Fortuitously, a Justice with a mechanical engineering degree drew the opinion in Rosales v. Allstate Vehicle & Prop. Ins. Co., which involved the application of a (literal) statutory formula in a section of the Insurance Code, to answer the question whether the payment of all possible damages for a prompt-payment claim extinguished a claim for attorneys’ fees under the prompt-payment statute.

Here’s the formula, from section 542A.007(a) of the Insurance Code, edited slightly in the opinion for easier review:

In this case, the insurer paid the amount found by an appraisal on a home-damage claim (minus the deductible), plus an amount to cover any prompt-payment interest for the time period leading up to the payment. Under the statute, then, “the amount to be awarded in a [prompt-payment] judgment for a covered loss is presently zero dollars, and because the amount of attorney’s fees is a multiple of that amount, Chapter 542As formula must result in an award of zero attorney’s fees.”

The opinion also deftly summarizes the surprisingly voluminous federal district-court authority, distinguishing some adverse precedent as not accurately reflecting the Texas Supreme Court’s most recent guidance on similar issues. No. 05-22-00676-CV (May 16, 2023).

Ryan, an accounting firm, made a claim on its professional liability policy for losses caused by a rogue director’s submission of fraudulent tax returns. The insurer acknowledged an obligation to pay for losses resulting from employee “theft,” but instead:

“… maintain[ed] that that Weaver did not unlawfully take money from Ryan but that, instead, he started a chain reaction that caused money to improperly flow from the taxing authorities to Ryan’s clients, to Ryan, and then to Weaver and other employees.”

The Fifth Court found coverage for $346,612 paid to the director in bonuses, as an “unlawful taking” of those funds by him, and remanded for further consideration of related issues. Ryan, LLC v. Nat’l Union Fire Ins. Co., No. 05-22-00286-CV (March 13, 2023) (mem. op.).

This affidavit was conclusory about the alleged misrepresentations; thus it did not avoid summary judgment in an insurance-coverage dispute:Orange Cup Drive In LLC v. Mid-Continent Casualty Co., No. 05-21-00448-CV (Jan. 6, 2023) (mem. op.).

Overstreet v. Allstate, an insurance-coverage case about hail damage, presented an unsettled issue under Texas’ “concurrent causation” doctrine. Accordingly, the Fifth Circuit hailed the Texas Supreme Court for assistance, certifying the issue to it for review (a topic where the Fifth Circuit had previously certified the same topic, only for the parties to settle). No. 21-10462 (May 19, 2022). (As is customary for such requests, the Court disclaimed any intention to hale the Texas Supreme Court toward any particular result.)

In TOS episode The Changeling, the Enterprise crew confronted a hostile space probe called “Nomad” (right). In Great Divide Ins. Co. v. Fortenberry, the Fifth Court confronted a nomadic case in which neither side established venue in Dallas County, when a provision of the Workers’ Compensation Act requires a case to proceed in the county where the employee resided at the time of injury.

The plaintiff, a former Dallas Cowboy, averred that he lived in a Residence Inn in Dallas County at the time of his training-camp injury, but the Court found his affidavit did not establish the necessary facts that he had “some right of possession and not be a mere visitor” at the time. It also rejected arguments based on correspondence he received from the defendant insurance company’s office in Irving. But on the other hand, the insurance company failed to establish that it had a “principal office” in Travis County, just by showing that its agent for notice and filing was based there. Accordingly, the Court remanded for further development of the record about venue. No. 05-19-01541-CV (July 26, 2021) (mem. op.).

The unfortunate Mr. Cerullo had his home managed three times by storms. The resulting coverage litigation led to a dispute about allocation among insurers, as to which the Fifth Court  held:

But because the Insurers wrongfully refused to defend Vines-Herrin [the builder] or participate in the arbitration, they lost their opportunities to require that Cerullo and Vines-Herrin allocate an exact amount of damages to the relevant policy period or to request that the arbitrator do so. At the arbitration, Cerullo’s burden was to prove and obtain damages for all of the problems at his home, regardless of the date of occurrence, and Vines-Herrin’s burden was to prove that its negligence was not the cause of any of the problems in question. Neither was required to meet the extra burden of proving exactly how much of the damage occurred on any particular day. Neither was required to establish any sort of allocation among the absent insurers, and the arbitrator was not asked to make one. Consequently, this case presents a problem similar to that of the time on the risk cases, that is, how to apportion an established total amount of damages among the insurers whose policies were in effect during the time a portion of the loss was suffered by the insured.

Great American Lloyds Ins. Co. v. Vines-Herrin Custom Homes, LLC, No. 05-18-00337-CV (Jan. 8, 2019) (emphasis added).

