Lead Opinion
delivered the opinion of the Court,
This case presents the question whether an insurer breaches its duty of good faith and fair dealing to its insured if it denies a claim for an invalid reason when there was at the time a valid reason for denial. The trial court granted summary judgment against the insureds on their policy claim holding that there was no coverage, but rendered judgment on the jury verdict for the insureds on their extra-contractual claims. The court of appeals affirmed, concluding that a finding of no liability on the policy action does not, as a matter of law, defeat an insured’s extra-contractual claim.
This case arises out of a multiple car accident in which the Stokers’ automobile struck the rear end of another vehicle. It is undisputed that an unidentified pickup truck dropped a load of furniture on the highway, causing a chain reaction collision. Also, it is undisputed that this truck was not struck by any of the vehicles involved in the collision. The Stokers had no collision insurance and, therefore, submitted a claim to recover under their uninsured/underinsured vehicle coverage with Republic.
Republic hired Southwest to investigate the Stokers’ claim. Southwest recommended that the uninsured motorist claim be denied because it concluded that Mrs. Stoker, who was the driver, was more than fifty percent at fault in causing the accident. A Republic senior claims examiner confirmed Southwest’s decision. Mrs. Stoker acknowledged at the trial of her bad faith claim that fault is an issue in recovering under the uninsured motorist coverage.
The Stokers’ policy provided uninsured motorist coverage for damages caused by an unidentified hit and run vehicle only if the vehicle hit the insureds’ car. The language of the policy is in accord with the requirements of the Insurance Code regarding uninsured motorist coverage. Tex.Ins.Code art. 5.06 — l(2)(d) (in order to recover under uninsured motorist coverage “actual physical contact must have occurred.”). Republic initially did not rely on the lack of physical contact with the pickup as a reason for denying the Stokers’ claim.
Following Republic’s denial of the uninsured motorist claim, the Stokers sued for breach of the insurance contract, breach of the duty of good faith and fair dealing, and violations of the Deceptive Trade Practices Act and article 21.21 of the Insurance Code. The Stokers predicated all their allegations against Republic and Southwest on the fact that the companies gave an invalid reason for denial of the Stokers’ claim — Mrs. Stoker’s alleged fault. Republic and Southwest responded with a motion for summary judgment, asserting that because there was no physical contact there was no coverage under the policy, and consequently, the Stokers had no contractual and extra-contractual claims as a matter of law.
The trial court granted summary judgment on the contract issue. However, it submitted the balance of the case to a jury that found that Republic and Southwest had breached their duty of good faith and fair dealing and violated the DTPA and article 21.21 of the Insurance Code. The statutory violations were premised solely on the Stokers’ bad faith claim. The trial court rendered judgment for the Stokers on the verdict. The court of appeals affirmed both the summary
The Stokers have not perfected an appeal to this Court of that portion of the court of appeals’ judgment affirming summary judgment on their policy claim. We therefore take it as established that the uninsured/un-derinsured motorist coverage in the Stokers’ policy does not cover their claim. Additionally, Southwest does not contend here that because it was merely Republic’s agent, it owed the Stokers no duty of good faith and fair dealing. See Natividad v. Alexsis, Inc.,
An insurer has a duty to deal fairly and in good faith with its insured in the processing and payment of claims. Arnold v. National County Mut. Fire Ins. Co.,
In affirming the trial court’s judgment, the court of appeals cited to our decision in Viles,
We stated in Viles: “Whether there is a reasonable basis for denial [of a claim] must be judged by the facts before the insurer at the time the claim was denied.” Id. at 567. This statement, does not support the Stokers’ claim in this case. Unlike the situation in Viles, the Stokers’ accident was never covered by their policy because there was no collision with the pickup truck. The facts compelling denial of the Stokers’ claim were in existence at the time of the denial. Republic and Southwest’s reliance on a different, perhaps erroneous, reason for denying coverage is not dispositive. What is disposi-tive is whether, based upon the facts existing at the time of the denial, a reasonable insurer would have denied the claim. Aranda,
An argument has been made that because a policy claim is independent of a bad faith claim, an insured may recover for a bad faith denial of a claim even if the claim is not covered by the policy. We accept the prem-
It is further argued that the Stokers should have been entitled to rely on Republic’s reason for denying their claim in deciding whether to file suit. The Stokers were no more persuaded by the coverage language than they were by Republic’s statement to them that Mrs. Stoker was mostly to blame for the accident. They vigorously contested both reasons for denial of their claim. The Stokers cannot preclude Republic from relying on a reason for denying their claim that existed at the time, even if it was not the reason Republic gave.
As a general rule there can be no claim for bad faith when an insurer has promptly denied a claim that is in fact not covered. See e.g., O’Malley v. United States Fidelity & Guar. Co.,
The Stokers’ claim fails because, as a matter of law, they cannot meet the first prong of the Aranda test. As all the Stokers’ causes of action are predicated on their bad faith allegation, they are not entitled to recover against defendants. Accordingly, the judgment of the court of appeals in favor of the Stokers is reversed, and judgment is rendered that the Stokers take nothing.
Notes
. Our attention has been particularly called to Deese v. State Farm,
Concurrence Opinion
concurring.
An insurance company has a duty to treat its policyholders fairly. This duty requires
In the present ease, there is no evidence that the insurer’s mishandling of the claim caused any damages to the insured. For that reason, I join in the Court’s judgment. I strongly disagree, however, with the language in the majority opinion suggesting that bad faith recovery may be dependent on the insurer’s contractual liability. Fine print in an insurance policy should not excuse an insurer from liability for damages caused by its slipshod handling of a claim.
