St. Lukes United Methodist Church v. Church Mutual Insurance Company
S.D. Tex.3/31/2022
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UNITED STATES DISTRICT COURT March 31, 2022 SOUTHERN DISTRICT OF TEXAS Nathan Ochsner, Clerk CORPUS CHRISTI DIVISION ST. LUKEāS UNITED METHODIST § CHURCH, § § Plaintiff, § § v. § Civil Action No. 2:20-CV-00053 § CHURCH MUTUAL INSURANCE § COMPANY, § § Defendant. § MEMORANDUM OPINION AND ORDER Plaintiff St. Lukeās United Methodist Church seeks coverage for property damage under an insurance policy issued by Defendant Church Mutual Insurance Company. Both Parties agree that the church was damaged during Hurricane Harvey and that some of the damage is covered by the insurance policy. Both Parties also agree that the breach of contract claim should proceed to trial because there is a dispute over how much of the damage is covered by the policy. But the Parties disagree about whether St. Lukeās extracontractual bad faith claims should proceed. St. Lukeās argues that there is a genuine issue of material fact as to whether Church Mutual acted in bad faith. Church Mutual disagrees and moves for partial summary judgment. For the following reasons, the Court DENIES the Motion for Partial Summary Judgment. I. BACKGROUND A. PROCEDURAL BACKGROUND This lawsuit began over two years ago when St. Lukeās sued Church Mutual in the 214th Judicial District Court of Nueces County. (Dkt. No. 1-3). Church Mutual removed the case to this Court on the basis of diversity jurisdiction.1 (Dkt. No. 1). Church Mutual filed its Motion for Partial Summary Judgment, (Dkt. No. 20), to which St. Lukeās filed a Response, (Dkt. No. 23), and Church Mutual filed a Reply, (Dkt. No. 24). B. FACTUAL ALLEGATIONS IN THE ORIGINAL PETITION St. Lukeās is a church in Corpus Christi that was damaged during Hurricane Harvey. (Dkt. No. 1-3 at 2ā3). St. Lukeāsā insurance policy with Church Mutual covered certain damage to its property, including damage caused by wind and water. (Id. at 2). After Hurricane Harvey, St. Lukeās submitted a claim. (Id. at 3). But Church Mutual allegedly failed to fulfill its obligations by improperly investigating and wrongfully denying St. Lukeāsā claim. (Id. at 3, 5). Accordingly, St. Lukeās asserts the following claims under Texas law: breach of contract; Chapters 541 and 542 of the Texas Insurance Code; common law duty of good faith and fair dealing; and declaratory judgment. (Id. at 2ā5). St. Lukeās seeks monetary damages of over one million dollars, enhanced or treble damages, interest, costs, attorneyās fees, and expenses. (Id. at 2, 4ā5). 1 Neither party contests diversity jurisdiction under 28 U.S.C. § 1332. St. Lukeās is a citizen of Texas. (Dkt. No. 1 at 1); (Dkt. No. 1-3 at 1). Church Mutual is a citizen of Wisconsin. (Dkt. No. 1 at 1). And the amount in controversy exceeds $75,000. (Dkt. No. 1-3 at 2). C. EVIDENCE IN THE RECORD 1. The Policy The insurance policy issued by Church Mutual to St. Lukeās was in effect during Hurricane Harvey. (Dkt. No. 20-1 at 1ā2). The insurance policy is a Replacement Cost policy. (Id. at 6). Specifically, If Replacement Cost is shown in the Declarations Page as applicable to Covered Property, we will determine the value of the Covered Property in the event of loss or damage as follows . . . . (3) We will not pay on a Replacement Cost basis for any loss or damage: (a) Until the lost or damaged property is actually repaired or replaced; and (b) Unless the repairs or replacement are made as soon as reasonably possible after the loss or damage. (Id. at 15). The policy also provides an option for St. Lukeās to seek coverage on an Actual Cash Value (ACV) basis instead of on a Replacement Cost Value (RCV) basis. (Id.). 2. The Insurance Claim On August 25, 2017, St. Lukeāsā church was damaged during Hurricane Harvey. (Dkt. No. 20-2 at 1). The hurricane impacted the steeple, roof, and interior of the church. (Dkt. No. 23-1 at 4, 21, 47). Four days later, St. Lukeās submitted an insurance claim. (Dkt. No. 20-2 at 1). While Church Mutual acknowledged the claim the next day, its acknowledgment included a windstorm exclusion. (Id.). Specifically, Please note that your policy . . . excludes damages caused directly or indirectly by Windstorm or Hail, regardless of any other cause or event that contributes concurrently or in any sequence to the loss or damage; or caused by rain, whether driven by wind or not, if that loss or damage would not have occurred but for the Windstorm or Hail. (Id.) (emphases added). Church Mutualās corporate representative, Lynn Renlund, concedes that this windstorm exclusion should never have been included in St. Lukeāsā policy. (Dkt. No. 23-1 at 2ā4). 