5.1 C
New York
Friday, February 23, 2024

Texas Offers Insurers A “Get Out of Jail” Free Card When Appraisal Is Demanded


Steve Badger and the complete Texas insurance coverage business are happy as Texas punch that insurance coverage firms are immune from dangerous religion accountability when an insurer has induced these details:

On July 21, 2021, greater than two years after the twister and precisely one 12 months after Safeco answered the lawsuit, Safeco invoked the Coverage’s appraisal provision. Mr. Rodriquez incurred an extra $4,302.39 in bills for his appraiser and the umpire. On April 5, 2022, the appraisal panel decided the substitute value worth of the harm to Mr. Rodriquez’s dwelling to be $36,514.52 – greater than twenty-eight occasions Safeco’s $1,295.55 estimate and roughly $7,000 or 25% greater than the quantity acknowledged within the pre-suit [demand] to which Safeco didn’t reply.1

The insurance coverage firm’s outcome-oriented engineer even doctored a report to cover the excessive wind areas placing the house.

The Texas Supreme Court docket dominated the next:

When it applies, Chapter 542A modifications the foundations relevant to the litigation of sure statutory and common-law claims towards insurers, together with claims asserting violations of Chapter 542’s prompt-payment necessities…We perceive the events to agree that Chapter 542A governs Rodriguez’s claims.

Amongst its many different provisions, Chapter 542A limits the restoration of lawyer’s charges. Rodriguez acknowledges that part 542A.007’s restrictions on lawyer’s charges apply to his claims. He likewise doesn’t dispute that Safeco has paid the total appraisal quantity plus curiosity. With these undisputed issues established, we perceive the Fifth Circuit to ask a purely authorized query about Chapter 542A’s impact on the supply of lawyer’s charges: Does Chapter 542A prohibit the restoration of lawyer’s charges when an insurer in Safeco’s place has paid the total appraisal award plus any doable statutory curiosity? The reply is sure.

We want not and mustn’t search the reply from any supply aside from the statute’s plain language. The Legislature’s ‘voted-on language is what constitutes the legislation….’2

The illogic of judge-made and statutory legislation comes from the small print present in all insurance coverage firms in regards to the timing of when fee is due. The overwhelming majority of all property insurance coverage insurance policies say phrases to the impact that an insurance coverage firm doesn’t need to pay coverage advantages till 60 days after one among three issues occurs. First, they attain an settlement with the policyholder on the quantity of the loss. Second, an appraisal award is entered. The third is {that a} judgment is entered. These coverage provisions don’t have anything to do with whether or not the insurance coverage firm acted in good religion or breached the coverage by not paying the quantity well timed. Certainly, the insurance coverage firm may pay hundreds of thousands extra after 5 years of litigation after which say they “well timed paid” the coverage advantages as a result of the coverage doesn’t require them to pay till 60 days after a judgment.

It’s silly to get caught up on this “time of fee” provision. If the policyholder has met its post-loss obligations and the insurance coverage firm fails to pay the total quantity owed as a result of it failed to find out the right amount, it has breached the basic obligation and objective of the contract—fee of insurance coverage advantages. Beneath the brand new Texas statutory legislation, insurance coverage firms can demand appraisal and escape accountability for probably the most atrocious dangerous religion habits.

I’ve a variety of respect for Steve Badger. I recommend that folks learn his feedback on LinkedIn about this case. In my personal remark to him, I attempted to point out why the logic of the opinion and the interpretation of present Texas legislation is so flawed:

… an insurance coverage firm can deny a declare saying that the insured is black and Islamic, do nothing or deliberately delay the declare, and you purchase your method out of all that dangerous religion conduct by belatedly paying an appraisal award. Fairly unhappy public coverage. Silly logic.

Steve Badger filed a person amicus transient to the Texas Supreme Court docket on this case reflecting his issues, which all can learn.

The underside line is that Texas had a 100 12 months historical past of holding a Texas insurer accountable when it acted in dangerous religion and did not well timed pay a policyholder full advantages after the policyholder glad all circumstances precedent to restoration. Present case and statutory legislation not maintain insurers accountable when that happens as long as the insurer calls for appraisal and pays the appraisal award inside 60 days.

This is sort of a member of the mafia realizing dangerous issues will be finished however all forgiven by well timed going to confession. Certainly, there may be not even a penance requirement for the bad-acting insurer.

Thought For The Day    

In case you are impartial in conditions of injustice, you could have chosen the aspect of the oppressor. If an elephant has its foot on the tail of a mouse, and also you say that you’re impartial, the mouse won’t respect your neutrality.

— Archbishop Desmond Tutu


1 Appellant’s Transient on the Deserves in Rodriguez v. Safeco Ins. Co., 23-0534, at *9.

2 Rodriguez v. Safeco Ins. Co., — S.W.3d —, 2024 WL 388142 (Tex. Feb. 2, 2024).

Related Articles

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Latest Articles