Michael Knopp and Sandra Rybicki-Knopp v. State Farm Lloyd's

CourtCourt of Appeals of Texas
DecidedJuly 30, 2024
Docket05-22-00749-CV
StatusPublished

This text of Michael Knopp and Sandra Rybicki-Knopp v. State Farm Lloyd's (Michael Knopp and Sandra Rybicki-Knopp v. State Farm Lloyd's) 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
Michael Knopp and Sandra Rybicki-Knopp v. State Farm Lloyd's, (Tex. Ct. App. 2024).

Opinion

Affirmed and Opinion Filed July 30, 2024.

S In The Court of Appeals Fifth District of Texas at Dallas No. 05-22-00749-CV

MICHAEL KNOPP AND SANDRA RYBICKI-KNOPP, Appellants V. STATE FARM LLOYDS, Appellee

On Appeal from the 471st Judicial District Court Collin County, Texas Trial Court Cause No. 471-04386-2021

MEMORANDUM OPINION Before Justices Pedersen, III, Goldstein, and Kennedy Opinion by Justice Pedersen, III In this appeal arising from an insurance dispute, appellants complain the trial

court erred by granting summary judgment that they take nothing on their claims for

breach of contract and violations of the Texas Insurance Code. We affirm the trial

court’s judgment.

Background

Appellee State Farm Lloyds insured the home of appellants Michael Knopp

and Sandra Rybicki-Knopp. A hail storm damaged the home’s roof on March 24,

2019. Appellants submitted a claim to appellee on April 4, 2019. On April 22, 2019, independent adjuster James L. Ulibarri inspected the roof.

In an April 23, 2019 letter to appellants, Ulibarri acknowledged hail damage to roof

vents, valley metal, aluminum wall coping, exhaust caps, and rain caps. However, a

number of composite roof tiles were not damaged and, therefore, were not covered

by the policy due to lack of “accidental direct physical loss.” Moreover, tears to other

tiles were “not consistent with wind or hail damage” and, therefore, the policy did

not cover damage to the torn tiles. Ulibarri’s estimate, enclosed with his letter,

included $630.24 for labor “to manipulate undamaged composite slate tiles in order

to replace valley metal and roof vents.” Ulibarri estimated the damage to appellants’

roof to be $8,800.71. The total payable amount due to appellants from appellee was

$3,525.49, after reductions for depreciation and the policy’s deductible. Payment of

$3,525.49 was enclosed with Ulibarri’s letter. Appellee reserved its defenses.

Appellants disagreed with appellee’s coverage decision. Appellee retained an

engineer who performed a second inspection of the roof on or about August 23,

2019. In a September 9, 2019 letter to appellants, appellee continued to deny

coverage for any damage to the roof tiles. However, appellee enclosed payment of

$2,713.30 for additional labor to manipulate undamaged roof tiles. Appellee

reserved its policy defenses.

More than a year later, in December 2020, a roofing company sent appellee a

letter from the manufacturer of the roof tiles. According to appellee’s records, the

letter stated the roof tiles are “extremely difficult to repair” and recommended

–2– replacing tiles in areas where the valley metal is to be replaced. An employee of

appellee spoke to a person associated with the manufacturer who stated the tiles are

easily replaced if damaged and that it did not matter whether such tiles were in a

valley or slope area. Subsequently, appellee’s employee spoke with persons at two

roofing companies. One company reported it frequently repaired roofs like

appellants’ and that such roofs can be repaired. The other company also stated the

tiles can be repaired. Appellee’s employee conferred with another person involved

in assessing appellants’ claims. They agreed no changes to appellee’s existing

estimate were necessary because “a repair has been included for the roof and an

update for additional D&R of shingles in labor has been made in [S]eptember.”

Appellants invoked the policy’s appraisal clause.1 Appellee received the

appraisal demand December 15, 2020. On January 20, 2021, the appraisers issued

1 Appellants’ policy provides in part,

Appraisal. If you and we fail to agree on the amount of loss, either party can demand that the amount of the loss will be set by appraisal.

* * *

The appraisers will . . . attempt to set the amount of the loss of each item in dispute as specified by each party, and jointly submit to each party a written report of agreement signed by them. . . . The written report of agreement will set the amount of the loss of each item in dispute and will be binding upon you and us.

You and we do not waive any rights by demanding or submitting to an appraisal, and retain all contractual rights to determine if coverage applies to each item in dispute.

–3– an “award form” stating the monetary amount to replace the roof was $96,195.04 in

replacement cost value and $91,475.77 in actual cost value.2 The award stated it was

not a determination of coverage or cause of loss.

On January 28, 2021, appellee received the appraisal award.

On February 9, 2021, appellee informed appellants by letter that it would not

pay to replace the roof because damage to the roof’s shingles was not caused by hail

or wind and, therefore, was not covered by the policy. However, appellee paid

$2,550.86 to appellants as a supplemental payment for minor roof repair.

On May 27, 2021, appellants sent a notice letter to appellee. Appellants stated

appellee had breached the policy and violated Chapter 541 of the insurance code by

refusing in bad faith to pay the appraisal award and had violated Chapter 542 of the

insurance code by delaying payment. Appellants stated they had incurred $9,600.00

attorney’s fees. Appellants claimed “total damages” of $84,956.25. On July 11,

2021, appellee declined appellants’ request for additional payment.

Appraisal is only available to determine the amount of the loss of each item in dispute. The appraisers and the umpire have no authority to decide: (1) any other questions of fact; (2) questions of law, (3) questions of coverage; (4) other contractual issues . . . . 2 The policy differentiates payment for (1) actual cash value at the time of loss and (2) replacement cost value. For example, the policy in part provides appellee will pay the cost to repair or replace damaged property “subject to the following:” (1) until actual repair or replacement is completed, we will pay only the actual cash value at the time of the loss of the damaged part of the property, up to the applicable limit of liability shown in the Declarations, not to exceed the cost to repair or replace the damaged part of the property; (2) when the repair or replacement is actually completed, we will pay the covered additional amount you actually and necessarily spend to repair or replace the damaged part of the property, or an amount up to the applicable limit of liability shown in the Declarations, whichever is less . . . . –4– On August 11, 2021, appellants filed this lawsuit against appellee and John

Altizer, appellee’s adjustor, in district court.3 Against appellee, appellants alleged

breach of contract, statutory bad faith in violation of Chapter 541 of the insurance

code, common law bad faith, and failure to promptly pay their claim in violation of

Chapter 542 of the insurance code.4 They also sought declaratory relief.

One day after filing this lawsuit, appellants sent appellee a “demand for relief

under the Texas Insurance Code.” In it, they repeated that appellee breached the

policy and violated the insurance code. Appellants stated market costs of repair had

significantly increased since the date of the appraisal award. They attached to their

letter an estimate of increased costs prepared by independent adjuster Art Boutin.

Appellants asserted $105,044.03 in actual damages, $26,261.01 in attorney’s fees,

and $23,634.01 in penalties for failure to promptly pay their claim. The asserted

damages totaled $154.939.95.

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Michael Knopp and Sandra Rybicki-Knopp v. State Farm Lloyd's, Counsel Stack Legal Research, https://law.counselstack.com/opinion/michael-knopp-and-sandra-rybicki-knopp-v-state-farm-lloyds-texapp-2024.