992 F.3d 401
5th Cir.2021Background
- Dillon Gage, a precious-metals dealer, shipped two orders of gold coins (total ~$1.204M) after receiving what appeared to be valid checks and customer information for Kenneth and Laurie Bramlett.
- A criminal had stolen the Bramletts’ identities and intercepted their personal checks from the mail, then placed the orders and provided a reroute instruction so UPS would hold the packages.
- UPS allegedly rerouted shipments without Dillon Gage’s consent and the packages were retrieved at a UPS facility without proper signature; both shipments were stolen.
- Dillon Gage received the funds from the (fraudulent) checks, lost the coins, and submitted an insurance claim under a policy that covers transit losses but excludes losses “sustained ... consequent upon handing over such Insured property to any third party against payment by” a fraudulent check.
- Insurers denied coverage except for a $12,500 limited payment under a narrow exception; Dillon Gage sued. The district court granted summary judgment for the underwriters on stipulated facts.
- On appeal the Fifth Circuit certified two dispositive Texas-law questions to the Texas Supreme Court: (1) the meaning/scope of “consequent upon” in the exclusion, and (2) if the exclusion applies, whether UPS’s alleged errors constitute an independent cause under Texas law.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the losses were "sustained consequent upon" handing property to UPS against fraudulent checks (so exclusion applies) | "Consequent upon" requires more than mere but-for causation; UPS’s intervening errors were the proximate/substantial cause, so exclusion does not apply | "Consequent upon" should be read as but-for causation; loss would not have occurred but for acceptance/shipment on fraudulent checks, so exclusion applies | Certified to the Texas Supreme Court for authoritative construction of "consequent upon" (no decision on merits) |
| If exclusion applies, whether UPS’s alleged errors are an independent cause that restores coverage | UPS errors are independent, separable causes, so exclusion should not bar coverage | UPS errors are concurrent/inseparable with the fraudulent payment cause, so exclusion bars coverage | Certified to the Texas Supreme Court contingent on answer to first question (no decision on merits) |
Key Cases Cited
- Guar. Nat’l Ins. Co. v. Vic Mfg. Co., 143 F.3d 192 (5th Cir. 1998) (insured must show potential coverage; insurer bears burden to prove an exclusion)
- JAW The Pointe, L.L.C. v. Lexington Ins. Co., 460 S.W.3d 597 (Tex. 2015) (distinguishes independent vs. concurrent causation for coverage/exclusions)
- Nat’l Union Fire Ins. Co. of Pittsburgh, Pa. v. Hudson Energy Co., 811 S.W.2d 552 (Tex. 1991) (ambiguities in insurance contracts construed in favor of the insured)
- Fiess v. State Farm Lloyds, 202 S.W.3d 744 (Tex. 2006) (policy provisions must be read in context; distinct phrases interpreted together)
- City of Gladewater v. Pike, 727 S.W.2d 514 (Tex. 1987) (cause-in-fact requires substantial factor and but-for causation principles)
