Daugherty v. American Motorists Insurance

MURPHY, Chief Justice,

dissenting.

Because I respectfully disagree with the majority’s interpretation of the relevant contract provision and the characterization of acts taken by the insurer thereunder, I dissent. In order for the trial court to rule as it did, it had to impliedly find the communication of March 16 was not a “notification” of intent to pay Daugherty’s claim. After reviewing the record, I believe this finding was so contrary to the overwhelming weight of the evidence as to be clearly wrong and unjust.

At trial, the adjuster freely admitted to the communication of March 16 and the $62,-431.14 figure. The adjuster attempted to characterize the communication as an “offer” of the actual cash value determination as a preliminary suggestion in establishing the amount it would pay to Daugherty. The adjuster then claimed Daugherty had failed to “accept” the offer before he rescinded it the next day. The trial court apparently adopted this description.

The insurance policy, however, did not require an offer and acceptance as part of the process of giving notification of intent to pay the claim.1 See Fisk Elec. Co. v. Constructors & Assocs., Inc., 888 S.W.2d 813, 814 (Tex.1994) (“[ijssues of contract interpretation are determinable as a matter of law”). The insurance contract’s loss payment provision only required a simple statement of intent to pay Daugherty’s claim for the insurance company’s liability for payment to vest.

*800The record demonstrates that on March 16, the claims adjuster talked with Daugherty’s bookkeeper, whom he had regularly contacted and knew to be Daugherty’s representative in receiving reports on the claim, and informed her the payoff on the claim would be $62,431.14. He noted the amount represented the actual cash value of the vehicle minus Daugherty’s deductible. This conversation took place at the end of the period in which the insurance company was obligated to determine whether to pay or deny Daugherty’s claim and was two weeks after the method for determining actual cash value had been communicated to Daugherty’s representative. The communication also followed, by two days, a call by the claims adjuster’s supervisor informing him it was “ok to settle with the insured” for an amount which reflected the $62,431.14. The claims adjuster admitted he did not have the authority to settle a claim on his own and that his supervisor was the one who gave him the authority to settle for the quoted amount. Following the communication from the supervisor, the claims adjuster’s file notes that on March 16th he called the Houston Police Department and verified the vehicle had not been recovered. Soon thereafter, the adjuster made his call to Daugherty’s representative. The foregoing evidence clearly indicated the fact that the communication of March 16 was a “notification” of intent to pay the claim.

As to the majority’s contention that the notification was required to be in writing to be operative, I believe it is clear the parties did not intend such a requirement to control whether the insurance company’s obligation to pay had vested. See Biaza v. Simon, 879 S.W.2d 349, 356 (Tex.App. —Houston [14th Dist.] 1994, writ denied) (noting that contract language should be given its plain meaning, unless it appears such meaning would defeat the intention of the parties). The insurance company notes the requirement of a writing in amendatory provision (f), which provides

f. After we receive the information we request, we must notify you in writing whether the claim will be paid or has been denied or whether more information is needed:
1) Within 15 “business days”; or
2) Within 30 days if we have reason to believe the loss resulted from arson.

This provision puts an onus on the insurance company to quickly and efficiently resolve a claim. See id. The provision’s intention would be defeated if the insurance company were permitted to avoid its quick and efficient resolution of a claim by its own failure to comply with the requirement that its notification be in writing.2

As to the insurance company’s contention the communication was to Daugherty’s representative who was without the power to accept its “offer,” and the offer was revoked before Daugherty contacted them with an acceptance, I believe the notification provision did not require an offer and acceptance to be effective. Therefore, I find this contention to be unconvincing.

For these reasons, I dissent from the majority’s disposition of the case. I would reverse the trial court’s finding that the insurance company did not notify Daugherty of its intent to pay the replacement costs for his stolen automobile and remand the case to the trial court for further determinations on Daugherty’s remaining causes of action.

. The policy provided for an appraisal and independent evaluation in the event the insurance company and Daugherty disagreed on the amount of loss. Nevertheless, the insurance company does not contend the March 16 communication should be construed under this provision.

. By interpreting the provision as the majority has, the insurance company has incentive not to put their notification of an insured in writing. In effect, two wrongs by the insurance company, the failure to put their notification of payment in writing and the failure to pay according to the notification, will provide a "right” for them.