Delayed Insurance Payment? Texas Does Not Allow Insurers To Profit From Nonpayment During Appraisal

Chip Merlin | Property Insurance Coverage Law Blog | June 29, 2019

Rene Sigman of Merlin Law Group’s Houston office was getting some pretty good results for clients this week when she sent me a Texas Supreme Court appraisal case which makes delaying insurers more accountable for inaccurate or plain wrongful estimates of the benefits owed to policyholders. All this Texas good news had me thinking “Yippee-Yi-Yo-Ki-Yay!”

The ruling is simple, but the reasoning is complex and at time restrained. Indeed, and respectfully, it is my opinion that aspects of the decision are simply wrong if one had studied and cited insurance adjustment treatises rather than relied upon insurance law cases about how property insurance adjustments are to be made. Here is the ruling:

[A]n insurer must pay damages in the form of 18% interest on the amount of the claim and reasonable and necessary attorney’s fees if it delays payment of a claim for more than the applicable statutory period or sixty days…..We hold that neither State Farm’s invocation of the policy’s appraisal process for resolution of a dispute as to the amount of loss, nor State Farm’s payment based on the appraisal amount, exempts State Farm from TPPCA damages as a matter of law. And without State Farm having accepted liability under the policy or having been adjudicated liable, we hold that Barbara Tech is not entitled to TPPCA damages as a matter of law.

The bottom line is that policyholders may be entitled to interest but must prove entitlement. To prove all this, policyholders should not hire second rate Texas insurance attorneys because proving the entitlement is a lot easier said than done.

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