ACCEPTED 01-14-00278-CV FIRST COURT OF APPEALS HOUSTON, TEXAS 12/21/2015 12:54:32 PM CHRISTOPHER PRINE CLERK
NO. 01-14-00278-CV FILED IN 1st COURT OF APPEALS HOUSTON, TEXAS IN THE FIRST COURT OF APPEALS OF TEXAS 12/21/2015 12:54:32 PM CHRISTOPHER A. PRINE Clerk
JOHN DAVIS d/b/a J.D. HOUSE OF STYLE v.
NATIONAL LLOYDS INSURANCE COMPANY
On Appeal from the 281st Judicial District Court Harris County, Texas, Cause No. 2010-58199
RESPONSE TO MOTION FOR REHEARING
Scott A. Brister - SBN 00000024 Scot G. Doyen – SBN 00792982 ANDREWS KURTH LLP Alasdair Roberts – SBN 24068541 111 Congress Ave., Suite 1700 DOYEN SEBESTA, LTD., L.L.P. Austin, Texas 78701 450 Gears Road, Suite 350 phone: (512) 320-9200 Houston, Texas 77067 Fax: (512) 320-9292 Phone: (713) 580-8900 sbrister@andrewskurth.com Fax: (713) 580-8910
ATTORNEYS FOR APPELLEE NATIONAL LLOYDS INSURANCE COMPANY
AUS:696416.1 TABLE OF CONTENTS
Argument ............................................................................. 1
I. “(X)” was unambiguously an instruction ....................... 1
II. The damages for repairs related to a different policy .... 4
III. No breach means no extra-contractual claims ............... 6
Conclusion .......................................................................... 12
ii
AUS:696416.1 INDEX OF AUTHORITIES Page(s)
Cases
In re Allstate Cnty. Mut. Ins. Co., 447 S.W.3d 497 (Tex. App.—Houston [1st Dist.] 2014, orig. proceeding) ..................................................................................9, 10
Chrysler Ins. Co. v. Greenspoint Dodge of Houston, Inc., 297 S.W.3d 248 (Tex. 2009)........................................................................9
CMA-CGM (Am.) Inc. v. Empire Truck Lines Inc., 285 S.W.3d 9 (Tex. App.—Houston [1st Dist.] 2008, no pet.)...............................................................................................................6
Elledge v. Friberg-Cooper Water Supply Corp., 240 S.W.3d 869 (Tex. 2007)........................................................................8
Geodyne Energy Income Prod. P'ship I-E v. Newton Corp., 161 S.W.3d 482 (Tex. 2005)........................................................................3
Isaacs v. Plains Transp. Co., 367 S.W.2d 152 (Tex. 1963)........................................................................4
JAW The Pointe, L.L.C., v. Lexington Ins. Co., 460 S.W.3d 597 (Tex. 2015)........................................................................9
In re K.M.S., 91 S.W.3d 331 (Tex. 2002)..........................................................................8
Kachina Pipeline Co., Inc. v. Lillis, 471 S.W.3d 445 (Tex. 2015)........................................................................3
Liberty Nat’l Fire Ins. Co. v. Akin, 927 S.W.2d 627 (Tex. 1996)........................................................................9
iii
AUS:696416.1 Provident Am. Ins. Co. v. Castañeda, 988 S.W.2d 189 (Tex. 1998)......................................................................12
Republic Ins. Co. v. Stoker, 903 S.W.2d 338 (Tex. 1995)..................................................................8, 10
State Farm Lloyds v. Page, 315 S.W.3d 525 (Tex. 2010)........................................................................8
Transp. Ins. Co. v. Moriel, 879 S.W.2d 10 (Tex. 1994)..........................................................................9
Other Authorities
BLACK’S LAW DICTIONARY 1700 (10th ed. 2014) ...........................................3
iv
AUS:696416.1 ARGUMENT There is no good reason to reconsider whether a pre-printed
“(X)” as an instruction on an insurance policy made the policy
ambiguous. There is no good reason to reconsider a jury finding on
repairs based on the assumption this was a Replacement Cost Value
(RCV) policy when the Court has affirmed it was an Actual Cash
Value (ACV) policy. And there is no good reason to encourage an
insured to seek extra-contractual damages after the contract claim he
pursued for five years is dismissed as groundless. National Lloyds
respectfully urges the Court to deny Davis’s motion for rehearing.
I. “(X)” was unambiguously an instruction Davis’s first complaint is that this Court “is just preferring one
page over another” in an ambiguous policy. The parties’ briefs have
already covered this issue thoroughly.
