34 F.4th 496
5th Cir.2022Background
- Overstreet bought homeowner’s insurance covering wind and hail; his roof was ~3 years old at purchase.
- Multiple hailstorms occurred: earlier storms (0.75" hail) before the policy and a severe June 6, 2018 storm (1.25" hail) after the policy began; Overstreet’s roof began leaking immediately after June 6.
- Allstate’s adjuster estimated loss at $1,263.23 (below the deductible), so no payment; Overstreet’s expert (Earle) attributed the observed damage to the June 6 storm.
- Allstate argued most damage was caused by preexisting wear/earlier hail (excluded), while Overstreet argued the covered June 6 hail was the sole cause.
- The district court granted summary judgment for Allstate, concluding concurrent causation applied and Overstreet failed to segregate covered from non-covered damage; Overstreet appealed.
- The Fifth Circuit concluded Texas law leaves key questions unresolved and certified three questions to the Texas Supreme Court rather than deciding the issues itself.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| 1. Does the concurrent causation doctrine apply when any non-covered damage (including wear and tear) exists even if that preexisting damage did not directly cause the particular loss? | Overstreet: No; minor or noncausal preexisting wear should not trigger apportionment when the covered peril itself produced the loss. | Allstate: Yes; any non-covered preexisting damage triggers the doctrine and requires apportionment. | Unresolved by Fifth Circuit — certified to the Texas Supreme Court. |
| 2. If doctrine applies, must a plaintiff who alleges a covered peril alone caused the loss bear the burden to attribute losses between covered and non-covered perils? | Overstreet: He alleged the covered storm caused the entire loss; he should not be required to apportion when evidence supports sole causation. | Allstate: Yes; insured bears burden to segregate and prove the portion caused solely by the covered peril. | Unresolved — certified to the Texas Supreme Court. |
| 3. If the plaintiff bears that burden, can the plaintiff meet it by presenting evidence that the covered peril caused 100% of the loss (i.e., implicitly attributing full loss to the covered peril)? | Overstreet: Yes; evidence that the covered storm solely caused the damage satisfies the segregation burden. | Allstate: No; courts require affirmative apportionment and may reject implicit 100% attribution absent specific allocation. | Unresolved — certified to the Texas Supreme Court. |
Key Cases Cited
- Lyons v. Millers Cas. Ins. Co. of Texas, 866 S.W.2d 597 (Tex. 1993) (primary Texas case articulating concurrent causation rule requiring segregation of covered and noncovered losses).
- Fiess v. State Farm Lloyds, 392 F.3d 802 (5th Cir. 2004) (discusses segregation requirement and certified a question to Texas Supreme Court in related context).
- Frymire Home Servs., Inc. v. Ohio Sec. Ins. Co., 12 F.4th 467 (5th Cir. 2021) (recent similar Fifth Circuit decision that certified identical questions to the Texas Supreme Court).
- Wallis v. United Servs. Auto. Ass’n, 2 S.W.3d 300 (Tex. App.—San Antonio 1999) (holds apportionment required when noncovered damage exists).
- Southland Lloyds Ins. Co. v. Cantu, 399 S.W.3d 558 (Tex. App.—San Antonio 2011) (treats concurrent causation as a fact question for the jury in some circumstances).
- State Farm Fire & Cas. Co. v. Rodriguez, 88 S.W.3d 313 (Tex. App.—San Antonio 2002) (treats concurrent causation as fact issue when record lacks allocation findings).
- Utica Nat. Ins. Co. of Tex. v. Am. Indem. Co., 141 S.W.3d 198 (Tex. 2004) (explains need for finder-of-fact determinations to resolve concurrent-cause disputes).
