Richard Seim and Linda Seim v. Allstate Texas Lloyds and Lisa Scott

Court of Appeals of Texas·Decided July 30, 2019·No. 02-16-00050-CV·Published

Opinion

In the

Court of Appeals

Second Appellate District of Texas at Fort Worth

No. 02-16-00050-CV

RICHARD SEIM AND LINDA SEIM, Appellants V.

ALLSTATE TEXAS LLOYDS AND LISA SCOTT, Appellees

On Appeal from the 141st District Court Tarrant County, Texas

Trial Court No. 141-270531-14

Before the En Banc Court

Memorandum Opinion on Remand and on En Banc Reconsideration by Justice Gabriel (joined by Justices Kerr, Birdwell, Bassel, and Womack)

Dissenting Memorandum Opinion on Remand and on En Banc Reconsideration by Chief Justice Sudderth (joined by Justice Pittman.)

MEMORANDUM OPINION ON REMAND AND ON EN BANC RECONSIDERATION

Appellants Richard and Linda Seim appeal from the trial court’s summary judgment dismissing their contractual and extracontractual claims against their home insurer and its adjuster, appellees Allstate Texas Lloyds and Lisa Scott, after the Seims’ claim for water damage to their home was denied. On original en banc submission, we affirmed the trial court’s summary judgment and held that because the Seims’ expert’s two causation reports and supporting affidavit were effectively unsworn, none raised a fact issue on any of the Seims’ claims. Seim v. Allstate Tex. Lloyds, No. 02-16-00050-CV, 2017 WL 1738028, at *5–6 (Tex. App.—Fort Worth May 4, 2017) (en banc) (mem. op. on reconsideration) (“We are thus left with no sworn evidence that the Seims’ loss occurred during the policy period.”) (hereinafter, Seim I), rev’d, 551 S.W.3d 161, 166 (Tex. 2018) (per curiam). The Texas Supreme Court, in reversing Seim I and remanding the appeal to this court, held that because Allstate and Scott did not secure a ruling on their objections to the evidence regarding the form defects, Allstate and Scott waived the objections. 551 S.W.3d at 163–64, 166 (hereinafter, Seim II).1 On remand, a panel of this court held that the Seims’ expert’s

1 Seim II additionally overruled two opinions from this court, which held that an order granting a summary-judgment motion implicitly sustains the prevailing party’s evidentiary objections. 551 S.W.3d at 164–66 (overruling Frazier v .Yu, 987 S.W.2d 607, 610 (Tex. App.—Fort Worth 1999, pet denied), and Blum v. Julian, 977 S.W.2d 819, 823–24 (Tex. App.—Fort Worth 1998, no pet.)).

reports were conclusory and incompetent to raise a fact issue—a substantive defect that requires no trial objection or ruling—scuttling the Seims’ claims against Allstate and Scott. Seim v. Allstate Tex. Lloyds, No. 02-16-00050-CV, 2018 WL 5832106, at *6 (Tex. App.—Fort Worth Nov. 8, 2018) (mem. op.) (hereinafter, Seim III). We granted the Seims’ motion for en banc reconsideration, withdrew the Seim III memorandum opinion and judgment, and now hold that Allstate and Scott conclusively established the affirmative defense of limitations, which was a ground asserted in their traditional summary-judgment motion. See Tex. R. App. P. 49.7. Thus, we affirm the trial court’s summary judgment on this legal basis.

I. BACKGROUND

A. CLAIMS FOR INSURANCE COVERAGE Clearly, the facts and procedural history surrounding this appeal have been recited multiple times. Seim II, 551 S.W.3d at 162–63; Seim III, 2018 WL 5832106, at *2–3; Seim I, 2017 WL 1738028, at *1–2. But because those opinions did not specifically address the grounds raised by Allstate and Scott in support of their summary-judgment motion in the context of rule 166a, we will explore the facts leading to the Seims’ suit against Allstate and Scott and their pleadings. Tex. R. Civ. P. 166a(b)–(c), (i).

The Seims’ home was allegedly damaged after three storms blew through the Seims’ neighborhood in a five-year period: on April 13, 2007; April 9, 2008; and May 8, 2012. The Seims filed claims with Allstate, which insured their home at the

time of all three storms. Each storm occurred during and was governed by a different and separate contract based on the effective date of each contract. The Seims’ claims for coverage—designated claim numbers 0102779105, 0112511373, and 02450198152—were resolved in some manner.3 The Seims later alleged that they “made the repairs as instructed by Allstate and had no issues of water ingress” after the damage caused by the 2012 storm was repaired.

Allstate again issued the Seims a home-insurance policy in a separate contract, making coverage effective from April 27, 2013, through April 27, 2014. This contract provided that during the coverage period, damage “caused by rain . . ., whether or not driven by wind,” would not be covered “unless the direct force of wind or hail makes an opening in the roof or wall and the rain . . . enters through this opening and causes the damage.” The contract further provided that any cause of action or suit brought against Allstate “must be started within two years and one day after the cause of action accrues.” See generally Godoy v. Wells Fargo Bank, N.A., 575 S.W.3d 531, 533,

2 Throughout the opinion and after initially identifying each claim number in full, we will refer to each claim by its last three numbers.

3 Claim number 105 was denied for rot damage because “rot damage to the soffit on the small portion of the roof [was] not a covered peril in the policy” and denied for roof replacement because the roof was repairable. It appears the Seims received some payment from Allstate for the roof repairs. Claim number 373 resulted in a partial payment for roof repairs. Claim number 815 resulted in two payments to the Seims to repair the roof and to remediate mold damage to the home’s interior.

537–38 (Tex. 2019) (holding contractual waiver of statutory limitations period allowed if specific and for a reasonable time).

On August 13, 2013, a severe storm again hit the Seims’ neighborhood. The Seims filed a claim with Allstate—claim number 0297959876—seeking coverage for damages to their roof and in two rooms of their home that they asserted were caused by hail and rain from this most recent storm. Scott inspected the home on September 10, 2013. During her inspection, she noticed some interior leaks, primarily around the skylights in the great room and sunroom, but found no collateral damage to the home’s exterior. Scott also inspected the tile roof and found no wind or hail damage. Some of the tiles, however, had “thermal cracking,” and it was apparent that prior repairs to the ridge line had been made. Scott did find a tile with a missing piece that was next to a skylight. But because there was no opening in the roof caused by wind or hail—“shingles off or hail so big that . . . it’s gone through and water can penetrate”—Scott concluded that any new damage was not covered under the policy. Scott did not inspect the attic, which she would do “sometimes,” because she had not seen any damage to the roof caused by wind or hail. The same day as Scott’s inspection, Allstate formally denied the claim and informed the Seims in the denial letter that because “[t]here is no opening created by wind or hail that is causing the roof to leak, . . . there is no coverage for the interior water damage.”

B. TRIAL-COURT PROCEEDINGS The Seims filed suit against Allstate on February 11, 2014, regarding its actions and inactions after the 2013 storm and its ultimate denial of the Seims’ claim for coverage.4 They raised claims for unfair settlement practices, common-law fraud, breach of contract, violations of the statutory prompt-payment-of-claims requirements (PPC), and breach of the common-law duty of good faith and fair dealing (GFFD).

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