Richland Trace Owners Association v. Landmark American Insurance Company, Vericlaim, Inc. and Jason Roberts Keen

Court of Appeals of Texas·Decided April 11, 2022·No. 05-20-00944-CV·Published

Opinion

Reverse and Remand and Opinion Filed April 11, 2022

In The

Court of Appeals

Fifth District of Texas at Dallas No. 05-20-00944-CV

RICHLAND TRACE OWNERS ASSOCIATION, Appellant V.

LANDMARK AMERICAN INSURANCE COMPANY, VERICLAIM, INC.

AND JASON ROBERTS KEEN, Appellees

On Appeal from the 95th District Court Dallas County, Texas

Trial Court Cause No. DC-20-02854

MEMORANDUM OPINION

Before Justices Myers, Osborne, and Nowell Opinion by Justice Nowell In this lawsuit, appellant Richland Trace Owners Association seeks damages

for breach of contract, violations of the Texas Insurance Code, and common-law bad faith along with a request for declaratory judgment. Richland Trace appeals an adverse summary judgment entered in favor of appellees Landmark American Insurance Company, Vericlaim, Inc., and Jason Roberts Keen. In two issues, Richland Trace argues the trial court erred by granting appellees’ traditional motion for summary judgment. We reverse the trial court’s judgment and remand this cause for further proceedings.

FACTUAL AND PROCEDURAL BACKGROUND Richland Trace is a condominium community consisting of approximately twenty buildings. Landmark issued two insurance policies to Richland Trace that are relevant to this lawsuit: (1) Policy LHD421652, which was in effect from January 5, 2016 through January 5, 2017 (the 2016 Policy), and (2) Policy LHD422499, which was in effect from January 5, 2017 through January 5, 2018 (the 2017 Policy). In 2017, Richland Trace made a claim that a March 26, 2017 hail storm caused damage to its property; the claim was made pursuant to the 2017 Policy.

Vericlaim served as Landmark’s adjuster, and Keen, an adjuster employed by Vericlaim, adjusted Richland Trace’s 2017 claim. When Richland Trace and Landmark were unable to agree about the amount of loss caused by the March 2017 storm, Richland Trace invoked the 2017 Policy’s appraisal provision, which states:

If [Landmark] and [Richland Trace] disagree on the value of the property or the amount of loss, either may make written demand for an appraisal of the loss. In this event, each party will select a competent and impartial appraiser. . . . The appraisers will state separately the value of the property and amount of loss. If they fail to agree, they will submit their differences to the umpire. A decision agreed to by any two will be binding.

...

If there is an appraisal, [Landmark] will still retain [its] right to deny the claim.

Richland Trace appointed Frank Molina as its appraiser, and Landmark appointed Rondi Perry. Molina and Perry conducted the appraisal in February 2018. The appraisers agreed on the amount of loss; therefore, an umpire was not necessary. Both appraisers signed the Appraisal Award:

The applicable deductible for the loss was $100,000. Because the appraised amount of the loss did not exceed the deductible, Landmark did not pay any benefits under the 2017 Policy. Richland Trace did not contest the Appraisal Award.

Richland Trace filed its original petition on February 20, 2020, and alleged its property was covered by three Landmark insurance policies numbered LHD422499, LHD421652, and LHD420748. Richland Trace asserted that, as a consequence of “a storm,” its property sustained extensive damage, it gave notice of the loss to Landmark, Landmark assigned the claim to an adjuster to report on and adjust the loss, and Landmark failed to pay in accordance with its policy. Richland Trace further alleged that Keen, the adjuster, knew the damage to its property predated the March 2017 storm. The original petition states: “Had Keen performed even the most cursory inspection typically performed by an insurance adjuster by accessing hail fall data for the property, Keen would have discovered that the likely date of hail damage to the roofs was March 23, 2016, a date for which Landmark insured Plaintiff’s property under a prior policy.”

