Reading The Insurance Policy

Insurance lawyers will tell their clients to read the insurance policy and then the attorney can discuss with the client how courts interpret the language in the policy. A 2018, opinion from the Southern District of Texas, Corpus Christi Division, styled, Mark Eller V. United Property & Casualty Insurance Company, is a good read for seeing how at least this particular court interprets the policy at issue in this case.

United filed a “Motion to Abate Proceedings to Complete Appraisal Process” and Eller responded.

Eller owns property damaged in Hurricane Harvey on or about August 25, 2017. United was the insurer and provided an estimate of the loss that was far less than what Eller says. A pre-suit demand was made under Texas Insurance Code, Chapter 542A on February 1, 2018.

On February 22, 2018, United made a demand for an appraisal, naming its appraiser and asking Eller to name an appraiser, which he did on June 14, 2018. On the same day he filed this lawsuit.

It is undisputed that the policy contains an appraisal condition that is intended to be satisfied prior to filing a legal action. Like any contractual terms, such appraisal provisions are generally enforceable, absent fraud, accident, or mistake. While it is anticipated that the appraisal will be completed prior to filing suit, nothing in United’s motion supports a need for abatement while the appraisal process takes place. Neither is there any estimate of how much time is necessary or where the appraisers are in the process, which was triggered no later than June 14, 2018—nearly two months prior to the consideration of this motion.

Eller opposes abatement because it does not serve judicial efficiency, is discretionary, and was not pled as a condition precedent. He also argues that the amount of the damage to the property is only one aspect of this case and he should be permitted to proceed with discovery on the extra-contractual, bad-faith claims.

This court looked at other cases and did not find cases that required abatement while the appraisal process proceeds. More specifically, this case need not be held hostage while the parties engage in the appraisal process.

It has been nearly a year since the hurricane. United has already received the benefit of the 60 day pre-suit notice under 542A. Because United has cited no evidence that prejudice will result from allowing the case to proceed simultaneously with the completion of the appraisal process, the Court finds no compelling reason to abate the case.