Ever for the reason that Texas Supreme Court docket modified the panorama of Texas legislation concerning appraisal in Barbara Applied sciences Corp. v. State Farm Lloyds, 589 S.W.3d 806 (Tex. 2019) and Ortiz v. State Farm Lloyds, 589 S.W.3d 127 (Tex. 2019), practitioners and courts have been struggling to use the Texas Supreme Court docket’s holdings. Barbara Applied sciences and Ortiz answered some questions however raised others.
One query ensuing from Barbara Applied sciences and Ortiz is: Does the cost of an appraisal award plus the estimated curiosity due underneath the Texas Immediate Cost of Claims Act (“TPPCA”) entitle an insurer to abstract judgment on an insured’s claims underneath the TPPCA, absolving the insurer from having to pay legal professional’s charges underneath the Act? Courts have now answered this query in another way. Most just lately, the Fourteenth Court docket of Appeals weighed in on this challenge and located that the reply is “No.” See Texas Honest Plan Ass’n v. Ahmed, 2022 Tex. App. LEXIS 5770 (Tex. App.—Houston [14th Dist.] Aug. 11, 2022, mot. for reh’g en banc filed Aug. 26, 2022).
Background Concerning TPPCA Publish-Appraisal Litigation
The Texas Supreme Court docket held in Barbara Applied sciences that an insured can recuperate damages underneath the TPPCA (and legal professional’s charges) regardless of an insurer’s well timed cost of an appraisal award underneath sure circumstances. Nevertheless, the Court docket additionally held that there isn’t a legal responsibility for the insurer underneath the TPPCA except the insurer accepts legal responsibility or is adjudicated liable underneath the coverage, and the insurer violated a deadline underneath the TPPCA. The Court docket defined that cost of an appraisal award will not be an acknowledgement of legal responsibility nor a dedication of legal responsibility for functions of damages underneath the TPPCA. Thus, the Texas Supreme Court docket overruled ample case legislation that immediate cost of an appraisal award disposed of all contractual and extra-contractual claims, together with statutory claims, the insured could have in opposition to the insurer.
The Ahmed Resolution
Ahmed concerned a hail declare. The insurer investigated the declare and decided that it was beneath the deductible. The insured sued the insurer, together with allegations that the insurer violated the TPPCA. The insurer demanded appraisal. The appraisers issued an agreed appraisal award figuring out the alternative value worth of the declare was $22,699.78, properly above the deductible. The insurer notified the insured that it could pay the complete alternative value worth. The insurer paid the insured $13,193.78, which it characterised as the worth of the appraisal award minus the deductible. The insurer then filed a standard and no-evidence summary-judgment movement on the insured’s claims underneath the TPPCA. The trial courtroom denied the movement.
In 2019, whereas this case was nonetheless pending within the trial courtroom, the Texas Supreme Court docket determined Barbara Applied sciences. The insurer then made an extra cost to the insured of $6,458.26, which it characterised as constituting $3,206.19 in statutory curiosity, $752.23 in prejudgment curiosity, and $2,500 for “estimated legal professional’s charges.” The insurer moved for reconsideration of its abstract judgment movement on the insured’s TPPCA declare, attaching new proof displaying it had paid each the appraisal award and the statutory curiosity it decided can be recoverable underneath the TPPCA. The insured filed a cross movement for abstract judgment in help of his TPPCA claims, which the trial courtroom granted. The trial courtroom then held a bench trial on legal professional’s charges and awarded the insured $96,358.50.
The Court docket in Ahmed noticed that the info within the instantaneous case have been just like these in Barbara Applied sciences. The Court docket in Ahmed was persuaded by language in Barbara Applied sciences that cost of an appraisal award is just like a settlement. The Court docket in Ahmed noticed:
As a result of cost of the appraisal award constitutes neither an admission of legal responsibility underneath the coverage nor a judicial dedication of legal responsibility, the mere indisputable fact that the insurer paid the appraisal award will not be determinative of legal responsibility, a core inquiry in a [claim under the TPPCA]. Accordingly, the insurer’s cost of an appraisal award “didn’t conclusively set up that it’s not responsible for [the insured’s] declare, because it should to keep away from [damages under the TPPCA] as a matter of legislation underneath part 542.060.