3. The Investigation An inspection ensued. Brian Briggs, an independent adjuster, inspected the church on September 1, 2017ātwo days after the insurance claim was submitted. (Dkt. No. 20-4 at 1). Briggs identified damage to the roof and interior of the church. (Id. at 2ā 6). After factoring in the deductible and other costs, Briggs calculated a net claim of $34,019.79.2 (Id. at 7ā9). Briggs also informed St. Lukeās that it should contact the Texas Windstorm Insurance Association. (Dkt. No. 23-1 at 4); (Dkt. No. 23-2 at 2ā4). It is unclear why Briggs instructed St. Lukeās to do so. Sometime in September 2017, Church Mutual denied St. Lukeās windstorm coverage. (Dkt. No. 23-1 at 5ā6, 54ā56). But, as early as September 19, 2017, Church Mutual discovered that St. Lukeās did, in fact, have windstorm coverage. (Id. at 8ā10, 47); (Dkt. No. 20-1 at 1). Church Mutual retroactively applied the change. (Dkt. No. 20-1 at 1). Church Mutualās September 28, 2017 letterāsent approximately one month after the claim was submittedārequests an additional thirty days to complete its investigation. 2 Briggsās report breaks down the net claim into three categories: church ($33,359.40), (Dkt. No. 20-4 at 7), other structures ($354.40), (id. at 8), and personal property ($305.99), (id. at 9). (Dkt. No. 20-3); (Dkt. No. 23-1 at 9). On the same day, Church Mutualās property claims supervisor recommended that Church Mutual retain an engineer āto assess the structural integrity of the steepleā and, if applicable, āfind a couple of qualified contractors.ā (Dkt. No. 23-1 at 8, 10ā11, 45). At the beginning of October 2017, Church Mutual hired Rimkus Consulting Group Inc., (āRimkusā), to examine the steeple, including its structural integrity, and determine whether any of the interior water damage was from the steeple. (Id. at 16, 44). A few weeks later, in mid-October 2017, Church Mutual sent St. Lukeās a letter containing key information. First, Church Mutual stated that it had ācompleted [its] analysis of potential policy benefitsā arising out of St. Lukeās insurance claim. (Dkt. No. 20-5 at 1). Second, Church Mutual provided an estimate of damages based on the ACV portion of the loss, including a breakdown of the figures supporting the $34,019.79 payment. (Id.). The breakdown includes figures like āReplacement Value of Lossā and the deductible, but it does not otherwise explain how the figures were calculated. (Id.). Third, Church Mutual explained that repairs should be completed āwithin 180 days if possibleā in order to recover depreciation. (Id.). Finally, Church Mutual notified St. Lukeās that it needed an additional thirty days to complete a full investigation because Church Mutual was waiting on findings from Rimkus regarding damage to the church steeple. (Id. at 2). Notably, the $34,019.79 payment was based on Briggsās estimate from the original inspection, which covered certain damage to the church, āother structures,ā and personal property. (Dkt. No. 20-4 at 7ā9); (Dkt. No. 23-1 at 12ā13). Sometime in November 2017, Rimkus requested scaffolding from Church Mutual to aid in examining the damage to the roof of the church and steeple. (Dkt. No. 23-1 at 18ā21). Apparently, the request went unanswered because Rimkus reiterated its request for scaffolding in January 2018. (Id. at 21ā22). Rimkus, by this point, had collected cost estimates for scaffolding. (Id. at 21). As of the beginning of February, Church Mutual still had not authorized scaffolding to inspect the church.3 (Id. at 22). In February 2018, Todd Van Sant of Guardian Consulting was brought into the picture to prepare an estimate regarding damage to the church and the corresponding repair. (Dkt. No. 23-3 at 3ā4); (Dkt. No. 23-1 at 79). Van Sant inspected the church in March 2018. (Dkt. No. 20-6 at 1); (Dkt. No. 23-3 at 6, 13); (Dkt. No. 23-1 at 79). The inspection included Van Sant physically getting inside a basket that was then lifted by a crane. (Dkt. No. 23-3 at 6). After this initial inspection, Rimkus concluded that scaffolding was indeed necessary to examine the steepleāāas originally thought.ā (Id. at 6, 9ā10). Van Santās inspection was approximately seven months after Briggsās inspection. Compare (Dkt. No. 20-6 at 1) with (Dkt. No. 20-4 at 1). At some point, scaffolding was finally used to inspect the damage to the steeple.4 (Dkt. No. 23-1 at 23). 3 Church Mutualās corporate representative, Lynn Renlund, attributed the delay to giving St. Lukeās the option to choose who it wanted to use for scaffolding. (Dkt. No. 23-1 at 1, 29). At least one Church Mutual employee, Leah Henkelman, expressed concern about the timeline when she stated that Church Mutual ācannot have any more delays on this file.ā (Id. at 28ā30). Henkelman then told the adjuster to agree to using scaffolding and schedule the inspection. (Id. at 23). 4 St. Lukeās cites (Dkt. No. 23-1 at 23) as evidence that the scaffolding went up in a particular month. See (Dkt. No. 23 at 7). But the deposition transcript indicates that the attorney stated when the scaffolding went up. The witness responded, āOkay.ā (Dkt. No. 23-1 at 23). St. Lukeās, therefore, does not provide evidence as to when the scaffolding went up. Later, in November 2018, Van Sant completed a second inspection. (Dkt. No. 23-3 at 10ā 11, 13). 