Juan Alvarez v. State Farm Lloyds

CourtCourt of Appeals of Texas
DecidedSeptember 27, 2017
Docket04-17-00251-CV
StatusPublished

This text of Juan Alvarez v. State Farm Lloyds (Juan Alvarez v. State Farm Lloyds) 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
Juan Alvarez v. State Farm Lloyds, (Tex. Ct. App. 2017).

Opinion

ACCEPTED 04-17-00251-CV FOURTH COURT OF APPEALS SAN ANTONIO, TEXAS 9/27/2017 2:37 PM

FILED INA. Lorber Melissa 4th COURT(512) OF APPEALS 615-1205 SAN ANTONIO, TEXAS mlorber@enochkever.com 09/27/2017 2:37:51 PM September 27, 2017 KEITH E. HOTTLE CLERK

Keith E. Hottle, Clerk of the Court Fourth Court of Appeals Cadena-Reeves Justice Center 300 Dolorosa, Suite 3200 San Antonio, Texas 78205-3037

Re: No. 04-17-00251-CV, Juan Alvarez v. State Farm Lloyds, In the Court of Appeals, Fourth District of Texas – San Antonio

Dear Mr. Hottle:

State Farm writes to inform the Court about two new Texas court decisions, issued since State Farm filed its appellee’s brief, that address the same issues as this case. Please forward this letter to the justices on the panel for this case.

Both of these new opinions support State Farm’s position in this case:

• On September 21, 2017, the United States Court of Appeals for the Fifth Circuit issued an opinion in Mainali Corp. v. Covington Specialty Insurance Co. (attached as Appendix A). The Fifth Circuit affirmed a take-nothing summary judgment on the insurer’s breach of contract and Insurance Code, Chapter 542 claims that had been granted after the insurer paid an appraisal award. Id. at 3-6.

• On September 22, 2017, the Texas Supreme Court denied the insurer’s petition for review in Richardson East Baptist Church v. Philadelphia Indemnity Insurance Co., No. 16-0347. The petition had challenged the Dallas court of appeals’ decision affirming a take-nothing judgment on breach of contract and Insurance Code, Chapter 541 claims after the insurer’s payment of an appraisal award. See No. 05–14–01491– CV, 2016 WL 1242480, *6-11 (Tex. App.—Dallas Mar. 30, 2016, pet. denied) (attached as Appendix B).

Sincerely,

/s/ Melissa A. Lorber Melissa A. Lorber

Bridgepoint Plaza p: 512.615.1200 ENOCH KEVER PLLC 5918 W. Courtyard Drive, Suite 500 enochkever.com f: 512.615-1198 Austin, Texas 78730 Keith E. Hottle, Clerk of the Court September 27, 2017 Page 2

CERTIFICATE OF SERVICE

I hereby certify that, on September 27, 2017, a true and correct copy of the above and foregoing has been served via electronic service on the following:

Joshua P. Davis josh@thejdfirm.com Katherine Ray Katie@thejdfirm.com Davis Law Group 1010 Lamar, Suite 200 Houston, Texas 77002

/s/ Melissa A. Lorber Melissa A. Lorber APPENDIX A Case: 17-10350 Document: 00514164951 Page: 1 Date Filed: 09/21/2017

IN THE UNITED STATES COURT OF APPEALS FOR THE FIFTH CIRCUIT United States Court of Appeals Fifth Circuit

No. 17-10350 FILED Summary Calendar September 21, 2017 Lyle W. Cayce Clerk MAINALI CORPORATION,

Plaintiff - Appellant

v.

