Dallas Fort Worth Insurance Lawyer Blog
Here is a 2024 opinion from the Western District of Texas, Austin Division, that deals with segregating damages in a homeowners claim. The opinion is styled, David Espinoza v. State Farm Lloyds.
Espinoza had a State Farm homeowners policy in force when a storm caused damage to his home. The claim was partially paid but State Farm but denied as to the full claim with State Farm alleging some of the damages were caused by matters not covered by the policy. State Farm filed a motion for summary judgment based on Plaintiff being unable to segregate the covered damages from the uncovered damages.
For an insurance company to be liable for a breach of its duty to satisfy a claim presented by its insured, the insured must prove that its claim falls within the insuring agreement of the policy.
Plaintiff alleges multiple damages while Defendant alleges that the only covered damage to the property is attributable to the date of loss is one wind damaged shingle. Defendant argues that Plaintiff cannot segregate the alleged damage attributed to the May 28, 2021, storm from other damages, as required by the concurrent cause doctrine. Texas recognizes the doctrine of concurrent causes, so that when covered and non-covered perils combine to create a loss, the insured is entitled to recover only that portion of the damage caused solely by the covered peril(s). As such, failure to provide evidence upon which a jury or court can allocate damages between those that resulted from covered perils and those that did not is fatal to an insured party’s claim. Because an insured can recover only for covered events, the burden of segregating the damage attributable solely to the covered event is a coverage issue for which the insured carries the burden of proof.
The Court then went over the evidence in the case and ruled in favor of State Farm. A reading of the facts of this case are important for any attorney dealing with the issue of segregation.