4. Damage Calculations Van Santās final report from late-February 2019 details the timeline of the church inspection. (Dkt. No. 23-1 at 79ā81). He explains: Upon close-up examination to the tower by scaffold, it was determined that the damages to the masonry work on the tower was much more significant and that the cross was un- salvageable and required replacement. The roof, however, was not significantly damaged . . . . Due to the increased damages to the steeple structurally, the costs of this estimate increased dramatically. (Id. at 79ā80). The total estimated cost of repair is listed as $1,676,314.83. (Id. at 94). After Van Sant submitted his first estimate, he spoke with Church Mutualās adjuster, Gary Roos, and then revised his estimate. (Dkt. No. 23-3 at 19ā21). Among other changes, Van Sant reallocated portions of his estimate as code-upgrade costs and depreciation. (Id.). His revised estimate lists $699,722.49 as code-upgrade costsāwhich substantially reduced the payout under the policy. (Dkt. No. 23-1 at 117). In listing these repair costs as code upgrades, Van Sant relied on information provided by Church Mutualās adjuster. (Dkt. No. 23-3 at 21). Van Sant, however, did not state which building codes apply to the church repairs. (Id. at 21ā22). Van Sant also applied depreciation in the range of 40ā50%, again at the direction of Church Mutualās adjuster.5 (Id. at 18, 20ā21). 5 Church Mutualās general practice is to not depreciate āanything more than 50 percent even if the calculation should be more than 50 percent based on,ā for example, the age of the (continue) St. Lukeāsā expert witness disagrees with Van Santās estimate. In August 2020, that expert concluded that the code-upgrade costs are just $83,808.04. (Dkt. No. 23-4 at 149, 151). The difference between the $699,722.49 code-upgrade estimate of Church Mutual and the $83,808.04 code-upgrade estimate of St. Lukeās is the heart of their dispute. 5. Insurance Payments In June 2019, Church Mutual issued a $111,290.83 payment to St. Lukeās. (Dkt. No. 20-7). Church Mutual explained that St. Lukeās may recover depreciation by completing repairs and replacement within 180 days. (Id.). The $111,290.83 appears to be the second payment issued to St. Lukeās. In March 2021, Church Mutual issued a third payment of $277,444.15. (Dkt. No. 20-9 at 1). Of that amount, $100,000 was for the āCode Compliance Policy Limitā and the rest for āHoldback.ā6 (Id.). Less than a month after this payment, Church Mutual issued St. Lukeās a fourth payment, this time for $162,895.11. (Id. at 2). II. LEGAL STANDARD Summary judgment is appropriate when there is āno genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law.ā Fed. R. Civ. P. 56(a). āA material fact is one that might affect the outcome of the suit under governing law,ā and āa fact issue is genuine if the evidence is such that a reasonable jury could return a verdict for the non-moving party.ā Renwick v. PNK Lake Charles, L.L.C., 901 F.3d building. (Dkt. No. 24-1 at 6). There is no other evidence regarding Church Mutualās depreciation practices. 6 Both Parties agree that the insurance policy has a $100,000 limit for covering code. (Dkt. No. 23 at 2); (Dkt. No. 24 at 4). 605, 611 (5th Cir. 2018) (quotations omitted). The moving party āalways bears the initial responsibility of informing the district court of the basis for its motion,ā and identifying the record evidence āwhich it believes demonstrate[s] the absence of a genuine issue of material fact.ā Celotex Corp. v. Catrett, 477 U.S. 317, 323, 106 S.Ct. 2548, 2253, 91 L.Ed.2d 265 (1986). āIf the moving party fails to meet [its] initial burden, the motion [for summary judgment] must be denied, regardless of the nonmovantās response.ā Little v. Liquid Air Corp., 37 F.3d 1069, 1075 (5th Cir. 1994) (en banc) (per curiam). If the movant meets this burden, the nonmovant must then come forward with specific facts showing there is a genuine issue for trial. Fed. R. Civ. P. 56(c); Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 586ā87, 106 S.Ct. 1348, 1356, 89 L.Ed.2d 538 (1986). The nonmovant must āgo beyond the pleadings and by [the nonmovantās] own affidavits, or by the depositions, answers to interrogatories, and admissions on file, designate specific facts showing that there is a genuine issue for trial.ā Nola Spice Designs, LLC v. Haydel Enters., Inc., 783 F.3d 527, 536 (5th Cir. 2015) (citations omitted). āThe nonmovant must identify specific evidence in the record and articulate the precise manner in which that evidence supports his or her claim.ā Carr v. Air Line Pilots Assān, Intāl, 866 F.3d 597, 601 (5th Cir. 2017) (per curiam) (cleaned up). āIf the evidence is merely colorable, or is not significantly probative,ā summary judgment is appropriate. Parrish v. Premier Directional Drilling, L.P., 917 F.3d 369, 378 (5th Cir. 2019) (citation omitted). The nonmovantās burden āwill not be satisfied by some metaphysical doubt as to the material facts, by conclusory allegations, by unsubstantiated assertions, or by only a scintilla of evidence.