Vanessa Anderson v. American Risk Insurance Company, Inc.

CourtCourt of Appeals of Texas
DecidedJune 21, 2016
Docket01-15-00257-CV
StatusPublished

This text of Vanessa Anderson v. American Risk Insurance Company, Inc. (Vanessa Anderson v. American Risk Insurance Company, Inc.) 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
Vanessa Anderson v. American Risk Insurance Company, Inc., (Tex. Ct. App. 2016).

Opinion

Opinion issued June 21, 2016

In The

Court of Appeals For The

First District of Texas ———————————— NO. 01-15-00257-CV ——————————— VANESSA ANDERSON, Appellant V. AMERICAN RISK INSURANCE COMPANY, INC., Appellee

On Appeal from the 295th District Court Harris County, Texas Trial Court Case No. 2012-68212

MEMORANDUM OPINION

Vanessa Anderson appeals the trial court’s rendition of summary judgment

in favor of American Risk Insurance Company, Inc. (“ARIC”). Anderson brought

contractual and extra-contractual claims against ARIC related to an insurance

coverage dispute that arose after her house was damaged during a storm. After paying the appraisal award, ARIC filed a traditional motion for summary judgment

on all claims. The trial court granted summary judgment and rendered a take-

nothing judgment. Anderson contends that the trial court erred in granting

summary judgment because material issues of fact existed and payment of the

appraisal award did not preclude her claims. We affirm.

Background

Anderson’s residence in Spring, Texas was covered by an ARIC

homeowner’s insurance policy. During a storm on June 12, 2012, a tree fell

through the roof of her home. All told, after the storm, one bedroom and one

bathroom were destroyed by the tree, and the home had no water, power, or air

conditioning.

According to her summary-judgment affidavit, Anderson called ARIC to

report the loss that day, but she was only able to reach an answering service, which

told her that an ARIC representative would be in touch. On June 13, 2012,

Anderson called ARIC again and spoke with Chad Pleasant. Pleasant was not

aware that Anderson had called the day before and informed her that someone

would be out to inspect the loss. He further stated that Anderson would have to

submit receipts for expenses incurred in relation to the loss and that she was

responsible for any further damage to her home. According to Anderson’s

affidavit, Pleasant promised a return call, but did not call her back “right away.”

2 Anderson further averred that reimbursements from ARIC “were severely

delayed.”

ARIC’s summary-judgment evidence shows that, within three days of the

tree falling, Steve Mazey inspected the property on behalf of ARIC. Mazey

estimated the total loss at $58,784.05, a figure that included the actual cash value

of damage to the home as well as $500 to compensate for the loss of food in two

refrigerators and $1,688.66 to compensate for damage to the backyard fence. Less

the $2,500 deductible, the estimated total owed to Anderson under the policy was

$56,284.05. Mazey recommended an initial payment of $47,505.79 and a

completion payment of $8,778.26.

From June to September 2012, ARIC made a series of payments to

Anderson totaling $52,475.22. On June 15, 2012, ARIC issued Check No. 1289

for $500. On July 3, 2012, ARIC issued three checks to Anderson: Check No.

1354 for $47,005.79, Check No. 1355 for $500.00, and Check No. 1356 for

$172.52. On September 6, 2012, ARIC issued another two checks: Check No.

1544 for $3,081.00 and Check No. 1545 for $1,215.91.

Anderson lived at the apartment complex Marquis at Woodlands from

August 11, 2012, through October 10, 2012. According to her affidavit, she

accrued late fees because ARIC was slow to reimburse her though she was “very

3 prompt about submitting” receipts. Anderson concludes her affidavit by

explaining:

There was very little to no response from carrier from the moment I filed the claim. [Additional living expenses] were reimbursed extremely slow or not at all. I owe relatives money for rent and apartment complex rent and utilities. My credit is on the line for unpaid debt.

On November 8, 2012, Anderson sent a demand letter to ARIC seeking

$300,000 to settle her claims: $200,000 for actual damages, $25,000 for mental

anguish, and $75,000 for attorney’s fees and expenses. On November 20, 2012,

she filed suit, asserting claims for breach of contract, breach of the common law

duty of good faith and fair dealing, various violations of Chapter 541 of the Texas

Insurance Code and Deceptive Trade Practices Act (“DTPA”), and violations of

the prompt payment provisions set forth in Chapter 542 of the Texas Insurance

Code.

ARIC answered and denied all of Anderson’s allegations. In May 2013, the

parties attempted mediation, but were unable to resolve the dispute. ARIC then

invoked its right to appraisal, as provided for under the policy, and designated

Scott Gerner as its appraiser.1 Anderson initially refused to participate in the

1 The appraisal provision of the policy provides:

Appraisal. If you and we fail to agree on the actual cash value, amount of loss, or the cost of repair, either can make a written demand for appraisal. Each will then select a competent, independent appraiser and notify the

4 appraisal process, and ARIC filed a motion to compel appraisal. In September

2013, the trial court granted ARIC’s motion to compel appraisal, and Anderson

designated Darrin Snuggs as her appraiser. In December 2013, pursuant to an

agreed motion, the trial court appointed John A. Coselli, Jr. to serve as a neutral

umpire for the appraisal.

In an affidavit filed in support of ARIC’s summary-judgment motion,

Gerner averred that he attempted to contact Snuggs to coordinate appraisal on

multiple occasions between November 2013 and March 2014, but Snuggs never

responded. In April 2014, Anderson appointed a new appraiser, Max Judge.

According to Gerner’s affidavit, Judge initially informed Gerner that he did not

intend to inspect the property because repairs were already 70% complete.

Ultimately, however, Gerner and Judge both inspected Anderson’s property on

May 17, 2014. Gerner submitted his initial estimate to Coselli two days later and

other of the appraiser’s identity within 20 days of receipt of the written demand. The two appraisers will choose an umpire. If they cannot agree upon an umpire within 15 days, you or we may request that the choice be made by a judge of a district court of a judicial district where the loss occurred. The two appraisers will then set the amount of the loss, stating separately the actual cash value and loss to each item.

If the appraisers fail to agree, they will submit their differences to the umpire. An itemized decision agreed to by any two of these three and filed with us will set the amount of the loss. Such award shall be binding on you and us.

Each party will pay its own appraiser and bear the other expenses of the appraisal and umpire equally.

5 provided a requested room-by-room comparison on June 24, 2014.2 Coselli issued

the appraisal award on July 17, 2014, and Gerner co-signed that award on

August 1, 2014.

The appraisal award set the total replacement cost value for Anderson’s

home and other structures at $75,289.90. Less the $2,500 deductible and prior

payments, the net appraisal award payment due for dwelling and other structures

totaled $24,666.20.3 The appraisal award set the total additional living expenses

(“ALE”) owed at $21,000. Less prior payments and the amount above policy

limits, the net appraisal award payment due for additional living expenses totaled

$8,746.48.4 ARIC’s summary-judgment evidence shows that ARIC issued checks

to Anderson on August 8, 2014, in the amounts of $24,666.20 and $8,746.48, in

payment of the appraisal award.

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