COVINGTON SPECIALTY INSURANCE COMPANY; ENGLE MARTIN; ASSOCIATES, INCORPORATED; LYNN SUMMERS,

Defendants - Appellees

Appeal from the United States District Court for the Northern District of Texas

Before DAVIS, CLEMENT, and COSTA, Circuit Judges. GREGG COSTA, Circuit Judge: A fire damaged a gas station and convenience store owned by Mainali Corporation. Mainali filed a claim with its property insurer, Covington Specialty Insurance Company, which paid the claims based on an independent adjuster’s estimates. Mainali thought it was owed more, so it sued Covington for breach of contract, breach of the duty of good faith and fair dealing, fraud, and violations of the Texas Insurance Code and Texas Deceptive Trade Practices Act. After a full appraisal process, a panel’s appraisal award was less than Covington had already paid to Mainali under the insurance policy. But Covington did pay a relatively small additional sum to ensure its payments Case: 17-10350 Document: 00514164951 Page: 2 Date Filed: 09/21/2017

No. 17-10350 were consistent with the way the appraisal panel allocated the losses. The district court granted summary judgment for Covington on all of Mainali’s claims. The key issue we decide involves the application of the Prompt Payment of Claims Act to payments of an award pursuant to an appraisal process. For the reasons that follow, we AFFIRM. I. Mainali owned a gas station and convenience store (the Property) in Decatur, Texas. Covington insured Mainali’s Property. The commercial package insurance policy included coverage for the building, associated business personal property, the gas and fuel pumps, the gas station’s canopy and awnings, and lost business income. It also provided for payment of loss on an actual cash value basis—that is, with deduction for depreciation—and required payment of the depreciation holdback or full replacement cost value only if the insured repaired or replaced the property. In April 2014, a fire damaged Mainali’s Property. The following day, Mainali notified Covington of the fire. Three days after the fire, Covington sent Lynn Summers, an independent adjuster, to investigate Mainali’s claim. Over the course of several payments made from May 2014 through January 2015, Covington paid Mainali $389,255.59 using an actual cash value basis. Mainali disputed this calculation. And in March 2015, about two months after Covington’s last payment, Mainali filed suit against Covington and Summers in state court. Covington removed the lawsuit to federal court and then exercised its right of appraisal under the policy. As a result, Covington and Mainali each designated an appraiser, and the two appraisers agreed on an umpire. The appraisal panel issued an appraisal award of $387,925.49 as actual cash value and a replacement cost value of $449,349.61. The latter was the relevant figure as Mainali did not repair or replace the Property. The appraisal award provided that it was “inclusive of all FIRE damages sustained 2 Case: 17-10350 Document: 00514164951 Page: 3 Date Filed: 09/21/2017

No. 17-10350 to the insured property” and was the sum of three types of losses: Building, Contents, and Business Interruption. Although Covington had already paid more than the total amount the appraisal panel said it owed, it paid an additional $15,175.82 for the building allocation after the panel announced its award. Covington and Summers subsequently moved for summary judgment on Mainali’s claims. They argued that under Texas law, the timely payment of the appraisal award precluded liability on Mainali’s breach of contract and extracontractual claims. Mainali responded that the appraisal award was incomplete because it did not expressly include any amounts for fuel and gas pumps, the gas station’s canopy and awnings, or code upgrades. As for its extracontractual claims, Mainali pressed only its claim under the Prompt Payment of Claims Act in Chapter 542 of the Texas Insurance Code. It argued the postappraisal payment was subject to that Act’s interest penalties for payments made more than 60 days after the insurer receives necessary documentation from the insured. The district court granted Covington’s motion. II. Mainali first challenges the district court’s grant of summary judgment on the breach of contract claim. Under Texas law, “appraisal awards made pursuant to the provisions of an insurance contract are binding and enforceable, and every reasonable presumption will be indulged to sustain an appraisal award.” Franco v. Slavonic Mut. Fire Ins. Ass’n-CIC, 154 S.W.3d 777, 786 (Tex. App.—Houston [14th Dist.] 2004, no pet.). “The effect of an appraisal provision is to estop one party from contesting the issue of damages in a suit on the insurance contract, leaving only the question of liability for the court.” TMM Invs., Ltd. v. Ohio Cas. Ins. Co., 730 F.3d 466, 472 (5th Cir. 2013) (quoting Lundstrom v. United Servs. Auto.

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Juan Alvarez v. State Farm Lloyds, Counsel Stack Legal Research, https://law.counselstack.com/opinion/juan-alvarez-v-state-farm-lloyds-texapp-2017.