Ortiz v. State Farm Lloyds
Ortiz v. State Farm Lloyds
Opinion of the Court
The sole issue presented in this appeal is whether the trial court erred in granting summary judgment in favor of State Farm Lloyds on Oscar Ortiz's Texas Insurance Code and common law bad faith claims following State Farm's payment of an appraisal award. Ortiz asserts this court must reconsider our decision in Garcia v. State Farm Lloyds ,
BACKGROUND
Ortiz submitted a claim to State Farm for damage to his property resulting from wind and a hailstorm. After inspecting the property, State Farm determined Ortiz sustained $723.53 in damages to his property and informed Ortiz that no payment would be made for the claim since the damage amount did not exceed Ortiz's deductible. After a second inspection, State Farm found some additional damage but the damage total still did not exceed Ortiz's deductible, so no payment was made.
On April 14, 2015, Ortiz sued State Farm asserting contractual and extra-contractual claims. On August 4, 2015, State Farm invoked the appraisal process provided in Ortiz's insurance policy, and *158Ortiz's lawsuit was abated pending the completion of the appraisal process. On December 15, 2015, an appraisal award was issued in the amount of $9,447.52. On December 30, 2015, State Farm paid Ortiz $4,243.93, representing the actual cost value of the loss minus the deductible and recoverable depreciation. State Farm recognized that Ortiz would be entitled to the depreciation after he made the repairs.
On February 24, 2016, State Farm filed a motion for summary judgment asserting its payment of the appraisal award estopped Ortiz from maintaining a breach of contract claim. State Farm further asserted the payment of the appraisal award also precluded Ortiz's extra-contractual claims. The trial court granted summary judgment in favor of State Farm, and Ortiz appeals.
STANDARD OF REVIEW
We review the grant of a summary judgment de novo. Katy Venture, Ltd. v. Cremona Bistro Corp. ,
GARCIA V. STATE FARM LLOYDS
In Garcia , this court addressed the effect of an insurer's payment of an appraisal award on an insured's contractual claims.
We next addressed the effect of the insurer's payment of an appraisal award on an insured's extra-contractual claims.
*159USAA TEX. LLOYDS CO. V. MENCHACA
Ortiz argues this court must revisit our prior holding in Garcia because the Texas Supreme Court held in Menchaca that a statutory bad faith claim "can be proven without a corresponding breach of contract claim." We note, however, Menchaca is not a case involving the payment of an appraisal award. See Losciale v. State Farm Lloyds , No. 4-17-0016,
In Menchaca , the Texas Supreme Court enumerated the following "five distinct but interrelated rules that govern the relationship between contractual and extra-contractual claims in the insurance context":
First, as a general rule, an insured cannot recover policy benefits as damages for an insurer's statutory violation if the policy does not provide the insured a right to receive those benefits. Second, an insured who establishes a right to receive benefits under the insurance policy can recover those benefits as actual damages under the Insurance Code if the insurer's statutory violation causes the loss of the benefits. Third, even if the insured cannot establish a present contractual right to policy benefits, the insured can recover benefits as actual damages under the Insurance Code if the insurer's statutory violation caused the insured to lose that contractual right. Fourth, if an insurer's statutory violation causes an injury independent of the loss of policy benefits, the insured may recover damages for that injury even if the policy does not grant the insured a right to benefits. And fifth, an insured cannot recover any damages based on an insurer's statutory violation if the insured had no right to receive benefits under the policy and sustained no injury independent of a right to benefits.
In his brief, Ortiz "does not identify which of these 'rules' he relies [on] as support for his Insurance Code claims against State Farm." Losciale ,
If Ortiz seeks to rely on an insured's ability to recover policy benefits as actual damages under the second and third rules, those rules provide the insured can only recover if the insurer's statutory violation caused "the loss of the benefits" or the loss of the insured's "contractual right to policy benefits." Here, however, "[t]he payment of the appraisal award satisfie[d] [Ortiz's] right to receive benefits under [his policy] and, therefore, there is no 'loss of benefits' " or loss of a contractual right to policy benefits. Losciale ,
*160Therefore, having reviewed the five rules set forth by the Texas Supreme Court in Menchaca , we conclude nothing in those rules requires us to revisit our decision in Garcia or provides a basis for reversing the summary judgment granted in favor of State Farm in the instant case.
CONCLUSION
Because State Farm promptly paid the appraisal award in the instant case and Ortiz did not raise any ground for setting aside the appraisal award, summary judgment was properly granted on Ortiz's breach of contract claim. See Garcia ,
Reference
- Full Case Name
- Oscar ORTIZ v. STATE FARM LLOYDS
- Cited By
- 2 cases
- Status
- Published