in Re United Services Automobile Association

446 S.W.3d 162, 2014 Tex. App. LEXIS 9312, 2014 WL 4109756
CourtCourt of Appeals of Texas
DecidedAugust 21, 2014
Docket01-13-00508-CV
StatusPublished
Cited by21 cases

This text of 446 S.W.3d 162 (in Re United Services Automobile Association) is published on Counsel Stack Legal Research, covering Court of Appeals of Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
in Re United Services Automobile Association, 446 S.W.3d 162, 2014 Tex. App. LEXIS 9312, 2014 WL 4109756 (Tex. Ct. App. 2014).

Opinion

OPINION

REBECA HUDDLE, Justice.

Relator, the United Services Automobile Association (“USAA”), has petitioned this Court for a writ of mandamus directing the trial court to vacate its order granting the motion for new trial of the real parties *166 in interest, Mark and Stacey Bent. 1 The Bents sued USAA, alleging breach of a homeowner’s insurance policy and violations of the Texas Insurance Code, and a jury awarded the Bents damages in the amount of $400,000. The trial court initially entered judgment on the verdict, but then granted the Bents’ motion for new trial. USAA then initiated this proceeding.

After USAA filed its petition, the Supreme Court of Texas decided In re Toyota Motor Sales, U.S.A., Inc., which announced that a trial court’s legally appropriate and reasonably specific order granting a new trial may be reviewed on its substantive merits in a mandamus proceeding. 407 S.W.3d 746, 758-59 (Tex.2013). Applying that standard of review to this case, we hold that none of the trial court’s reasons for granting a new trial was proper. Accordingly, we conditionally grant mandamus relief.

Background

A. The Bents’ insurance policy

In 2005, Mark and Stacey Bent bought a home in the City of Piney Point Village for $1 million. The Bents subsequently made improvements to the home, and on September 5, 2008, an appraiser estimated the home’s value at $1.6 million.

The Bents purchased a homeowner’s policy from USAA. The homeowner’s policy covered losses up to $1.34 million, but excluded losses caused by mold, microorganisms, or operation of ordinances or other law. The policy’s “loss payment” provision established a 5-day deadline for payment in certain circumstances:

If we notify you that we will pay your claim, or part of your claim, we must pay within 5 business days after we notify you. If payment of your claim or part of your claim requires the performance of an act by you, we must pay within 5 business days after the date you perform the act.

But a longer deadline applied to claims resulting from weather or major natural disasters: If a claim resulted “from a weather related catastrophe or a major natural disaster, each claim handling deadline ... is extended for an additional 15 days.”

B. Hurricane Ike

On September 13, 2008, Hurricane Ike damaged the home’s roof and air conditioning units, toppled a number of trees into the Bents’ driveway and pool, and damaged the interior of the home. Stacey reported a claim to USAA, and USAA assigned an adjuster to investigate. After visiting the property, the adjuster evaluated the damages at approximately $7,500, which he later revised upwards to $14,302.33. USAA subtracted the Bents’ one-percent deductible and mailed the Bents a letter approving their claim. On the same day, USAA issued a check for $1,162.33 and marked the claim closed. According to Stacey, the cost of removing the fallen trees was not included in this initial payment because the adjuster told her that those costs were not covered by the policy.

In December 2008, the Bents obtained a $500,000 home equity loan. At that time, Mark and Stacey both signed a document stating that the home had a fair market value of, $1.6 million. Each represented that they had “no knowledge of any condition, proceeding, defect, casualty or any *167 other matter now or potentially existing that would affect the [fair market value].”

C. The April 2009 flood

In April 2009, the home suffered further damage from a flood. The Bents held a flood insurance policy issued through USAA General Indemnity Company, an entity related to USAA. Stacey reported the flood claim to USAA. While mitigating the flood damage, workers discovered mold in the walls. Stacey reported the mold to USAA, and USAA’s adjusters informed the Bents that mold damage was not covered by their homeowner’s policy. The Bents signed a proof of loss stating that the flood caused an estimated $98,288.27 in further damages to the home. The Bents took the position at trial, however, that at least some of the mold was attributable to leaks in the roof caused by the hurricane rather than the flood, and USAA had “missed it” during its original inspection.

After the flood, the Bents discovered additional damage to the roof, not included in USAA’s initial damage appraisal, which they attributed to Hurricane Ike and reported to USAA. In May 2009, USAA conducted an inspection at which Stacey and a contractor hired by the Bents were present. USAA found water damage to the roof and interior of the house beyond that documented in the first inspection after the hurricane, significant hail damage to the roof from a storm two months earlier, and damage from foot traffic. USAA’s inspector determined that the shingles used on the roof were no longer available for purchase and therefore recommended a roof replacement instead of a roof repair. At the same time, Stacey and the inspector discussed the cost of removing the trees toppled by the hurricane, and the inspector stated that the homeowner’s policy covered the costs of removing trees from the driveway if the Bents could produce proper documentation of the trees’ location and cost of removal. Accordingly, in June 2009, USAA revised the total estimate of the damages to the home attributable to Ike, notified the Bents that it would pay an additional amount, and issued a further payment on the same day. 2

D. The Bents’ pursuit of their insurance claims

In July 2009, after another inspection at which Stacey and a contractor were present, USAA further revised the total estimate of the damages to the home attributable to Ike to $98,079.62. It notified the Bents of this estimate and made a corresponding payment. Also in July 2009, Stacey obtained an estimate of $162,174.85 for the total cost of repairs attributable to Ike or the flood.

In October 2009, the Bents submitted another estimate of additional damages, including items not previously identified during USAA’s inspections of the home. Because the estimate was not fully itemized, USAA requested additional information and informed the Bents through a series of phone calls and written correspondence that it could not make further payments until it received additional information.

In November 2009, USAA conducted a further inspection, again with Stacey and a contractor present, at which USAA’s inspector explained the additional detail that *168 USAA required. The Bents did not send further information until December 2009, when an attorney acting on their behalf wrote to USAA requesting that it direct all further correspondence to him. USAA corresponded with that attorney until he withdrew from representation of the Bents, then corresponded with the Bents directly and with another attorney throughout late 2009 and the first half of 2010, but received no additional information supporting the Bents’ claims under the homeowner’s policy.

In December 2009, USAA invoked the appraisal process referenced in the homeowner’s policy.

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Cite This Page — Counsel Stack

Bluebook (online)
446 S.W.3d 162, 2014 Tex. App. LEXIS 9312, 2014 WL 4109756, Counsel Stack Legal Research, https://law.counselstack.com/opinion/in-re-united-services-automobile-association-texapp-2014.