“(X)” and several other pre-printed instructions appear
repeatedly on the declarations page of Davis’ policy (6ARR8). In the
Optional Coverages section, the instruction “(Percentage)” appears
AUS:696416.1 next to Inflation Guard, the instruction “(Fraction)” next to Monthly
Limit of Indemnity, the instruction “(Days)” next to Extended Period
of Indemnity, and the instruction “(X)” next to both Replacement Cost
and Maximum Period of Indemnity:
Davis is correct that each of these “has to mean something”:
• “(Percentage)” means the Inflation Guard provision must state a percentage;
• “(Fraction)” means the Monthly Limit of Indemnity must state a fraction;
• “(Days)” means the Extended Period of Indemnity must state the number of days extended; and
• “(X)” means an X must be placed under Replacement Cost and Maximum Period of Indemnity if those items apply.
The instructions for the first three of these items allowed a range of
options, but Replacement Cost and the Maximum Period of Indemnity
were binary options: an insured either bought and paid for them or
did not. Mr. Davis did not.
AUS:696416.1 Davis says the Court should have considered evidence of
industry practice in interpreting this policy. But “(X)” is not a term of
art, 1 and there is no evidence it has a special meaning by custom and
usage in the insurance industry. Since it is clearly used here as an
instruction, extrinsic evidence of industry custom cannot change that. 2
Nor does Kevin Mohr’s testimony require the Court to find this
policy ambiguous. Witnesses do not decide whether there are two
reasonable interpretations of a contract; courts do. 3 If the rule were
otherwise, parties could create ambiguity merely by hiring an expert
to say so. Mr. Mohr was designated by National Lloyds to appraise
property damage and coverage on Davis’s property (CR33), but his
1 See BLACK’S LAW DICTIONARY 1700 (10th ed. 2014) (“A word or phrase having a specific, precise meaning in a given specialty, apart from its general meaning in ordinary contexts.”). 2 See Kachina Pipeline Co., Inc. v. Lillis, 471 S.W.3d 445, 454 (Tex. 2015) (“[I]ndustry custom cannot impose obligations beyond those within the written Agreement.”). 3 See Geodyne Energy Income Prod. P'ship I-E v. Newton Corp., 161 S.W.3d 482, 490-91 (Tex. 2005) (holding that a contract provision “is not ambiguous, and thus did not need to be submitted to the jury.”).
AUS:696416.1 opinions about whether it was ambiguous and how it should be
construed are not binding on this Court. 4
II. The damages for repairs related to a different policy Next, Davis argues that even if National Lloyds owed nothing
on his policy, it must pay him $17,200 for repairs because “repair
damages are separate and apart from diminished property value.”
Neither the evidence nor the policy supports this claim.
The jurors were not told whether the policy was ACV or RCV,
and their answer for repairs was not specific to either. But the
evidence clearly was; as this Court stated in its opinion: “Davis
presented no evidence of the depreciated value of his roof, nor did he
provide any evidence segregating the cost of repairs[.]” See Opinion at
25. National Lloyds presented the only evidence of repairs needed to
restore the roof to its depreciated condition, and that evidence showed it
was less than the policy’s deductible (2RR94-96; 6ARR166). Thus, the
4 See Isaacs v. Plains Transp. Co., 367 S.W.2d 152, 153 (Tex. 1963) (holding truck driver’s statements that he was at fault “were pure conclusions and opinions, were not offered for impeachment, and were not admissible against the employer[.]”).
AUS:696416.1 jury’s answer could not have reflected the cost of restoring the roof to
its depreciated roof (per ACV coverage), but only of restoring a brand-
new roof (per RCV coverage). This Court having concluded this was
an ACV policy, the jury’s answer regarding and RCV policy had to be
disregarded.
National Lloyds had no duty to pay for damages or repairs
beyond its policy. In the policy, National Lloyds promised to pay “at
our option” either (1) the value of damaged property or (2) the cost of
repairing it. 5 The policy also provided that: “If the adjusted amount of
loss is less than or equal to the Deductible, we will not pay for that
loss.” 6 Since National Lloyds could select whether to pay for damages
or repairs “at our option,” and the damages were below the
deductible, National Lloyds could select that option and pay nothing.
So even if had Davis presented evidence of repair expenses incurred to
5 See 6CRR138, ¶¶ 1(a)(1)-(2)(“In the event of loss or damage covered by this Coverage Form, at our option, we will either: (1) Pay either the value of lost or damaged property; [or] (2) Pay the cost of repairing or replacing the lost or damaged property, subject to b. below[.]”)). 6 See 6CRR137, ¶ D; 6CRR173 ¶ A(2).
