinsured motorist was liable for the accident and, if so, the amount of

damages suffered by the insured. A plaintiff who succeeds in this first phase of the case may then

proceed to litigate its Insurance Code claims in light of the result of the initial trial.

A wrinkle in the cases before us is that the insureds did not sue for breach of their insurance

policies. Although they seek recovery of the amount they claim to be owed under their policies,

they brought only extracontractual, Insurance Code claims. They contend that because they

brought only statutory claims, and because there are no breach-of-contract claims to sever and try

first, no bifurcation of trial is required. As explained below, we disagree.

Under USAA Texas Lloyds v. Menchaca, 545 S.W.3d 479 (Tex. 2018), a plaintiff seeking

recovery of benefits owed under an insurance policy must first establish his entitlement to policy

benefits as a contractual matter before he can recover them as damages for an Insurance Code

claim. As a result, although the plaintiffs’ claims in these cases are not labeled breach of contract,

they nevertheless must establish State Farm’s liability under their insurance policies as a

prerequisite to recovery on their Insurance Code claims. Just as an initial “car crash” trial is

typically required to determine the underinsured motorist’s liability and the amount of damages

when the insured brings both breach-of-contract and Insurance Code claims, insureds who bring

only Insurance Code claims seeking policy benefits as damages must also succeed in an initial “car

crash” trial in order to lay the predicate for their statutory claims. We therefore conditionally grant

the petitions for writ of mandamus and direct the trial courts to proceed in accordance with this

opinion.

I. BACKGROUND

Real Parties in Interest Al Dodds and Alexander Nicastro have UIM insurance with State

Farm. The same counsel represents Nicastro and Dodds in this Court.

2 Nicastro was injured when Dominique Smith allegedly swerved into Manuel Reyes who,

in turn, collided with Nicastro. Nicastro seeks to recover “past medical expenses and anticipated

future medical expenses totaling up to $438,247.00.” According to State Farm, Nicastro provided

documentation of $11,747 in incurred medical costs. Nicastro requested State Farm approve his

acceptance of a $30,000 settlement with Smith’s insurer. State Farm obliged and told Nicastro he

“has been fully indemnified” for his medical expenses. Nicastro then sought UIM benefits from

State Farm. His UIM policy limit is $100,000, but State Farm refused to pay anything.

Dodds was injured when Jose Cojchamale allegedly ran a red light and struck his vehicle.

The impact caused Dodds to strike another vehicle. Dodds seeks to recover past medical expenses

of $45,668.92 and future medical expenses of $212,250.00, totaling $257,918.92. With State

Farm’s approval, Dodds accepted a $30,000 settlement from Cojchamale’s insurer, the maximum

amount of Cojchamale’s policy. Dodds then sought UIM benefits from State Farm, which paid

Dodds an additional $18,190.41 without an explanation for the discrepancy between the amount

paid and the amount requested. Dodds’ UIM policy limit is $50,000.

Nicastro and Dodds both sued State Farm and two State Farm adjusters, who they allege

failed “to attempt in good faith to effectuate a prompt, fair, and equitable settlement of a claim

with respect to which the insurer’s liability has become reasonably clear,” TEX. INS. CODE

§ 541.060(a)(2)(A), and failed to “promptly provide to a policyholder a reasonable explanation of

the basis in the policy, in relation to the facts or applicable law, for the insurer’s denial of a claim

or offer of a compromise settlement of a claim,” id. § 541.060(a)(3). Neither Nicastro nor Dodds

sued State Farm for breach of his UIM policy.

Dodds’ UIM policy covers amounts he is “legally entitled to recover” from an underinsured

motorist when “the total limits of insurance and self-insurance for bodily injury liability from all

3 sources are less than the amount needed to compensate the insured for bodily injury damages.”

Nicastro’s policy covers amounts he is “legally entitled to recover” from an underinsured motorist

whose limit of liability “is not enough to pay the full amount the covered person is legally entitled

to recover as damages.” As damages for their Insurance Code claims, Nicastro and Dodds both

seek the amounts State Farm allegedly should have paid them under their UIM policies.

In both cases, State Farm filed motions for bifurcated trial under Rule 174(b). State Farm

argued that before its liability for Insurance Code claims can be determined, an initial trial is

necessary to establish the liability and underinsured status of the other motorists. The matters to

be determined in this initial trial, State Farm contends, are necessary predicates to the plaintiffs’

statutory claims. As State Farm sees it, the plaintiffs must obtain a judicial determination that the

third parties are liable for their injuries and are underinsured motorists before the plaintiffs can

recover on their Insurance Code claims. Nicastro and Dodds opposed State Farm’s motions,

arguing that (1) they may recover UIM benefits as extracontractual damages without first

establishing that they are “legally entitled to recover” from the underinsured motorists if they do

not allege a breach-of-contract claim, and (2) this Court’s decision in USAA Texas Lloyds v.

Menchaca, 545 S.W.3d 479 (Tex. 2018), overruled Brainard v. Trinity Universal Insurance Co.,

216 S.W.3d 809 (Tex. 2006), and changed well-established principles governing UIM claims.

The trial courts denied State Farm’s motions. State Farm petitioned for mandamus relief

in the Fifth Court of Appeals, arguing the trial courts abused their discretion in denying State

Farm’s motions to bifurcate. The court of appeals denied the petitions without substantive

explanation. State Farm filed mandamus petitions in this Court.

4 II. STANDARD OF REVIEW

Mandamus is an extraordinary remedy that will issue “only to correct a clear abuse of

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