ā Boudreaux v. Swift Transp. Co., 402 F.3d 536, 540 (5th Cir. 2005) (internal quotations omitted). In reviewing a motion for summary judgment, the district court must view the evidence in the light most favorable to the nonmovant. Coleman v. Hous. Indep. Sch. Dist., 113 F.3d 528, 533 (5th Cir. 1997). This means that factual controversies are to be resolved in the nonmovantās favor, ābut only when . . . both parties have submitted evidence of contradictory facts.ā Little, 37 F.3d at 1075. III. DISCUSSION St. Lukeās asserts that Church Mutualās handling of its insurance claim violated the Texas Insurance Code and breached the duty of good faith and fair dealing. Church Mutual advances two main grounds for partial summary judgment.7 First, St. Lukeās does not provide evidence that it suffered damages that are separate from the amount that it is allegedly owed under the insurance policy. (Dkt. No. 20 at 1). Second, St. Lukeās does not provide evidence that Church Mutual lacked a reasonable basis to deny the claim.8 (Id. at 1, 7). St. Lukeās responds that there is a genuine dispute of material fact as to whether Church Mutual improperly classified certain line items as ācode upgradesā rather than 7 In this diversity case, the Court applies the substantive law of Texas. Turner v. Cincinnati Ins. Co., 9 F.4th 300, 308 (5th Cir. 2021) (citing Erie R.R. Co. v. Tompkins, 304 U.S. 64, 78, 58 S.Ct. 817, 822, 82 L.Ed. 1188 (1938)). 8 With respect to the code compliance repairs, Church Mutual also āseeks a partial summary judgment from the Court [1] that no payment for such damages was due or owing until such repairs were complete, and [2] that recovery of benefits under the Policy for any such damages is limited to $100,000.ā (Dkt. No. 20 at 2, 17ā19). In response, St. Lukeās asserts that this request āappears more in the nature of a request for declaratory relief (that is not pleaded) than a request for a ruling on a specific claim or defense of party.ā (Dkt. No. 23 at 1). The Court agrees with St. Lukeās. Church Mutual has not asserted a counterclaim and, in this context, is not seeking summary judgment on the breach of contract or declaratory judgment claims. Nor does Church Mutual provide the Court with a legal basis that shows it āis entitled to judgment as a matter of lawā in this regard. See Fed. R. Civ. P. 56(a). The Court DENIES Church Mutualās request. ārepair costsā to avoid paying St. Lukeās covered damages, thereby breaching the Texas Insurance Code and the duty of good faith owed to it. (Dkt. No. 23 at 1ā2). St. Lukeās acknowledges that these arguments are relevant to the breach of contract claimāa claim that is not addressed in the Motion for Partial Summary Judgment. (Id. at 2). St. Lukeās contends these arguments demonstrate the viability of its extra-contractual claims because the existence of its breach of contract claim means that St. Lukeās does not need to provide evidence of an independent injury to proceed on its extra-contractual claims. (Id. at 2ā3, 13). Additionally, the extra-contractual claims also can stand on their own because Church Mutual improperly denied the claim, delayed the investigation for more than one year, applied excessive depreciation, and reduced the payout to St. Lukeās by arbitrarily classifying repair costs as code upgrades. (Id. at 3, 11ā12). A. INDEPENDENT-INJURY RULE Church Mutual first argues that St. Lukeāsā extra-contractual claims fail as a matter of law under the independent-injury rule. (Dkt. No. 20 at 15ā17). St. Lukeās contends this rule does not apply. (Dkt. No. 23 at 13). St. Lukeās is correct. The Supreme Court of Texas has described āfive distinct but interrelated rules that govern the relationship between contractual and extra-contractual claims in the insurance context.ā USAA Tex. Lloyds Co. v. Menchaca, 545 S.W.3d 479, 489 (Tex. 2018). Three are relevant here: First, as a general rule, an insured cannot recover policy benefits as damages for an insurerās 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 insurerās statutory violation causes the loss of the benefits . . . . [And], if an insurerās 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. Id. The Court begins with the first rule: St. Lukeās generally cannot recover policy benefits as damages for Church Mutualās alleged statutory violation if the insurance policy does not provide St. Lukeās with a right to receive those benefits. See id. at 490ā95. The Parties agree that there is a live dispute as to whether St. Lukeās is entitled to additional policy benefits under the insurance contract. Because there is no determination at this stage whether St. Lukeās has a right to receive the additional benefits, the Court cannot conclude that St. Lukeās is categorically prohibited from asserting extra-contractual claims. In other words, it remains to be seen whether the policy provides St. Lukeās āa right to receive those benefits.