A federal district court in Texas has ruled that a "reasonableness exception" limiting an insurer's liability under the Texas Prompt Payment of Claims Act was not overruled by a recent decision by the Texas Supreme Court.
The Case
On June 28, 2019, the Supreme Court of Texas decided Barbara Technologies Corp. v. State Farm Lloyds, No. 17-0640 (Tex. June 28, 2019). There, the court declared that an insurer's payment of an appraisal award "neither established liability under the policy nor foreclosed [Texas Prompt Payment of Claims Act ('TPPCA')] damages[.]"
Several days later, on July 3, 2019, the U.S. District Court for the Southern District of Texas issued a memorandum and order ("M&O") granting Allstate Texas Lloyds' motion for summary judgment on all claims brought against it by plaintiff Hyewon Shin. The district court granted summary judgment on the plaintiff's TPPCA claim on the ground that, under Texas law, "full and timely payment of an appraisal award under the policy" precluded an award of penalties under the Texas Insurance Code's prompt payment provisions as a matter of law.
Thereafter, the plaintiff moved for reconsideration of the TPPCA claim in light of Barbara Technologies.
The district court found that Barbara Technologies had "overruled the prior line of cases on the effect of appraisal awards, at least as far as those opinions held that full and timely payment of an appraisal award preclude[d] TPPCA damages."
The district court also invited supplemental briefing on further effects, if any, of Barbara Technologies on the plaintiff's case. In particular, the district court asked the parties to address whether the "reasonableness" exception set forth in Mainali Corp. v. Covington Specialty Ins. Co., 872 F.3d 255 (5th Cir. 2017), survived Barbara Technologies and whether Allstate's initial payment to the plaintiff was reasonable.
The District Court's Decision
The district court granted the plaintiff's motion for reconsideration but then confirmed its grant of summary judgment to Allstate on the plaintiff's TPPCA claim.
In its decision, the district court explained that, in Mainali, the Fifth Circuit held that there was no statutory violation of the TPPCA if the insurer's preappraisal payment was "reasonable." The district court then reasoned that not only did Barbara Technologies not specifically reject Mainali, but it cited Mainali with approval in support of the contention that when an insurer complied with the TPPCA in responding to an insured's claim, requesting necessary information, investigating, evaluating, and reaching a decision on the claim, use of the contract's appraisal process did not vitiate the insurer's earlier determination on the claim.
Accordingly, the district court said, Mainali's reasonableness exception survived Barbara Technologies and Barbara Technologies, in conjunction with Mainali, stood for the proposition that, for an insurer to avoid a TPPCA claim by a plaintiff, the insurer must have made a reasonable preappraisal payment within the statutorily-provided period.
Next, the district court observed that Allstate had made a preappraisal payment within the required time period. The district court explained that the appraiser had reached an award of $25,944.94, which was 5.6 times greater than the initial preappraisal payment by Allstate of $4,616,63. Nevertheless, the district court found that Allstate's preappraisal payment was reasonable as a matter of law, for two reasons.
First, it said, Allstate "complie[d] with the TPPCA in responding to the claim, requesting necessary information, investigating, evaluating, and reaching a decision on the claim[.]"
Second, the district court added, the difference between Allstate's preappraisal and appraisal payments was no larger than the difference in other cases in which courts had made a similar reasonableness finding.
Accordingly, the district court concluded, because Allstate made a reasonable preappraisal payment within the statutorily-provided period, the plaintiff's TPPCA claim failed as a matter of law.
The case is Shin v. Allstate Texas Lloyds, No. 4:18-CV-01784 (S.D. Tex. Sep. 3, 2019). Attorneys involved include: For Hyewon Shin, Plaintiff: Charlie Christopher Gustin, LEAD ATTORNEY, Houston, TX; Noah Michael Wexler, LEAD ATTORNEY, Roland Thomas Christensen, Arnold Itkin LLP, Houston, TX; Adam Dennis Lewis, Arnold & Itkin, LLP, Houston, TX; Christopher Jake Balser, Jacob Mansour Karam, Arnold & Itkin LLP, Houston, TX; Rebecca Lynn Adams, Lynn Pinker et al., Dallas, TX. For Roland Thomas Christensen, Defendant: W Neil Rambin, LEAD ATTORNEY, Sara E. Inman, Drinker Biddle & Reath, LLP, Dallas, TX; Susan E Egeland, Drinker, Biddle & Reath LLP, Dallas, TX.