Dr. Shiwach successfully defended a tort claim against him after his insurer denied coverage, and then won a lawsuit against his carrier about its duty to defend. The Fifth Court affirmed, noting as to the key policy exclusion: “Shiwach’s potential liability could rest on the rape allegation, for which no coverage exists, or the covered allegations that Shiwach—as an individual, physician, employee, and manager of HT and UHS—(1) failed to take actions to correct problems with suicides and over drugging of patients, (2) failed to provide adequate security measures and staffing, (3) negligently hired and retained employees, or (4) improperly admitted and failed to discharge patients.”

The Fifth Court found coverage, noting the importance of often-overlooked language about inclusion of other allegations in particular claims. It noted that the underlying petition “did not clearly allege whether any one act or omission caused or arose out of any other, nor did it provide any connection between the potentially covered allegations and the rape. It did not limit the potentially covered allegations in paragraphs 12 and 13 to factual conditions which purportedly created the opportunity for the rape, and it did not limit the entities’ liability (including Shiwach’s liability as an employee or manager of HT and UHS) to the rape. And although Broderick sought her ‘legal damages for the rape,’ the petition did not limit Broderick’s damages to the rape in paragraph 15, the prayer for relief. Moreover, the petition expressly alleged each ‘action or inaction’ described was a ‘proximate or producing cause’ of Broderick’s damages.” AIX Specialty Ins. Co. v. Shiwach, No. 05-18-01050-CV (Dec. 18, 2019) (mem. op.)

An insurer failed to show prejudice, and thus could not take advantage of a “consent-to-settle” provision in an uninsured motorist first-party policy.  The key Texas Supreme Court case “did not recognize difficulty in proving the value of a potential subrogation claim as sufficient prejudice”; to the contrary, it “indicates that the only kind of prejudice sufficient to make a consent-to-settlement breach material is loss of a valuable subrogation right[.]” And the insurer also failed to conclusively prove a loss of value, even under its view of the law. Davis v. State Farm Lloyds, No. 05-18-00969-CV (Nov. 12, 2019) (mem. op.).

Rhymes sued Maria Hernandez for injuries arising from a car accident. Hernandez ultimately defaulted. During the course of the proceedings, “Rhymes’ attorney was also communicating with [United Automobile Insurance Services, a claims-handling service] about the accident and attempting to settle his personal injury claim . . . . UAIS made several unsuccessful attempts to contact [the insured parties] about the matter before the default judgment was signed.” As to notice, “[t]he evidence established that [Hernandez] never gave notice of suit to or requested a defense from UAIS or Old American [Insurance Company].”

Rhymes then sued to collect on Hernandez’s policy. The Fifth Court reversed a summary judgment in his favor and rendered judgment for the defendants, finding that notice was a condition precedent to coverage under the policy, and rejecting two arguments made by Rhymes about the practicalities of the situation:

• “Rhymes also argues that the notice of suit provision was actually satisfied here because his attorney sent appellants copies of the petition in the underlying suit and confirmation of service on Maria. . . . Notice given by a third party does not trigger the insurer’s duty to defend and does not estop the insurer from asserting the insured’s breach as a bar to liability.”
• And as to prejudice, while the defendants’ “claim file relating to the accident showed that appellants viewed coverage as ‘clear’ and liability as ‘accepted,'” the default judgment established prejudice as a matter of law, as it “not only deprived appellants of the opportunity to litigate the claim’s merits but also imposed ‘a new burden of proof on new issues’ in order to set the default judgment aside.”

United Automobile Insurance Services v. Rhymes, 05-16-01125-CV (May 4, 2018) (mem. op.)

In a time of much furor about “leaks” to the media, the Fifth Court addressed a more traditional form of “leak” in Allen v. State Farm Lloyds, reversing a directed verdict for the insurer in a coverage dispute about a homeowners’ “Water Damage Endorsement.” In a detailed opinion, the Court found that the plaintiffs’ experts made legitimate, non-conclusory points about whether home damage was caused by plumbing leaks, and thus whether “deterioration” occurred within the meaning of the Endorsement. In a footnote, the Court also reminds of the importance of moving to strike allegedly improper expert testimony, and continuing to assert the original objection as the testimony unfolds at trial. No. 05-16-0018-CV (Aug. 1, 2017) (mem. op.)