ā See Menchaca, 545 S.W.3d at 489. This is where the second Menchaca rule comes into play. Again, āan 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 insurerās statutory violation causes the loss of the benefits.ā Menchaca, 545 S.W.3d at 489. Put differently, ā[i]f an insurerās wrongful denial of a valid claim for benefits results from or constitutes a statutory violation, the resulting damages will necessarily include at least the amount of the policy benefits wrongfully withheld.ā Id. at 496 (internal quotations omitted). For example, the Supreme Court of Texas has found that a plaintiff can recover āat least the amount of the policy benefits wrongfully withheldā when the plaintiff succeeds on common-law bad faith and statutory violations at trial but does not assert a breach of contract claim. Id. at 495 (citing Vail v. Tex. Farm Bureau Mut. Ins. Co., 754 S.W.2d 129, 130, 136 (Tex. 1988)). In other words, a plaintiff can recover the amount owed under an insurance policy without necessarily asserting a breach of contract claim. Id. This rule is known as the āentitled-to-benefits rule.ā Id. Here, St. Lukeās has pursued a breach of contract claim as well as claims under the Texas Insurance Code and common law. The second Menchaca rule authorizes this approach. Despite the application of the second Menchaca rule, Church Mutual urges the Court to read the last of the above Menchaca rulesāthe independent-injury ruleāas precluding the extra-contractual claims brought by St. Lukeās. Specifically, it argues that the extra-contractual claims categorically ārequire evidence that the plaintiff suffered damages other than unpaid policy benefits.ā (Dkt. No. 20 at 16) (emphasis in original). Church Mutual is incorrect. There are two aspects of the independent-injury rule. First, āif an insurerās statutory violation causes an injury independent of the insuredās right to recover policy benefits, the insured may recover damages for that injury even if the policy does not entitle the insured to receive benefits.ā Menchaca, 545 S.W.3d at 499. Second, āan insurerās statutory violation does not permit the insured to recover any damages beyond policy benefits unless the violation causes an injury that is independent from the loss of the benefits.ā Id. at 500 (emphasis in original). Church Mutual focuses on this second aspect, arguing that St. Lukeās fails to provide evidence of an injury that is independent from the loss of benefits. (Dkt. No. 20 at 16ā17). Church Mutual overlooks the fact that St. Lukeās is not pursuing an independent- injury theory by seeking damages outside of the allegedly denied policy benefits. Rather, the damages St. Lukeās seeks are the policy benefits. Menchaca āclarifies definitively that where an insured seeks to recover damages for an insurerās violations of the Texas Insurance Code, the insured must prove either (1) a right to receive benefits under the policy; or (2) compliance with the independent-injury rule.ā Garza v. Allstate Fire & Cas. Ins. Co., 466 F. Supp. 3d 705, 713 (S.D. Tex. 2020); accord Burgess v. Allstate Fire & Cas. Ins. Co., ____ S.W.3d ____, ____, No. 03-20-00088-CV, 2021 WL 5498758, at *7 (Tex. App.ā Austin Nov. 24, 2021, no pet.). St. Lukeās has elected to pursue the first option but not the second. Thus, Church Mutual misreads Menchaca as holding that the independent- injury rule requires an independent injury to assert extra-contractual claims. Church Mutualās position is also contrary to Fifth Circuit precedent. In Lyda Swinerton Builders, Incorporated v. Oklahoma Surety Company, the plaintiff argued that the district court erred by rendering judgment for the defendant. 903 F.3d 435, 451 (5th Cir. 2018). The district court construed Texas law to require a plaintiff to first establish an independent injury before obtaining extra-contractual damages under the Texas Insurance Code. Id. The Fifth Circuit reversed and remanded. Id. at 453. Relying on Menchaca, the Fifth Circuit reiterated that āthe independent-injury rule does not restrict the damages an insured can recover under the entitled-to-benefits rule.ā Id. at 452. Instead, āthe independent-injury rule limits the recovery of other damages that āflowā or āstemā from a mere denial of policy benefits.ā Id. (emphasis in original). Accordingly, the Fifth Circuit held that the plaintiff could recover actual damages under Chapter 541 if, on remand, the plaintiff could establish that the defendantās alleged misrepresentations caused the plaintiff to be deprived of a benefit under the insurance policy. Id. at 453. For good measure, the Fifth Circuit reiterated that the recovery of any actual damages in this manner is āwithout limitation from the independent-injury rule.