AUS:696416.1 return the roof to its depreciated condition (which he did not), he could
not avoid the policy’s deductible by making repairs himself.7
III. No breach means no extra-contractual claims Davis’s final argument is that the Court should reverse and
award him policy benefits based on his extra-contractual claims even if
National Lloyds properly denied his claim. This argument is raised for
the first time on rehearing. “As a general rule, we do not address new
arguments presented in a rehearing.” CMA-CGM (Am.) Inc. v. Empire
Truck Lines Inc., 285 S.W.3d 9, 18 (Tex. App.—Houston [1st Dist.] 2008,
no pet.). Davis had the chance to make this argument earlier, because
National Lloyds argued that disposing of Davis’s policy claims “also
disposes of Davis’s extra-contractual claims.” 8 Davis did not respond
to that argument,9 so it comes too late now.
7 See also 6CRR144 (providing that Covered Property will be valued in the event of loss at “actual cash value”). 8 See Appellee’s Br. at 22 (citing State Farm Lloyds v. Page, 315 S.W.3d 525, 532 (Tex. 2010)). 9 See Reply Br. of Appellant at 9-11.
AUS:696416.1 In any event, this argument is based entirely on a single case
from the Thirteenth Court of Appeals — one that is likely to be
reversed soon. In USAA Texas Lloyd's Co. v. Menchaca, the Corpus
Christi court held in a memorandum opinion that extra-contractual
claims were extinguished by a finding of no coverage, but not by a
finding of no breach due to a deductible. 10 USAA has petitioned for
review (represented by former Chief Justice Wallace Jefferson), and
the Texas Supreme Court ordered full briefing on May 1, 2015.11
Menchaca is neither binding nor persuasive for several reasons.
First, Davis’s policy treats the deductible as part of coverage, not
independent of it. The first sentence of the Commercial Property form
here stated: “Various provisions in this policy restrict coverage. Read
the entire policy carefully to determine rights, duties and what is and is
not covered.” (6CRR131 (emphasis added)). Thus, a reader looking at
what the policy covers must look at both of the following clauses:
10 See No. 13-13-00046-CV, 2014 WL 3804602 (Tex. App.—Corpus Christi July 31, 2014, pet. filed). 11 See http://www.search.txcourts.gov/Case.aspx?cn=14-0721&coa=cossup.
AUS:696416.1 • “A. Coverage. We will pay for direct physical loss of or damage to Covered Property at the premises described[.]” (6CR131); and
• “D. Deductible … If the adjusted amount of loss is less than or equal to the Deductible, we will not pay for that loss.” (6CR137).
To determine “what is and is not covered,” one cannot disregard the
clause that provides “we will not pay” claims below the deductible.
Thus, this was a coverage dispute according to this policy, so the
Corpus Christi court’s distinction does not apply.
Second, the Menchaca court picked a few Supreme Court
opinions and ignored others, which courts of appeals cannot do.12
Some Supreme Court opinions say that “[w]hen the issue of coverage is
resolved in the insurer’s favor, extra-contractual claims do not
survive.”13 But plenty of others say that when the insurer did not
breach the contract, extra-contractual claims do not survive:
12 See, e.g., Elledge v. Friberg-Cooper Water Supply Corp., 240 S.W.3d 869, 870 (Tex. 2007); In re K.M.S., 91 S.W.3d 331, 331 (Tex. 2002). 13 State Farm Lloyds v. Page, 315 S.W.3d 525, 532 (Tex. 2010) (emphasis added); see also Republic Ins. Co. v. Stoker, 903 S.W.2d 338, 341 (Tex. 1995) (“As a general rule there can be no claim for bad faith when an insurer has promptly denied a claim that is in fact not covered.”).
AUS:696416.1 • “[I]n most circumstances, an insured may not prevail on a bad faith claim without first showing that the insurer breached the contract.” Liberty Nat’l Fire Ins. Co. v. Akin, 927 S.W.2d 627, 629 (Tex. 1996) (emphasis added)).
• “Having concluded that Chrysler did not breach the insurance contract, no basis supports these [extra-contractual] awards.” Chrysler Ins. Co. v. Greenspoint Dodge of Houston, Inc., 297 S.W.3d 248, 254 (Tex. 2009)
• “An insurer generally cannot be liable for failing to settle or investigate a claim that it has no contractual duty to pay.” In re Allstate Cnty. Mut. Ins. Co., 447 S.W.3d 497, 501 (Tex. App.—Houston [1st Dist.] 2014, orig. proceeding) (emphasis added).
• “The threshold of bad faith is reached when a breach of contract is accompanied by an independent tort.” Transp. Ins. Co. v. Moriel, 879 S.W.2d 10, 17 (Tex. 1994).
• “[T]he policy[] … excluded coverage for JAW’s losses, and JAW therefore cannot recover against Lexington on its statutory bad faith claims.” JAW The Pointe, L.L.C., v. Lexington Ins. Co., 460 S.W.3d 597, 610 (Tex. 2015).