In KLZ Diamond Tools, Inc. v. TKG General Agency, Inc. (July 18, 2016), the Dallas Court of Appeals considered an appeal of summary judgment granted in favor of TKG, the insurer defendant, against KLZ, the plaintiff insured. KLZ claimed that the insurer failed to pay the full amount owed under a policy relating to approximately $400,000 in stolen merchandise. The insurer advanced half, but requested additional documentation relating to the merchandise. KLZ contended that the request was just stalling, and after the insurer failed to pay the full amount of the claim, sued for breach of contract, insurance code violations, deceptive trade practices, among other claims. The insurer filed a motion for summary judgment. The district court struck KLZ’s responsive summary judgment evidence due to the failure to properly prove up the attached documents and said at the hearing that it had no choice but to grant summary judgment in the absence of responsive evidence. The district court did tell KLZ’s counsel that it would allow KLZ to supplement. But the district court entered an order granting summary judgment before the deadline it gave to KLZ for the supplement, which was timely filed.

The first issue on appeal was whether the trial court erred by orally stating that KLZ was permitted to supplement an affidavit but then granting summary judgment before the deadline given. Recognizing that the summary judgment rule anticipates a party’s summary judgment evidence may not initially be properly presented and allows supplementation, the Dallas Court of Appeals held that it was an abuse of discretion to grant summary judgment without waiting for the supplemental affidavit and without explaining its ruling after having initially granting leave to supplement. Considering the supplemental evidence, the Court further concluded that summary judgment was improper because KLZ had offered summary judgment evidence creating a question of fact as to whether the insurer had improperly refused to pay the entire claim.

KLZ Diamond Tools v TKG General Agency (July 18, 2016)

Pinkus, visiting Dallas on business, suffered fatal injuries in a car accident while driving to dinner with his son.  The Fifth Court affirmed summary judgment for his employer’s workers compensation carrier, finding (1) that the “continuous coverage” doctrine did not apply when his trip “merely placed him in a position to take advantage of an opportunity for a ‘distinct departure’ on a ‘personal errand,'” and (2) for the same reasons, the “dual purpose travel” doctrine did not apply either.  A concurrence would have analyzed the dual-purpose doctrine differently, but reached the same result. Pinkus v. Hartford Casualty, No. 05-14-00892-CV (Nov. 5, 2015).

Almost a year after the Ebola virus and dozens of news crews arrived in Dallas, the Court of Appeals has conditionally granted mandamus to prevent Texas Health Resources’ insurer from being required to produce a privileged note regarding a plaintiff’s Ebola-related claims. Nina Pham, who contracted the disease while working as a nurse at Presbyterian Hospital, has sued THR on a variety of tort claims for the injuries she sustained from the disease. The single document at issue reflects a conversation among the insurer’s claims adjuster, THR’s associate general counsel, and its risk manager. Although the insurer and its claims adjuster were not parties to the lawsuit, the Court nevertheless held that the communications reflected in the document were privileged. Because the note was made in the course of investigating Pham’s claim, and because the insurer represents the employer rather than itself on claims involving the employer’s liability policy, the note reflected a confidential communication within the scope of the attorney-client privilege.

In re Texas Health Resources, No 05-15-00813-CV

Bruce Bernstein wrecked his Porsche, then sued his insurer for violations of the Insurance Code and DTPA. An appraiser valued the car at $4900, and Safeco had tendered a check for $5287.50. The trial court granted summary judgment for Safeco, and the Court of Appeals affirmed. Bernstein could not recover under the prompt payment provisions of the Insurance Code because Safeco had timely paid the appraisal award, nor could he recover for bad faith because he did not appeal the adverse judgment on his breach of contract claim. Bernstein also could not recover on his fraud claim because he could not identify any misrepresentation by Safeco that would have led him to believe the insurer would cover “the true value of the car,” which he apparently claimed to be “the investment he made to the Porsche beyond the basic value of the car.”

Bernstein v. Safeco Ins. Co. of Ill., No. 05-13-01533-CV

A car fell on David Fusaro at the house of his friend, Christopher Becherer. The car was owned by Becherer’s mother, and the pair were working on her brakes. Becherer’s homeowner’s insurer denied coverage, relying on an exclusion for injuries “arising out of the ownership, maintenance, operation, use, loading or unloading of: Motor or engine propelled vehicles or machines designed for movement on land . . . which are owned or operated by or rented or loaned to an insured.” After Fusaro obtained a $1.1 million judgment, Becherer assigned his coverage claim to Fusaro, who lost the coverage case on summary judgment. Fusaro argued that Becherer’s mother’s case was not “owned or operated by or rented or loaned to” Becherer, but the Court of Appeals affirmed. Construing the words in light of their ordinary meaning, Becherer’s mother had loaned the vehicle to her son, and he was operating the vehicle by performing ordinary acts of maintenance on it.