The Court docket in Ahmed additionally relied on Martinez v. Allstate Automobile & Property Insurance coverage Co., 2020 U.S. Dist. LEXIS 220008 (S.D. Tex. 2020). There, Choose Ellison reasoned that dismissing a declare underneath the TPPCA on the premise that the insurer had paid the appraisal award together with the statutory legal professional’s charges can be akin to forcing an insured right into a settlement to which it didn’t agree. The Court docket in Martinez relied on case legislation that didn’t concern appraisal and even insurance coverage. Regardless, the Court docket in Ahmed concluded:
As mentioned in Martinez, and following the logic of Barbara Applied sciences, we conclude that, whereas advance cost of an appraisal award and statutory curiosity could entitle an insurer to an offset, it doesn’t entitle the insurer to abstract judgment on an insured’s [claim under the TPPCA]. To conclude in any other case can be to topic the insured on this case, Ahmed, to a settlement to which he didn’t agree.
Individually, the Court docket in Ahmed decided the trial courtroom erred in granting abstract judgment in favor of the insured on legal responsibility. The insurer disputed that its cost of the appraisal award was an admission of legal responsibility on the insurance coverage declare that might topic it to legal responsibility underneath the TPPCA.
Implications of the Ahmed Resolution
It is very important be aware the constraints of Ahmed. Whereas Ahmed is persuasive authority, it’s not the legislation of the land. It was issued by an intermediate appellate courtroom. So, except sure trial courts, it’s not binding on each Texas courtroom. See In re Riggs, 315 S.W.3d 613, 616 n.2 (Tex. App.—Fort Value 2010, no pet.) (choices of different intermediate appellate which are “not reviewed by our larger courtroom” “are persuasive however not binding on the opposite intermediate appellate courts of our state”).
It additionally stays to be seen whether or not Ahmed shall be appealed to and reviewed by the Texas Supreme Court docket. To this finish, the insurer in Ahmed already filed a movement for rehearing en banc with the Fourteenth Court docket of Appeals, which sits in Houston. In its movement, the insurer argues that the panel opinion departs from the properly settled rule that legal professional’s charges are barred absent damages. It additionally argues that the panel opinion misconstrues and misapplies Martinez (which can also be a non-binding resolution) andfails to comply with Ortiz (which is a binding resolution). So the authorized points raised in Ahmed are removed from settled at this level.
That is essential as a result of there may be case legislation, resembling White v. Allstate Automobile & Property Insurance coverage Co., 2021 U.S. Dist. LEXIS 180770 (S.D. Tex. Sept. 22, 2021), that finds the other of Ahmed. In White, Choose Tipton held that an insured can’t recuperate legal professional’s charges underneath the TPPCA with out first establishing its proper to damages underneath the TPPCA—i.e., penalty curiosity, which the insured can’t do if penalty curiosity has been voluntarily paid. Notably, Choose Tipton even quoted a previous resolution of the Fourteenth Court docket of Appeals, stating that “a plaintiff who doesn’t recuperate precise damages can’t recuperate attorneys’ charges underneath the Insurance coverage Code.” This corresponds with the black-letter rule mentioned in Ortiz that “legal professional’s charges and prices incurred within the prosecution or protection of a declare … usually are not damages.” Ortiz v. State Farm Lloyds, 589 S.W.3d 127, 135 (Tex. 2019). Notably, Choose Tipton additionally just lately denied reconsideration of his resolution. See No. 6:19-CV-00066, 2021 WL 4311114, (S.D. Tex. Sept. 21, 2021). White was mentioned in a previous weblog right here.
Additional, opposite to Ahmed, appraisal and settlement negotiations are totally different in some ways. Appraisal is a creature of contract and the settlement to make appraisal accessible is entered into earlier than a dispute arises. Appraisal can also be accessible to the insured earlier than litigation commences and earlier than the insured incurs any attorneys’ charges. Sometimes, there isn’t a contractual proper to require one other social gathering to interact in settlement negotiations. Settlement negotiations, resembling those who happen at a mediation, are often a way to reach at a compromise of your entire matter to keep away from the time and price of litigation. Appraisal resolves solely the disputed quantity of the loss, not protection, and both the 2 appraisers should agree, or the umpire should aspect with one of many appraisers. See Karl A. Schulz, Correct Outcomes in Appraisal – The Significance of the Umpire’s Topic Matter Experience, 15 J. Client & Industrial Regulation 54, 57 (2012). And importantly, the Texas Supreme Court docket has not held that implementing an appraisal award is akin to implementing a settlement settlement that was by no means bargained for as analogized in Ahmed and Martinez. That’s as a result of it’s not. There isn’t any query that the insured agrees to appraisal to set the quantity of loss—i.e., it’s a bargained-for contract provision—and may invoke appraisal at virtually any time, together with earlier than incurring any attorneys’ charges or partaking in litigation.
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