Michael Tatsch v. Chrysler Group, LLC and Infinity County Mutual Insurance Company

Court of Appeals of Texas·Decided January 30, 2015·No. 04-13-00757-CV·Published

Opinion

ACCEPTED

04-13-00757-CV

FOURTH COURT OF APPEALS

SAN ANTONIO, TEXAS

1/30/2015 1:50:24 PM

KEITH HOTTLE

CLERK

NO. 04-13-00757-CV

FILED IN

4th COURT OF APPEALS

IN THE FOURTH COURT OF APPEALS SAN ANTONIO, TEXAS SAN ANTONIO, TEXAS 01/30/2015 1:50:24 PM KEITH E. HOTTLE

Clerk

MICHAEL TATSCH,

Appellant,

V.

CHRYSLER GROUP LLC

AND INFINITY COUNTY MUTUAL INSURANCE COMPANY,

Appellees.

APPELLEE INFINITY COUNTY MUTUAL INSURANCE COMPANY’S MOTION FOR REHEARING OR FOR EN BANC RECONSIDERATION

Pursuant to Tex. R. App. P. 49, Appellee Infinity County Mutual Insurance Company (“Infinity”) moves for rehearing or en banc reconsideration:

I. Summary of Motion.

Except for limited circumstances, that do not exist in this case, an insurance policy holder must establish that his claim is covered in order to recover under the Texas Insurance Code. Infinity challenged the existence of coverage in its motion for summary judgment, and the trial court granted the motion. But this Court reversed the summary judgment on this question because Plaintiff Michael Tatsch (“Tatsch”) did not allege a breach of contract claim against Infinity.1 This Court then reversed summary judgment on Tatsch’s claim that Infinity denied his claim without a proper investigation in violation of the Texas Insurance Code. In effect, the Court held that Tatsch may proceed under his failure to investigate theory irrespective of whether the Infinity policy covered his claim. This is an error that the Court should correct by granting rehearing or en banc reconsideration.

II. Statement of Facts.

A. Tatsch’s allegations and the summary judgment.

Tatsch alleged that Infinity violated the Texas Insurance Code and the Texas Deceptive Trade Practices Act. First Am. Pet. at CR 59-61. Tatsch did not allege that coverage existed under the policy, or that Infinity breached the policy. But he sought damages that would arise only if Infinity had an obligation to pay, but failed to do so: diminished value, lost use of the truck, cost of repair, lost income, and out of pocket expenses. Id. at CR 61-62.

Infinity filed a hybrid motion for summary judgment consisting of a motion for traditional summary judgment on the question of whether coverage exists, and

1 The Opinion is attached hereto.

2

2083123v.1 a no evidence summary judgment on Tatsch’s claims under the Insurance Code and DTPA. CR 39-56. In the traditional portion of its motion, Infinity asserted that Tatsch’s loss was the result of mechanical breakdown or failure that is excluded under the policy. CR 45-46. Infinity supported its motion for traditional summary judgment with an authenticated copy of the policy and Tatsch’s deposition testimony. CR 71-110 (deposition) & CR 111-40 (Policy).

In the no evidence portion of its motion, Infinity challenged Tatsch’s evidence that it violated the Texas Insurance Code by (1) failing to attempt in good faith to effectuate a settlement of a claim for which liability is reasonably clear; (2) failing to provide Tatsch with a reasonable explanation of the basis for denying his claim; (3) denying the claim without conducting a reasonable investigation; and (4) refusing to settle based solely on the availability of other insurance. Infinity also challenged the evidence supporting Tatsch’s damages. The trial court granted Infinity’s motion.

B. This Court’s opinion.

The Court affirmed the summary judgment in part, and reversed and remanded the judgment in part. App. A, Opinion. The Court reversed the summary judgment on the question of coverage because Tatsch did not allege a cause of action for breach of contract. Op. at 12. But the Court did not address the

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2083123v.1 question of whether Infinity carried its summary judgment burden with respect to the question of coverage.

The Court reversed the no evidence summary judgment as to Tatsch’s allegation that Infinity breached its duty to investigate, but affirmed summary judgment on his other theories. Op. at 14-15. The Court noted the evidence that Infinity could not obtain a sample of the truck fuel because it was discarded before Tatsch made a claim under the policy, but found that Infinity did not inspect the truck itself, and held that “this was more than a scintilla of evidence” that Infinity breached its duty to conduct an investigation. Id. at 14-15. The Court noted that Tatsch did not present any evidence to support the other statutory theories, including his claim that Infinity denied coverage even though its liability was reasonably clear. Id. at 13. The Court did not address damages, stating instead that “we focus our review on the underlying liability questions.” Op. at 14 n 4.

III. Argument

This Court (1) reversed summary judgment on the question of coverage because Tatsch did not allege a claim for breach of contract but (2) held that Tatsch has sufficient evidence to proceed on his claim that Infinity failed to conduct a reasonable investigation under the Texas Insurance Code. This is error. Summary judgment on coverage was appropriate because coverage was an essential element

4

2083123v.1 of Tatsch’s claims under the Insurance Code and DTPA. That is, in the absence of exceptional circumstances a party seeking recovery under the Texas Insurance Code must first establish that the policy covers the claim in question. This Court’s opinion runs afoul of this rule. Progressive County Mutual Ins. Co. v. Boyd, 177 S.W.3d 919 (Tex. 2005) (Holding that the absence of coverage negated the insured’s extra-contractual insurance code and common law claims); Liberty Nat’l Fire Ins. Company v. Akin, 927 S.W.2d 627, 629 (Tex. 1996) (“But, in most circumstances, an insured may not prevail on a bad faith claim without first showing that the insurer breached the contract.”); 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.”)

A limited exception to this general rule arises if an insurer commits an “extreme” act that causes damages independent of a claim under the policy. Stoker, 903 S.W.3d at 341. This is not such a case; the compensatory damages sought by Tatsch arise only if the policy covers his claim.

A. The Court’s Opinion is in error because coverage is an essential element of Tatsch’s claims under the Texas Insurance Code.

This Court reversed the traditional summary judgment on the question of

coverage solely because Tatsch did not allege that Infinity breached the policy. This is error because coverage is an essential element of Tatsch’s claim under the

5

2083123v.1

Texas Insurance Code, and for recovery of his alleged damages. In this regard, the Court’s Opinion conflicts with the Supreme Court’s decisions in Stoker and Boyd and with this Court’s own opinions.

In Stoker, the plaintiffs sued the insurer for breaching the policy and for violating the Insurance Code and DTPA by giving an incorrect reason for denying their claim. Stoker, 903 S.W.2d at 339. The trial court granted summary judgment to the insurer on the question of whether it breached the policy, but submitted the extra contractual claims to the jury. Id. The jury found for the plaintiffs on the extra contractual claims. Id. The Supreme Court reversed, reasoning that “there can be no claim for bad faith when an insurer has promptly denied a claim that is not in fact covered.” Id.

In Boyd, the plaintiff sued his automobile insurance carrier for breach of contract, bad faith, violations of the Insurance Code and other extra contractual claims. Id. at 919-20. The trial court severed the extra-contractual claims from the breach of contract claim, and granted summary judgment on the extra contractual claims. Id. at 920. Thereafter, a jury returned a verdict for the insurer on breach of contract. Id.

The Supreme Court held that the judgment on the breach of contract claim negated the plaintiff’s extra contractual claims. Id. The Court, therefore, reasoned

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Michael Tatsch v. Chrysler Group, LLC and Infinity County Mutual Insurance Company, (Tex. Ct. App. 2015).

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