Fusaro v. Trinity Universal Ins. Co., No. 05-14-00481-CV

In this insurance coverage case, the Court of Appeals construed the “business risk exclusion” to preclude coverage for water damage to a townhome complex that the insured was building.  A business risk exclusion is a typical provision in commercial general liability insurance policies that is used to exclude coverage for “certain risks relating to the repair or replacement of the insured’s faulty work or products or defects in the insured’s work or product itself.”  The reason behind including such exclusion is simple:  the insured should be able to control the quality of the goods and services it supplies.  In this case, the Court found that the exclusion precluded coverage because the evidence established that property damage at issue occurred during the construction of the townhome complex.

Dallas Nat’l Ins. Co. v. Calitex Corp.

In this insurance coverage lawsuit, the Court of Appeals held that the insurer had no duty to defend the appellant in the lawsuit brought against them for conversion under  when the appellant sold their home’s former (foreclosed-upon) owner’s personal property at a garage sale.  According to the Court, the removal and purported sale of the personal property was “intentional and deliberate,” and thus failed to qualify as an “occurrence” covered by the policy.

Drew v. Texas Farm Bureau Mut. Ins. Co.

The Court of Appeals has reversed a trial court’s judgment awarding approximately $46,000 in attorney fees in a denial of coverage dispute. The case was brought by a homebuyer who sued his builders for a number of defects.  The buyer obtained a judgment against the builders in arbitration. The builders had tendered the buyer’s claim to their insurer, Oklahoma Surety Co., but OSC denied coverage for both the defense of the case and ultimate liability. After arbitration, the builders assigned their coverage claim to the buyer, who then sued OSC for the builders’ defense costs and for indemnification under the policy. The trial court ruled that OSC had a duty to the defend the case, but had no duty to indemnify for damages. The Court of Appeals disagreed, holding that an exclusion for property damage to “your work” applied under the “eight corners” rule, thereby barring both coverage and the duty to defend.

Oklahoma Surety Co. v. Novielo, No. 05-13-01546-CV

The Court of Appeals has dissolved a temporary injunction that would have prevented a court in Bastrop County from continuing to oversee a homeowner’s insurance appraisal process. James and Patricia Barrentines’ home in Bastrop was damaged by one the wildfires that plagued that area in 2011. Their insurer, Safeco, demanded an appraisal of the loss, and both parties appointed their own appraisers pursuant to the policy. When the two party-appointed appraisers were unable to agree on an umpire, Safeco went to court in Bastrop County to have one appointed. The court-appointed umpire issued an appraisal favorable to the homeowners, but the Bastrop County court then appointed a different umpire. The Barrentines then refiled in Dallas and obtained a temporary injunction forbidding any reappraisal. The Dallas Court of Appeals reversed that ruling, holding that it disturbed — rather than preserved — the status quo by interfering with the Bastrop County court’s authority to conduct the appraisal under the insurance contract.

Safeco Lloyds Ins. Co. v. Barrentine, No. 05-13-01011

Chandler Management sued First Specialty Insurance after the insurer denied coverage of a claim for wind and hail damage at a Dallas apartment complex managed by Chandler. The insurer moved to dismiss based on a forum selection clause in the policy that provided for exclusive jurisdiction in New York. The Dallas Court of Appeals affirmed the trial court’s dismissal order, without prejudice to refiling in New York. The Court found no error in the trial court’s decision to dismiss the claims against two additional defendants because they had expressly agreed to the insurer’s motion and because the claims against them were also based on the insurance contract. The insurer also established that the policy was procured through a licensed agent, which allowed First Specialty to issue surplus lines insurance in Texas (and therefore allowed it to enforce the contract against its insured). The Court shrugged off a number of claimed failures of the policy under the Insurance Code, holding that noncompliance with those provisions did not affect enforcement of the contract because nothing showed that they were “material and intentional” violations. Finally, the Court rejected Chandler’s arguments that the forum selection clause was overreaching and against public policy.