ā Id. In sum, Church Mutual urges the Court to adopt an improper reading of Texas law.9 In this respect, the Court denies the Motion for Partial Summary Judgment. B. BAD FAITH CLAIMS Church Mutualās second argument is that bad faith claims alleged by St. Lukeās fail on the merits. Even assuming that St. Lukeās can succeed on its breach of contract claim at trial, Church Mutual maintains the bad faith claims still fail because there is no evidence of bad faith. Claims under Chapter 541 of the Texas Insurance Code and under the common law duty of good faith and fair dealing are analyzed together. See, e.g., Ortiz v. State Farm Lloyds, 589 S.W.3d 127, 133 (Tex. 2019). The claims are analyzed together because these extra-contractual claims share the same predicate for recovery: bad faith. Higginbotham 9 In support of its arguments, Church Mutual also relies on federal district court opinions that pre-date Menchaca. (Dkt. No. 20 at 13 n.45, 16 n.55). Menchaca and Lyda, however, guide this Courtās analysis. v. State Farm Mut. Auto. Ins. Co., 103 F.3d 456, 460 (5th Cir. 1997); accord Alvarado v. State Farm Lloyds, No. 7:14-CV-166, 2016 WL 6905865, at *4 (S.D. Tex. June 15, 2016). 1. Chapter 541 of the Texas Insurance Code St. Lukeās alleges that Church Mutualās claims handling process violated Section 541.060 of the Texas Insurance Code.10 (Dkt. No. 1-3 at 4). Section 541.003 prohibits āa trade practice that is defined in this chapter as or determined under this chapter to be an unfair method of competition or an unfair or deceptive act or practice in the business of insurance.ā Tex. Ins. Code § 541.003. Section 541.060 provides that certain settlement practices constitute āan unfair method of competition or an unfair or deceptive act or practice in the business of insurance[.]ā Id. § 541.060(a). There are two settlement practices that are referenced by St. Lukeās. See (Dkt. No. 1-3 at 4). First, Church Mutual allegedly failed āto attempt in good faith to effectuate a prompt, fair, and equitable settlement of . . . a claim with respect to which the insurerās liability has become reasonably clear[.]ā See Tex. Ins. Code § 541.060(a)(2)(A). Second, Church Mutual allegedly refused to pay the claim āwithout conducting a reasonable investigation with respect to the claim[.]ā See id. § 541.060(a)(7). Section 541.151 provides a private cause of action for violations under Section 541.060. Tex. Mut. Ins. Co. v. Ruttiger, 381 S.W.3d 430, 438 (Tex. 2012). 10 St. Lukeās notes that Church Mutual has not moved for summary judgment on St. Lukeāsā claim under Chapter 542 of the Texas Insurance Code. (Dkt. No. 23 at 3 n.2). Church Mutualās Motion for Partial Summary Judgment and Reply do not make arguments responding to St. Lukeāsā Chapter 542 claim. See (Dkt. No. 20); (Dkt. No. 24). The Court therefore does not reach the Chapter 542 claim. For the same reason, the Court does not reach the declaratory judgment claim brought by St. Lukeās. 2. Common Law Duty of Good Faith and Fair Dealing St. Lukeās also asserts a claim for breach of the common law duty of good faith and fair dealing. Here, St. Lukeās essentially makes the same two allegations that it made with respect to its Chapter 541 claims: Church Mutual refused to pay, or delayed in paying, the insurance claim after liability became reasonably clear, (Dkt. No. 1-3 at 4), and Church Mutualās investigation was deficient, (id. at 5). Under Texas law, an insurer has a common law duty of good faith and fair dealing. Arnold v. Natāl Cnty. Mut. Fire Ins. Co., 725 S.W.2d 165, 167 (Tex. 1987). A plaintiff can assert a claim under the common law duty of good faith and fair dealing by alleging (1) āthat the insurer had no reasonable basis for the denial or delay in payment of a claimā; and (2) āthat the insurer knew or should have known of that fact.ā Union Bankers Ins. Co. v. Shelton, 889 S.W.2d 278, 283 (Tex. 1994); accord Lawyers Title Ins. Corp. v. Doubletree Partners, L.P., 739 F.3d 848, 869 (5th Cir. 2014). The evidence must āpermit the logical inference that the insurer had no reasonable basis to delay or deny payment of the claim, and that it knew or should have known it had no reasonable basis for its actions.ā Lyons v. Millers Cas. Ins. Co. of Tex., 866 S.W.2d 597, 600 (Tex. 1993). The focus is not on whether the claim was valid. Id. at 601. Rather, the focus is āon the reasonableness of the insurerās conduct in rejecting the claim.ā Id. 3. Analysis of Statutory and Common Law Bad Faith Claims Having provided an overview of the law governing both bad faith claims, the Court turns to the Partiesā arguments and the evidence. Again, āan insurer will not be faced with a tort suit for challenging a claim of coverage if there was any reasonable basis for denial of that coverage.ā Higginbotham, 103 F.3d at 460. āEvidence that only shows a bona fide dispute about the insurerās liability on the contract does not rise to the level of bad faith.