Delay In Paying Claim

What about those times that an insurance company pays a claim but the payment has been a lot later than it should have been paid?  That is an issue that is partially addressed in a January 2020, opinion from the United States District Court, Southern District of Texas, Houston Division.  The opinion is styled, Zachary Dunne v. Allstate Vehicle And Property Insurance Company.

This part of the ruling is the result of a Motion For Summary Judgment filed by Allstate.

The facts are not in dispute.  Dunne’s home was damaged in a storm that was insured by Allstate on June 20, 2018.  Dunne reported the claim on July 3, 2018.  Allstate’s adjuster determined the damage was below Dunne’s deductible despite increasing its estimate.

The dispute over the damage continued and eventually Allstate, on January 10, 2019,  invoked the appraisal provision in the Policy, which provides a means for determining the amount of loss when the insurer and insured cannot agree.  The respective parties appraisers returned an agreed appraisal on February 19, 2019, and Allstate issued checks totaling the appraisal amount less depreciation and deductible that same day.

Allstate sought summary judgement on Dunne’s cause of action under Section 542.054 of the Texas Insurance Code, also known as the Texas Prompt Payment of Claim Act (TPPCA).  Allstate’s only argument is that full, timely payment of the appraisal award forecloses liability under the TPPCA.  This Court denied Allstate’s motion citing the Texas Supreme Court 2019, opinion, Ortiz v. State Farm Lloyds, which said in part, an insurer’s payment of an appraisal award does not as a matter of law bar an insured’s claims under the TPPCA.  Thus, Allstate’s motion on the TPPCA claim was denied.