In its first amended pleading filed in April 2020, Richland Trace maintains the Appraisal Award only includes damage from the March 2017 storm. It alleges its property also sustained extensive damage as a result of a storm on March 23, 2016, and that damage is subject to coverage under the 2016 Policy. However, Richland Trace asserts, Landmark has refused to pay the claim made pursuant to the 2016 Policy.

Appellees moved for summary judgment on the ground that the Appraisal Award forecloses Richland Trace’s claims under the 2016 and 2017 Policies. Appellees argue the Appraisal Award bars Richland Trace’s claims in this suit

because the award determined that the amount and extent of Richland Trace’s loss fell below its deductible, and the court must enforce the binding Appraisal Award. Appellees argue any hail damage that occurred before March 2017 would have been present when the appraisal was conducted, the appraisers were responsible for assessing and valuing all existing hail damage, and loss for all hail damage was included in the Appraisal Award. In response, Richland Trace argues the Appraisal Award only accounted for damage caused by the March 2017 storm and did not include damage resulting from the March 2016 storm.

LAW & ANALYSIS

A. Standard of Review We review the trial court’s grant of summary judgment de novo. Lujan v.

Navistar, Inc., 555 S.W.3d 79, 84 (Tex. 2018). A traditional motion for summary judgment requires the moving party to show no genuine issue of material fact exists and it is entitled to judgment as a matter of law. TEX. R. CIV. P. 166a(c); Lujan, 555 S.W.3d at 84. When reviewing a motion for summary judgment, a court considers the evidence in the light most favorable to the nonmovant and indulges every reasonable inference and resolves any doubts in the nonmovant’s favor. BPX Operating Co. v. Strickhausen, 629 S.W.3d 189, 196 (Tex. 2021). When reviewing the grant of summary judgment, we credit evidence favoring the non-movant, indulging every reasonable inference and resolving all doubts in their favor. Lujan, 555 S.W.3d at 84. A defendant may obtain summary judgment by negating one of

the elements of the plaintiff’s cause of action or by conclusively proving all of the elements of an affirmative defense. Stanfield v. Neubaum, 494 S.W.3d 90, 96 (Tex. 2016). If the defendant produces evidence demonstrating summary judgment is proper, the burden shifts to the plaintiff to present evidence creating a fact issue. Id. at 97.

B. Law Governing Appraisals The appraisal process resolves the issue of damage caused by a specific

occurrence. See State Farm Lloyds v. Johnson, 290 S.W.3d 886, 893 (Tex. 2009). Setting the amount of loss “requires appraisers to decide between damages for which coverage is claimed from damages caused by everything else.” Id. “Although every reasonable presumption will typically be made in favor of an appraisal award, when reviewing a summary judgment proceeding, that rule must yield to the degree its application conflicts with the presumptions required to be made in favor of a nonmovant.” Wells v. Am. States Preferred Ins. Co., 919 S.W.2d 679, 683 (Tex. App.—Dallas 1996, writ denied); see also Richardson v. Allstate Tex. Lloyd’s, No. 05-06-00100-CV, 2007 WL 1990387, at *3 (Tex. App.—Dallas July 11, 2007, no pet.) (mem. op.) (same).

Appraisal awards contractually resolve the amount of the covered loss when disputed by insurers and insureds. Ortiz v. State Farm Lloyds, 589 S.W.3d 127, 132 (Tex. 2019). “[A]n enforceable appraisal award . . . is binding on the parties with respect to that amount.” Id.

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Richland Trace Owners Association v. Landmark American Insurance Company, Vericlaim, Inc. and Jason Roberts Keen, (Tex. Ct. App. 2022).

Richland Trace Owners Association v. Landmark American Insurance Company, Vericlaim, Inc. and Jason Roberts Keen (Richland Trace Owners Association v. Landmark American Insurance Company, Vericlaim, Inc. and Jason Roberts Keen) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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