Texas Windstorm Insurance Association v. Dickinson Independent School District
561 S.W.3d 263
Tex. App.2018Background
- TWIA issued a named-perils windstorm/hail policy to Dickinson ISD (policy period Sept. 1, 2008–Sept. 1, 2009). Hurricane Ike made landfall Sept. 13, 2008; DISD later claimed storm-related damage.
- TWIA and DISD used the policy appraisal clause; an umpire and DISD appraiser signed an appraisal award totaling $10,815,967.43 (TWIA’s appraiser did not sign).
- DISD moved for partial summary judgment on causation and damages, relying solely on the Appraisal Award and the policy; the trial court granted those motions and excluded much of TWIA’s affirmative‑defense evidence.
- After a one‑issue jury trial (whether TWIA breached the policy by failing to pay the appraisal award), the jury found breach and the trial court entered judgment for DISD for about $9.6 million.
- On appeal TWIA challenged (1) the partial summary judgments on causation/damages, (2) exclusion of TWIA’s defense evidence, (3) the jury question/instructions, and (4) sufficiency of the evidence supporting breach/damages.
- The court of appeals held the trial court erred in granting DISD’s partial summary judgments because the Appraisal Award alone did not conclusively establish that the damages were caused by covered perils; it reversed and remanded for a new trial.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether appraisal award alone conclusively establishes causation and covered damages for summary judgment | Appraisal award fixed amount and causation (loss caused by wind); appraisal process resolved causation and damage so summary judgment on those elements is proper | Appraisal determines amount of loss only; it does not decide liability or segregate covered vs. non‑covered causes; evidence raised genuine fact issues about causation | Reversed partial summary judgments: appraisal award alone insufficient to conclusively prove causation/coverage; remand for further proceedings |
| Whether trial court erred by excluding TWIA’s evidence of affirmative defenses | (n/a at trial; DISD argued preclusive effect of summary judgments) | TWIA sought to introduce evidence that appraisal failed to segregate covered losses and included non‑covered items | Error to have excluded TWIA’s defenses given reversal of summary judgments; remand leaves defenses open |
| Whether the trial court’s single jury question was proper (charge/instructions) | Single question on breach was appropriate given summary‑judgment rulings that resolved causation/damages | Proposed charge would let jury decide coverage/appraisal validity and related issues | Not decided on merits; remanded so court can select appropriate charge when full evidentiary record is developed |
| Sufficiency of evidence to support breach/damages (legal sufficiency) | Appraisal award and trial verdict support breach and damages award | Evidence showed lack of proof that award items were caused by covered perils; trial record was circumscribed by erroneous summary judgments | Not resolved on appeal because trial proceeded under erroneous rulings; remand warranted so parties can fully develop evidence on coverage/causation |
Key Cases Cited
- State Farm Lloyds v. Johnson, 290 S.W.3d 886 (Tex. 2009) (appraisal resolves amount of loss but not liability; courts decide causation where multiple causes alleged)
- In re Universal Underwriters of Tex. Ins. Co., 345 S.W.3d 404 (Tex. 2011) (appraisal clauses resolve disputes about amount of loss)
- Sec. Nat’l Ins. Co. v. Waloon Inv., Inc., 384 S.W.3d 901 (Tex. App.—Houston [14th Dist.] 2012) (appraisal award alone does not determine breach; appraisal limited to damages)
- Paulson v. Fire Ins. Exch., 393 S.W.2d 316 (Tex. 1965) (insured must present evidence providing reasonable basis to estimate portion of damage caused by covered peril)
- Travelers Indem. Co. v. McKillip, 469 S.W.2d 160 (Tex. 1971) (concurrent‑causes principle: recoverable portion is that caused solely by covered peril)
- Farmers Group, Inc. v. Poteet, 434 S.W.3d 316 (Tex. App.—Fort Worth 2014) (issues involving multiple potential causes require segregation of covered and noncovered losses; appraisal does not eliminate that requirement)