ā U.S. Fire Ins. Co. v. Williams, 955 S.W.2d 267, 268 (Tex. 1997) (per curiam). This bona-fide-dispute rule applies to claims for breach of the duty of good faith and fair dealing, id., and claims for bad faith under Chapter 541 of the Texas Insurance Code. Weiser-Brown Operating Co. v. St. Paul Surplus Lines Ins. Co., 801 F.3d 512, 525 (5th Cir. 2015). Broadly, Church Mutual asserts that the claim was handled reasonably.11 (Dkt. No. 20 at 1, 7ā8). In response, St. Lukeās points to three separate pieces of evidence that contradict this assertion: the initial perfunctory denial of the claim and then the lengthy duration of the investigation into the claim; the determination of the costs of code upgrades; and the calculation of depreciation on the building. (Dkt. No. 23 at 3, 11ā12). The Court concludes that Church Mutual has not carried its burden of demonstrating the absence of a genuine issue of material fact regarding the bad faith claims. The Court begins with Church Mutualās initial response to the insurance claim and the timeline of the investigation. For starters, Church Mutualās initial response to the insurance claim sowed confusion. St. Lukeās submitted an insurance claim on August 29, 11 Rather than cite to specific pages in the record, both Parties often cite to exhibits as a whole or simply fail to cite to the record at all. It is not the Courtās task to search the record for the Parties. United States v. del Carpio Frescas, 932 F.3d 324, 331 (5th Cir. 2019) (per curiam); Hernandez v. Yellow Transp., Inc., 670 F.3d 644, 651 (5th Cir. 2012) (āA district courtās decision on summary judgment is largely controlled by what the parties presented. If somewhere in a record there is evidence that might show a dispute of material fact, the district court needs to be pointed to that evidence as opposed to having to engage in an extensive search.ā). 2017. (Dkt. No. 20-2 at 1). Church Mutual responded the following day by stating that coverage for windstorm damage was excluded. (Id.). At some point in the following weeks, Church Mutual then denied St. Lukeās windstorm coverage. (Dkt. No. 23-1 at 5ā 6, 54ā56). By the middle of September, Church Mutual had backtrackedāSt. Lukeās did, in fact, have windstorm coverage. (Id. at 8ā10, 47); (Dkt. No. 20-1 at 1). But, for almost three weeks, St. Lukeās was left with the impression that the overwhelming majority of the damage from Hurricane Harvey would not be covered. This impression was seemingly reinforced by Church Mutualās initial investigation. Briggs, Church Mutualās independent adjuster, inspected the church two days after the insurance claim was submitted. (Dkt. No. 20-4 at 1). Following the inspection, however, Briggs told St. Lukeās that it should contact the Texas Windstorm Insurance Association. (Dkt. No. 23-1 at 4); (Dkt. No. 23-2 at 2ā4). Sometime after the September inspection but before the mid-October letter, Briggs also determined that St. Lukeās had a net claim of $34,019.79. (Dkt. No. 20-4 at 7ā9). One possible interpretation of Church Mutualās subsequent letter in mid-October 2017 is that Church Mutual doubled down on an estimate that did not factor in wind coverage. After completing its āanalysis of potential policy benefits,ā the letter incorporated Briggsās $34,019.79 figure. (Dkt. No. 20-5 at 1). Yet Church Mutualās reiteration of this figure seemingly came after it recognized the error regarding the windstorm coverage. To what extent the initial estimate was affected by the erroneous windstorm exclusion is unclear. Even if the erroneous windstorm exclusion had no impact on Church Mutualās initial estimate, there is a considerable difference between the initial payment Church Mutual issued in 2017, $34,019.79, and the combined amount that Church Mutual ultimately issued after completing its inspection of the steeple, $551,630.09. Compare (Dkt. No. 20-5) with (Dkt. No. 20-7); (Dkt. No. 20-9 at 1ā2). The subsequent investigation and resolution of the claim took various twists and turns. In late September 2017āless than a month after St. Lukeās submitted its insurance claimāChurch Mutual requested an additional thirty days to complete its investigation. (Dkt. No. 20-3); (Dkt. No. 23-1 at 9). The investigation took years, not days. In October 2017, Church Mutual asked Rimkus to examine the steeple. (Dkt. No. 23-1 at 16, 44). Van Sant then inspected the church in March 2018. (Dkt. No. 20-6 at 1); (Dkt. No. 23-3 at 6, 13); (Dkt. No. 23-1 at 79). In November 2018, Van Sant completed a second inspection. (Dkt. No. 23-3 at 10ā11, 13). Van Santās final report was issued in February 2019. (Dkt. No. 23-1 at 79ā81). But his report was revised the following month in March 2019āthis time with changes to the code-upgrade and depreciation amounts. (Dkt. No. 23-3 at 19ā 21); (Dkt. No. 23-1 at 117). The revised estimate was issued approximately eighteen months after St. Lukeās submitted its original insurance claim. In addition, subsequent paymentsāseparate and apart from