Chandler Mgmt. Corp. v. First Specialty Ins. Corp., No. 05-13-01044-CV

Hurricane Ike damaged property owned by Optimum Deerbrook LLC. Optimum’s lender, ViewPoint Bank, was a loss payee on Optimum’s property insurance policy with Allied Property & Casualty. Allied paid the claim, issuing checks jointly to Optimum and ViewPoint, but Optimum endorsed and deposited the checks in its own account. As a result, ViewPoint never received any of the insurance funds. ViewPoint sued Allied for breach of the insurance contract and a claim under article 3 of the UCC. The trial court granted summary judgment for the insurer, but the Court of Appeals reversed. Citing the Texas Supreme Court’s recent decision in McAllen Hospitals, LP v. State Farm, the Court held that the insurer had not fulfilled its payment obligation by delivering the checks only to the insured, and that delivery to both payees is required because neither of them, acting alone, could enforce or negotiate the instrument. The Court also held that summary judgment should have been granted in favor of the bank on its UCC claim because the drawer of a check is not discharged from its obligation when the check is issued to nonalternative copayees and is paid without one of their necessary endorsements. However, the Court held that the bank’s attorney fees affidavit was not sufficiently detailed to support summary judgment and remanded the case for further consideration of an award of attorney fees.

ViewPoint Bank v. Allied Prop. & Cas. Ins. Co., No. 05-12-01370-CV

In this insurance dispute, the United States Youth Soccer Association (“USYSA”) sought coverage form its liability insurer for claims filed against it by the National Association of Competitive Soccer Clubs (“NACSC”).  The NACSC alleged that USYSA had violated the bylaws of the governing board for soccer in the United States, the USSF, by discriminating against certain youth soccer players who want to play for both organizations.  The Court upheld the insurers denial of coverage based on the policy exclusion that precludes coverage for claims based on a breach of contract.  Employing the “eight corners” rule, the Court found that the allegations in the underlying lawsuit relate to breaches of the USSF bylaws, policies rules and regulations, which, in the Court’s view, constituted a breach of contract.

Arch Ins. Co. v. U.S. Youth Soccer Ass’n

The McGonagles bought property in Granbury, Texas subject to a dedication instrument involving the city’s historic district.  At closing, the McGonagles also purchased a title insurance policy.  The McGonagles later tried to resell the property, but couldn’t because  of the dedication instrument, so they sued the title insurance company, who had denied coverage.  The Court agreed with the title insurers, holding, among other things, that a dedication does not fall with the scope of title insurance coverage because it is not a tax, assessment or lien on real property.

McGonagle v. Stewart Title Guaranty Co.

In this insurance coverage dispute, the plaintiff argued that he did not fall with in the policy’s exclusions because the phrase “domestic employee” was ambiguous.  According to the plaintiff “domestic employee” could refer to either employees who work in a household or employees who are citizens of the United States.  The court rejected this argument, holding that the language of the policy combined with the regulatory framework unambiguously establish that “domestic employee” refers to household employees.

West v. S. County Mut. Ins. Co.

Clint Simon applied for a “Termite & Pest Control General Liability” insurance policy for his d/b/a, Sherlock Pest. The application included a “WDI Exclusion,” which excluded liability for claims or losses arising out of inspections for Wood Destroying Insects. That exclusion, in somewhat different form, was included in a pair of endorsements to the policy that was subsequently issued, as well as a later renewal policy. When a homeowner sued Simon for performing an improper inspection, the insurer invoked the WDI Exclusion to deny coverage. Simon sued, but the insurer obtained summary judgment on all claims. The Court of Appeals affirmed, holding that Simon could not have justifiably relied on a coverage certificate the insurer had filed with the Texas Department of Agriculture, which had not mentioned any exclusion in Simon’s insurance policy. Because the application, the initial policy, and the renewal policy all contained the WDI Exclusion, a reasonable person could not have relied on the coverage certificate as a representation that there was actually insurance coverage for WDI inspections. The Court also rejected Simon’s argument that the trial court should have granted a continuance to permit him to conduct more discovery, as his appellate brief failed to explain how the additional discovery would have allowed him to respond to the summary judgment motion.

Simon v. Tudor Ins. Co., No. 05-12-004430CV

The pace of opinions from the Court of Appeals has slowed down during the fall, but there is still news from the Texas Supreme Court. This morning, that court granted the petition for review in Farmer’s Insurance Exchange v. Greene. In August 2012, the Dallas Court of Appeals sided with the insurer in holding that a homeowner’s damages were barred by a vacancy clause in the insurance contract, which excluded liability for damages that occurred more than 60 days after the residence became vacant. The Court of Appeals rejected the insured’s claim that the exclusion did not apply because the vacancy of the home did not contribute to the fire that destroyed it. Oral argument at the Supreme Court is set for December 4, and you can find the parties’ briefs at the link below.

Greene v. Farmer’s Ins. Exch., No. 12-0867

What, you may be asking yourself, is a viatical settlement? A new securities opinion from the Dallas Court of Appeals provides the answer to that question, and in the process examines the scope of the Texas Securities Act. Life Partners, Inc. is in the business of buying life insurance policies and reselling interests in those policies to investors, transactions known as “life settlements” or “viatical settlements.” The purchasers of those policies are not told what Life Partners paid for them, and Life Partners remains the owner of the policies while holding them as the agent for the investors. Several of the company’s investors filed suit for violations of the TSA, alleging that the life settlements were actually investment contracts that qualified as securities under the TSA. The trial court court granted summary judgment for Life Partners.

