Delay In Paying Insurance Claim – Uninsured Coverage

Insurance lawyers will often run across the situation at issue in the 2018, Dallas Court of Appeals opinion, George Bryant v. Progressive County Mutual Insurance Company and Kristen Winkler.

This is a uninsured motorist (UM) case wherein Bryant sued Progressive and the adjuster, Winkler, for the harm caused by the UM driver and numerous insurance code violations.  The trial court severed the auto wreck from the bad faith insurance claims.  In an UM case, Brant first had to prevail at trial, which he did.  Bryant then continued his claims for insurance code violations.  The trial court granted a motion for summary judgment in favor of Progressive and this appeal followed.

Bryant alleged numerous appeal points but the one discussed here is the issue regarding the Texas Prompt Payment of Claims Act (PPCA).

Brant alleged Progressive violated sections 542.055 and .057.

Under the PPCA 542.055, says “(a) Not later than the 15th day … after the date an insurer receives notice of a claim, the insurer shall:

(1) acknowledge the receipt of the claim;

(2) commence any investigation of the claim; and

(3) request from the claimant all items, statements, and forms that the insurer reasonably believes, at that time, will be required from the claimant.”

The record shows Bryant notified Progressive of the accident on the day it occurred, April 14, 2013.  Progressive sent a letter to Bryant’s attorney on April 24, 2013, ten days after the notification of the claim, acknowledging receipt of the claim and requesting specific information.  The letter also marked the commencement of the investigation.  Thus, Progressive proved conclusively that it complied with Section 542.055.

Brant also argued there is some evidence showing Progressive violated section 542.057 by failing to pay his claim within five days of the trial court’s signing the judgment.  Section 542.057 provides, “Except as otherwise provided by this section, if an insurer notifies a claimant under Section 542.056 that the insurer will pay a claim or part of a claim, the insurer shall pay the claim not later than the fifth business day after the date notice is made.”  Progressive paid the claim twenty four days after the trial court signed the judgment.  This Court has held the deadlines in the PPCA for the payment of claims do not apply to the litigation process form UM claims.  This Court concluded the trial court did not err by granting Progressives motion for summary judgement on this claim.