Insurer Paid – Is There Still Any Liability

Insurance lawyers who handle home owner and property claims must know this case.  It is a 2018 case from the Northern District of Texas, Dallas Division.  It is styled, Meisenheimer v. Safeco Insurance Company of Indiana.

This is a storm damage claim.  Plaintiff suffered damage and made a claim.  Safeco sent out an adjuster who found total damage that was less than the $7,700 deductible amount.  Plaintiff hired a public adjuster who determined the loss to be $129,794.  Safeco re-inspected the property and the parties still could not reach a resolution.  Plaintiff claims the inspections were substandard.

The insurance contract includes an appraisal provision for resolving disputes over the proper amount of the claim.  Safeco invoked the appraisal process and both parties participated.  An umpire issued a final appraisal award of $54,535.  Safeco timely paid the final appraisal amount.

Plaintiff sued for breach of contract and for violations of the Texas DTPA and Texas Insurance Code.  Safeco moved for summary judgment on all causes of action.

Under Texas law, proving a breach of contract requires: (1) the existence of a valid contract, (2) performance or tendered performance by the plaintiff, (3) breach of the contract by defendant, and (4) damages to the plaintiff resulting from the breach.  If an insurer tenders the full appraisal award to the insured, regardless of whether the insured accepts the payment, the insured is estopped from suing the insurer for breach of contract.  This court granted summary judgment on the breach of contract claim in favor of Safeco.

An insured may recover damages inflicted by a statutory violation only if the damages are truly independent of the insured’s right to receive policy benefits and not predicated on the loss being covered under the insurance policy.  Plaintiff cannot maintain the Texas Insurance Code and DTPA claims unless he can meet the independent injury exception.  Plaintiff alleges he suffered independent injury by Safeco’s substandard investigation.  Plaintiff claims that Safeco’s actions caused him to hire a public adjuster and attorney, and the cost of these services is what he seeks.  The Court concludes that these claimed injuries are not independent of Plaintiff’s claim for policy benefits.  As a matter of law, that is not an injury independent of claims under the policy.  Thus, Safeco wins on all counts.

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