the initial paymentāwere issued in June 2019, March 2021, and April 2021. (Dkt. No. 20-7); (Dkt. No. 20-9 at 1ā2). The length of time it took to obtain scaffolding to accurately assess the damage was a large reason for Church Mutualās overall delay in processing the claim. As early as November 2017, Rimkus requested scaffolding to inspect the damage to the church. (Dkt. No. 23-1 at 20ā21). Two months later, Rimkus reiterated the request and had even gone so far as to collect cost estimates for scaffolding. (Id. at 21ā22). Notwithstanding, the March 2018 inspection did not include scaffolding. (Dkt. No. 23-3 at 6). It was not until the November 2018 inspectionāone year after the initial requestāthat scaffolding was provided and used. (Dkt. No. 23-1 at 23); (Dkt. No. 23-1 at 10ā11, 13). Next, St. Lukeās points to the difference in code upgrade estimates provided by the two experts as evidence of bad faith. (Dkt. No. 23 at 12). Because there was no explanation for reallocating certain repair costs as code upgrades, St. Lukeās reasons, there is a genuine issue of material fact regarding bad faith. (Id.). Church Mutual agrees that the difference between the two estimates constitutes the crux of this lawsuit. (Dkt. No. 24 at 4). But Church Mutual insists that this is a contractual disputeāa claim not addressed in the Motion for Partial Summary Judgment. (Id.). According to Church Mutual, St. Lukeās āfails to provide competent evidence that Church Mutual had no reasonable basis to calculate [the] code-compliance related damages as being higher than [St. Lukeāsā] expert concluded.ā (Id. at 5). To be sure, the primary basis of the breach of contract claim is the Partiesā disagreement over the propriety of labeling certain property repairs as code upgrades. In this respect, Church Mutual is correct that these arguments are relevant to the breach of contract claim. But here, the bad faith claim is based in part on how Church Mutual determined these costs were for code upgrades, not the determination itself. And St. Lukeās points to evidence in support. Van Sant issued a final report. (Dkt. No. 23-1 at 79ā81). The following month, Church Mutualās adjustor instructed Van Sant to reallocate estimated repair costs as code-upgrades and depreciationāwhich are not covered in full by the policy. (Dkt. No. 23-3 at 19); (Dkt. No. 23-1 at 117). Van Sant did as he was told. (Dkt. No. 23-3 at 21). In reallocating certain costs as code upgrades, Van Sant did not determine what building codes these repairs were supposed to comply with. (Id. at 21ā 22). Church Mutual offers little in explanation for this considerable change in the estimated insurance claim. Last, St. Lukeās argues that Church Mutual arbitrarily depreciated the recoverable damages and did not complete an analysis of the condition of the church. (Dkt. No. 23 at 8ā9, 12). Like the determination of code-upgrade costs, St. Lukeās points to Van Santās estimates. In the revised estimate, Van Sant depreciated costs at the direction of Church Mutualās adjuster. (Dkt. No. 23-3 at 18, 20ā21). But Van Sant himself did not calculate depreciation. The only evidence that Church Mutual identifies regarding the calculation of depreciation is its standard practice not to depreciate more than fifty percent. (Dkt. No. 24-1 at 6). But this says little about whether Church Mutual acted in good faith when it calculated the depreciation amount. Indeed, the entire theory of this case offered by St. Lukeās is that there is a consistent pattern of improper conduct. In sum, the evidence, considered together, demonstrates that there is a genuine issue of material fact as to whether Church Mutual acted in bad faith. To be sure, Texas law is clear that bona fide coverage disputes do not demonstrate bad faith. But the Court is not persuaded that this case is simply a coverage dispute. Consider Weiser-Brown, where the Fifth Circuit agreed with the district court that there was no legally sufficient basis to find bad faith under Chapter 541 of the Texas Insurance Code. 801 F.3d at 526. The Fifth Circuit relied in part on the insurance companyās efforts over the course of four months āto obtain an expert opinion on a complicated coverage issue.ā Id. at 527. But unlike in Weiser-Brown, Church Mutualās efforts took years rather than months. And unlike in Weiser-Brown, the evidence indicates there may be more than just a complicated coverage issue. Rather, the evidence raises questions about extensive delays, multiple changes in the level of coverage, and inadequate explanations for decisionmaking. IV. CONCLUSION Because there is a genuine issue of material fact as to whether Church Mutual acted in bad faith, the Court DENIES the Motion for Partial Summary Judgment. (Dkt. No. 20). It is SO ORDERED. Signed on March 31, 2022. R J ā” DREW B. TIPTON UNITED STATES DISTRICT JUDGE 23
Case Information
- Court
- S.D. Tex.
- Decision Date
- March 31, 2022
- Status
- Precedential