The case turned on the question of whether the profits sought by the investors of these viatical settlements were derived “solely from the efforts of others,” one of the four factors for determining whether investment contracts qualify as securities under SEC v. W.J. Howey Co., 328 U.S.293 (1946) and Searsy v. Commercial Trading Corp., 560 S.W.2d 637 (Tex. 1977). After a detailed analysis of a line of cases holding that viatical settlements were not securities, the Court disagreed. Because the investors were dependent upon Life Investors for the evaluation and purchase of the policies, and because they were also required to rely on Life Investors for information about the insureds, the profits were indeed derived solely from the efforts of Life Partners. In so holding, the Court expressly disagreed with the Waco Court of Appeals, which had reached the opposite conclusion in a previous case, and instead followed rulings by the 11th Circuit, the Tyler Court of Appeals, and several courts in other states. In doing so, the Court rejected Life Partners’ argument that it was engaged in the business of selling insurance, which is exempted from regulation by the TSA. Finally, the Court determined that while the claims of the two lead plaintiffs were barred by limitations, some of the claims of two other plaintiffs had been timely filed and could proceed on remand to the trial court.

Given the split of authorities, this case would seem to be a candidate for review by the Texas Supreme Court. We’ll keep you updated if it proceeds in that direction.

Arnold v. Life Partners, Inc., No. 05-12-00092-CV

Liability for foundation damage under a multi-year series of CGL policies was at issue in Mid-Continent Casualty Co. v. Castagna, No.05-12-00383-CV (Aug. 20, 2013).  Among other holdings, the Court concluded that one policy, which named “McClure Brothers Custom Homes, LLC,” did not extend to an entity of which it was a general partner, “McClure Brothers Homes LP,” because of an exclusion “with respect to the conduct of any current or past partnership . . . or limited liability company” not expressly named. While that policy did reach members and managers of the LLC, no summary judgment evidence made that connection as to this party.  The Court also found that a breach of the implied warranty of good workmanship, despite its relationship to the parties’ construction contracts, did not go so far as to trigger the “contractual liability” exclusion under Gilbert Texas Construction, LP v. Underwriters at Lloyds, 327 S.W.3d 118 (Tex. 2010).

Marquis Acquisitions and several related entities were sued after a fire at an apartment complex killed three people. The defendants were covered by several layers of insurance, which assumed the defense of the case in successive order as policy limits were exhausted. At each layer, one or another of the defendants sought to reject the insurers’ choice of defense counsel and to be represented instead by the business partner and personal attorney of the defendants’ primary owner. Marquis eventually filed suit against Steadfast Insurance, and that move finally created a conflict between Marquis and the insurer’s chosen counsel that caused the attorney to withdraw. Marquis thereafter sued the insurer to recover “the attorney fees it expended in getting Steadfast to retain separate counsel” for Marquis and some of the other insureds. The trial court granted summary judgment for the insurer, and the Court of Appeals affirmed. Marquis could not recover for breach of the insurance contract because it could not identify any specific terms or conditions that required Steadfast to immediately hire separate counsel based on an insured’s unspecified and unsubstantiated allegations of a conflict of interest. Marquis also could not recover the attorney fees it paid to Shaw as damages, since attorney fees are only recoverable “in addition to” the recovery of actual damages, not as independent damages themselves. The court went on to reject Marquis’ claim that Steadfast’s conduct had constituted an unfair or deceptive act or practice under the Insurance Code because Marquis could not point to any alleged misrepresentation by Steadfast, and further held there was no evidence that the insurer had any duty to independently identify conflicts among its insureds when appointing legal counsel to defend them.

Marquis Acquisitions, Inc. v. Steadfast Ins. Co., No. 05-11-01663-CV

In April 2009, American Home’s insured allegedly fell asleep while the stove was still on in her apartment, leading to a fire that damaged her unit and that of her neighbor, who was insured through Allstate. Allstate paid its insured’s claim for $18,000 in damages, then sought subrogation from American Home. However, American Home’s policy limit was $100,000, and the claim languished while American Home sought to determine the complete extent of the damage caused by the fire. After a year of waiting, Allstate filed for arbitration with Arbitration Forums, Inc. Both Allstate and American Home are signatories to AFI’s arbitration agreement, which requires parties to arbitrate subrogation claims “not in excess of $100,000.” The AFI arbitrator promptly ruled in favor of Allstate. American Home filed a post-hearing appeal as permitted by the AFI rules, arguing that arbitration was not compulsory because the overall damages from the fire were in excess of $600,000. The AFI arbitrator agreed and voided the prior award.