An insurer does not breach a policy if there is either no coverage or no
liability above the deductible, and courts sometimes use these terms
AUS:696416.1 interchangeably. 14 The Thirteenth Court had a duty to follow all of
these cases, not create a dubious distinction that ignores half of them.
It is hard to argue with Davis’s analogy that “[a] kitten is still a
cat, even though it is a smaller feline creature.” But it is irrelevant. If
an insurer says it will pay for cats but not kittens, there is no extra-
contractual duty to pay for a kitten.
It is theoretically possible that extra-contractual liability can
survive a finding that an insurer did not breach the policy, but only “if
its conduct was extreme and produced damages unrelated to and
independent of the policy claim.” 15 Davis alleges no extreme conduct
producing independent damages here; all three of his extra-
contractual claims alleged only that National Lloyds breached his
policy (4RR26-28), and without that breach they collapse.
14 See, e.g., Republic Ins. Co., 903 S.W.2d at 341 (stating “there can be no claim for bad faith when … [it] is in fact not covered,” but citing as support cases that bar fad-faith claims when there is no breach of contract). 15 See In re Allstate Cnty. Mut. Ins. Co., 447 S.W.3d 497, 502 n.2 (Tex. App.— Houston [1st Dist.] 2014, orig. proceeding) (quoting Progressive Cnty. Mut. Ins. Co. v. Boyd, 177 S.W.3d 919, 922 (Tex. 2005) (emphasis added)).
AUS:696416.1 First, Davis claimed National Lloyds misrepresented a material
fact or policy provision by denying his claim from Hurricane Ike
(CR213, 4RR26). Denial was based on failure to meet the deductible,16
which Davis said he understood. 17 Since this Court has held that
denial correct, it cannot be an extra-contractual “misrepresentation.”
Davis’s second extra-contractual claim was that National Lloyds
failed to attempt in good faith to settle his claim after liability became
reasonably clear (CR213, CR215). Since there was no liability, National
Lloyds had no extra-contractual duty to settle it sooner.
Davis’s third extra-contractual claim was that National Lloyds
refused to conduct a reasonable investigation (CR213, CR215). But
after numerous investigations by all parties, the jurors still found $0
due on this ACV policy (CR216). Since restoring Davis’s roof to its
depreciated pre-Ike condition did not exceed the deductible no matter
16 See 6CR227 (“We have investigated your claim and must respectfully deny Payment for the following reason(s): Total damage appears to be less than deductible.”). 17 A. [Davis] About a week or two later, I got a letter from them saying that they couldn't pay me but $3700 -- I mean, my deductible was $3700. So I had to come up with that and so I didn't worry with them no more. (2RR39).
AUS:696416.1 how many reasonable investigations were made, there was neither
evidence nor a jury finding that he suffered any damage from any
unreasonable investigation.18
CONCLUSION For the foregoing reasons, Appellee National Lloyds Insurance
Company prays this Court deny Appellant’s Motion for Rehearing.
Respectfully submitted,
ANDREWS KURTH LLP
By: /s/ Scott A. Brister Scot G. Doyen - SBN 00792982 Scott A. Brister - SBN 00000024 Alasdair Roberts – SBN 24068541 ANDREWS KURTH LLP DOYEN SEBESTA, LTD., L.L.P. 111 Congress Ave., Suite 1700 450 Gears Road, Suite 350 Austin, Texas 78701 Houston, Texas 77067 Phone: (512) 320-9200 Phone: (713) 580-8900 Fax: (512) 320-9292 Fax: (713) 580-8910 sbrister@andrewskurth.com sdoyen@ds-lawyers.com aroberts@ds-lawyers.com
COUNSEL FOR NATIONAL LLOYDS INSURANCE COMPANY
18 See Provident Am. Ins. Co. v. Castañeda, 988 S.W.2d 189, 198 (Tex. 1998) (“[F]ailure to properly investigate a claim is not a basis for obtaining policy benefits.”).
AUS:696416.1 CERTIFICATE OF COMPLIANCE
I certify that this Petition for Review contains 2,204 words as calculated per Rule 9.4(i)(1) of the Texas Rules of Appellate Procedure.
/s/ Scott A. Brister Scott A. Brister
CERTIFICATE OF SERVICE
I hereby certify that a true and correct copy of the foregoing document was served via electronic transmission on December 21, 2015 on the following counsel:
Richard P. Hogan, Jr. - rhogan@hoganfirm.com Jennifer Bruch Hogan - jhogan@hoganfirm.com James C. Marrow - jmarrow@hoganfirm.com HOGAN & HOGAN 711 Louisiana, Suite 500 Houston, Texas 77002
Humberto G. Garcia - humberto@speightsfirm.com Jason B. Speights - jason@speightsfirm.com SPEIGHTS & WORRICH 1350 N. Loop 1604 East, Suite 104 San Antonio, Texas 78232
AUS:696416.1