In the meantime, however, Allstate had filed an application to confirm the initial arbitration award. After the arbitrator voided that award, American Home moved to dismiss the court case. The county court at law apparently agreed with Allstate’s argument that the order declaring the initial award to be void was itself invalid because American Home had allegedly misrepresented its policy limits in order to obtain that order. It entered a final judgment confirming the initial award in favor of Allstate, and American Home appealed, arguing that the trial court lacked jurisdiction to enter judgment on a voided arbitration award. The court of appeals agreed, noting that “Necessarily embedded in the trial court’s ability to confirm an award is the presence of an award itself.” The court of appeals also rejected Allstate’s attempt to argue that the arbitrator’s decision to void the initial award was invalid, ruling that the documents relied upon for that argument did not constitute any evidence of misrepresentations being made by American Home. The case was therefore reversed and remanded with instructions to dismiss for lack of jurisdiction.

American Modern Home Ins. Co. v. Allstate Ins. Co., No. 05-11-00997-CV

In 2008, the mother of plaintiff Bich Nguyen purchased a life insurance policy from Allstate, representing that she had not been diagnosed with a lung disorder in the last 10 years or treated by a doctor in the last five years. The next month, the mother was diagnosed with lung cancer, and she died just a few months later. Allstate investigated, and found that the mother had a history of lung problems, treatment, and hospitalization. Allstate therefore rescinded the insurance policy, and Nguyen filed suit.

Allstate moved for summary judgment, and Nguyen responded with 650 pages of summary judgment evidence. Allstate objected, asserting that Nguyen had failed to meet her burden of actually demonstrating where her controverting evidence could actually be located in those voluminous documents. The trial court and the court of appeals both agreed. While Nyugen’s brief contained a 28-page “Real Factual Background,” that section failed to reference any of the summary judgment evidence in support of her version of the facts, and elsewhere simply referred generally to lengthy documents in support of her claims. Because citing generally to voluminous summary judgment evidence is not sufficient to raise an issue of fact to defeat summary judgment, and because Allstate had met its own summary judgment burden, the court of appeals affirmed the trial court’s decision.

Nguyen v. Allstate Ins. Co., No. 05-11-01120-CV

The court affirmed a judgment for the plaintiff in a car wreck case over complaints of improper jury arguments. Nguyen crashed her car into Myers car, and Myers sued. Nguyen did not contest liability at trial, but disputed the amount Myers’s claimed damages. The parties agreed in limine that Myers be precluded from mentioning Nguyen’s liability insurance. At trial, one of Myers’s chiropractors testified that Nguyen’s expert, Dr. Timberlake, was “hired by insurance companies to make judgment on patients he’s never seen before . . . .” Nguyen objected to this testimony as an interjection of insurance, which was overruled, and moved for a mistrial, which was denied. Later in closing, Myers’s counsel stated that Timberlake was “paid by them” and was “their hired gun.” The jury awarded Myers his requested damages and Nguyen filed a motion for new trial based on the court’s denial of mistrial, which was not granted.

On appeal, the court held that any error caused by the interjection of insurance did not rise to the level of “harmful error,” and the testimony was not an “incurable statement,” because the jury’s verdict could not have turned on the one isolated mention of insurance. Furthermore, Nguyen failed to preserve her arguments that Myers’s counsel’s statements were incurable jury arguments because she failed to object to them, request a limiting instruction, or assert that argument in her motion for new trial.

Nguyen v. Myers, No. 05-11-01510-CV

Denise and Greg Brown sued their homeowner’s association for failing to maintain portions of the property. The HOA counterclaimed, alleging that the Browns had made a number of unauthorized alterations to their home. The Browns then joined American Western, the HOA’s insurer, asserting numerous causes of action against the insurance company. The insurer moved for summary judgment, arguing that the Browns were not named insureds under the policy and that the HOA’s counterclaim was not a covered “occurrence” under the policy in any event. The trial court granted the motion, and the court of appeals affirmed. Under the terms of the insurance policy, American Western was only liable for damage that arose from “an accident,” and it did not apply to property damage to the insured’s own leased property. Thus, even if the Browns were named insureds under the policy — an issue the court of appeals did not reach — the insurer was still not obligated to defend them from the HOA’s counterclaim.

Brown v. American Western Home Ins. Co., No. 05-11-00561-CV

The plaintiffs were involved in a minor car accident in a parking lot. Benning parked the vehicle and began to exit it as planned, but was then assaulted with a pistol by the other driver. The assailant fled the scene and was not apprehended, but was later involved in a convenient store robbery. Benning sued Home State and Safeco for failure to pay benefits. The insurers filed a motion for partial summary judgment on all claims relating to injuries arising from the events after the collision, which was denied, and the parties filed an agreed motion for interlocutory appeal.

On appeal, the court noted that the insurance policy awards benefits for damages arising out of the use of an uninsured motor vehicle. Benning argued that the assault would not have occurred but for the vehicle collision. But the court held that the assault involved the vehicle only incidentally, as Benning would have parked and exited the vehicle in the same way whether or not the collision occurred. And despite carjacking-related cases from other jurisdictions permitting recovery, there was no evidence that the assailant meant to steal the car. Thus, the court reversed the summary judgment denial.

Home State County Mutual Insurance Company and Safeco v. Benning, No. 05-12-00246-CV

Texas Pallet Operations, LP rented commercial property form Ostrovitz & Gwinn, LLC  (“O&G”).  As required by the lease, Texas Pallet obtained property insurance from First Specialty Insurance Company.  In 2006, a fire damaged the property and O&G sought payment from First Specialty for the loss.  But First Specialty refused because, it argued, O&G was not a party to the insurance contract.  O&G sued, and the trial court dismissed the case on summary judgment.

On appeal, O&G’s primary argument was that dismissal was unwarranted because it had standing to enforce the insurance contract as a third-party beneficiary.  Specifically, O&G contended that the “Loss Payable Provisions” of the policy identified O&G by name as a “Loss Payee,” thus solidifying its status as a third-party beneficiary.  The Court disagreed.  Assessing the policy’s express language, the Court found that “the policy does not clearly and fully demonstrate an intention by [Texas Pallate] and First Specialty to contract for the direct benefit of [O&G].”  It then proceeded to rejected the other issues raised by O&G and affirm the trial court’s decision.

Ostrovitz and Gwinn, LLC v. First Specialty Insurance Co., No. 05-11-00143-CV

The court of appeals has issued an opinion affirming an insurer’s obligation to cover the costs of defense.  In an underlying lawsuit, two homeowners sued their builder for negligent construction of the home.  The builder had been insured by several companies over the years, including Great American and Audobon.  Great American initially agreed with the other insurers that it would  cover one-third of the defense costs, but it pulled out of that deal when it was revealed that the damage to the house had occurred before its policy went into effect.  Audobon then sued Great American.  The trial court granted summary judgment in favor of Audobon, and the court of appeals affirmed.

On appeal, Great American argued that it had no duty to defend the underlying case because discovery had established that the homwoners’ claim did not arise during its policy period.  The court of appeals rejected that argument because the duty to defend is invoked by the plaintiff’s pleading, not the underlying facts.  In this case, the homeowners’ petition alleged only that the injury had occurred at some unspecified date in the past, which could have included the period when Great American’s policy was in effect.  Thus, under the “eight corners” of the pleading and the insurance policy, Great American was obligated to cover the costs of defending the claim.

Great American Lloyd’s Ins. Co. v. Audobon Ins. Co., No. 05-11-00021-CV

In Farmers Insurance Exchange v. Greene, Appellee-Greene maintained a homeowner’s insurance policy with Famers Insurance Exchange (“FIE”).  Among other things, the Policy contained a vacancy provision which suspended coverage for any damage to the dwelling that occurred 60 days after the dwelling becomes vacant.  As luck would have it, Greene moved out of the covered residence 4 months before a fire destroyed it.  Greene notified FIE of the damage, but FIE denied her claim based on the vacancy provision.  She sued and the trial court granted summary judgment in Greene’s favor, finding that her violaiton of the vacancy clause did not contribute to the loss, and thus did not prevent her from recovering under the Policy.

The Court of Appeals reversed, holding that the vacancy clause was clear and unambiguous in that it suspends coverage sixty days after the residence becomes vacant.  It also noted that “the vacancy clause functions as an exclusion; it excepts a specific condition (vacancy) from coverage.”  Further, the Court found that Section 862.054 of the Insurance Code—which provides that an insured’s breach of a provision or condition in a policy does not constitute a defense to a suit for loss unless the violation contributed to the destruction of the property—was inapplicable.   The vacancy of the home increased the risk of insuring it, and the Court felt that, under such circumstances, “we are loathe to engraft by judicial fiat additional terms requiring FIE to assume liability for a risk the Policy specifically excluded.