I.
The evidence in this case supports the jury’s finding that Republic Insurance Company breached its duty of good faith and fair dealing by improperly investigating Linda Stoker’s claim. It does not, however, provide any support for the lower courts’ determination that Republic’s bad faith caused damages to the Stokers.
The three-car accident giving rise to the insurance claim occurred shortly after a truckload of furniture spilled out onto the highway. The driver of the truck did not stop, and was never identified. The Department of Public Safety officer who investigated the accident concluded in his report that the accident was caused by the unknown driver’s failure to secure the load of furniture.
Stoker’s car was damaged in the accident, and she submitted a claim to Republic for uninsured motorist coverage under her policy. Republic’s adjuster, Abraham Ponce, interviewed Stoker and looked at photographs she provided. Weeks later, after Stoker had repeatedly inquired as to the status of her claim, Ponce denied the claim solely on the ground that Stoker was more than fifty percent at fault in causing the accident.
At the time he denied the claim, Ponce had not received or reviewed the DPS accident report, spoken to the DPS officer, or visited the scene. Nor had he interviewed either of the other two drivers involved in the accident. Nor had he interviewed Stoker’s daughter, who was riding in the car at the time of the accident, or Stoker’s husband, who was driving immediately behind Stoker when the accident occurred. Evidently, Ponce had not even read Republic’s own insurance policy.
Months later, Republic’s Senior Claims Examiner confirmed by letter the company’s decision to deny Stoker’s claim. The letter again indicated that coverage was not available because Stoker was at fault.
After Stoker brought this suit, Republic offered a completely different justification for its denial of her claim: namely, that there was no direct contact between Stoker’s car and the truck that dumped the furniture. Based on this new defense, the trial court granted Republic’s motion for partial summary judgment on Stoker’s breach of contract claim. The case then proceeded to trial on her other claims, including bad faith.
At trial, the jury found that Republic had breached its duty of good faith and fair dealing and violated the Deceptive Trade Practices Act and article 21.21 of the Insurance Code. The jury also awarded the Stokers $1,975 for the reasonable and necessary costs of repairing their vehicle, and awarded Linda Stoker $5,000 for her mental anguish. The trial court rendered judgment on the jury verdict, and the court of appeals affirmed.
Republic and Southwest now argue that there is no evidence that the manner in which they investigated the claim was a proximate cause of damages to the Stokers. I agree.
The investigation of the claim clearly did not cause the damages to the Stokers’ vehicle; the Stokers would have incurred those same damages even if their claim had been investigated properly. With regard to Linda Stoker’s mental anguish, the entire proof consists of the following testimony:
Q [by the Stokers’ attorney]: What was your reaction to that denial?
A [by Linda Stoker]: I was very upset.
*343 Q: Why?
A: Because I felt like they were obligated to pay for the repairs to my car.
This exchange does not rise to the level of any evidence of compensable mental anguish. See Parkway Co. v. Woodruff,
The majority could have chosen to resolve the claim on this simple basis under existing law.
II.
A bad faith claim is not a claim for breach of contract; rather, it is based on a tort duty imposed by law. Chitsey v. National Lloyds Ins. Co.,
The special nature of this relationship is what led this Court to impose a duty of good faith and fair dealing in the first place. See Arnold v. National County Mut. Fire Ins. Co.,
Because the duty of good faith and fair dealing arises from the relationship between the parties, rather than the terms of the contract, a breach of the duty does not depend on a breach of the contract’s terms. The language of Arnold makes plain that an insurer may violate its duty of good faith and fair dealing, even when there is some reasonable basis for denial of a claim, if there is “a failure on the part of the insurer to determine whether there is any reasonable basis for the denial or delay.”
This Court reiterated this view just five years ago. See Viles v. Security Nat’l Ins. Co.,
The “special relationship” between the insured and insurer imposes on the insurer a duty to investigate claims thoroughly and in good faith, and to deny those claims only after an investigation reveals there is a reasonable basis to do so.
Id. at 568. This language, like the language of Arnold, makes plain that an insurer may be held liable for failure to conduct an adequate investigation — even if the claim ultimately proved to be invalid.
This Court made a similar point less than one year-ago, when we once again noted that a bad faith action “is separate from any cause of action for breach of the underlying insurance contract.” Transportation Ins. Co. v. Moriel,
We do agree ... that “[C]laims for insurance contract coverage are distinct from those in tort for bad faith; resolution of one does not determine the other.”
Moriel,
Courts in other jurisdictions have likewise held that recovery for bad faith does not depend on a breach of the insurance contract. In an opinion quoted at length in Moriel,
[T]he insurance contract and the relationship it creates contain more than the company’s bare promise to pay certain claims when forced to do so; implicit in the contract and the relationship is the insurer’s obligation to play fairly with its insured.
Rawlings v. Apodaca,
[T]he duty of good faith and fair dealing emanates from the special relationship of the parties to the insurance contract, not from the express or implied provisions contained in the contract. Therefore, it is the conduct of one party toward the other that is proscribed by the duty, even if such conduct is not elevated by the terms and provisions of the insurance policy to a contractual obligation.
Hatch v. State Farm, Fire and Cas. Co.,
III.
This Court’s previous decisions served to encourage insurers to handle all claims in a responsible manner. Today’s decision will encourage a different sort of conduct: it allows an insurer to deny a claim for any reason that comes to mind — without any investigation at all — as long as the insurer eventually finds some valid basis for denial.
The United States Supreme Court recently rejected a comparable effort to allow wrongdoers to escape liability for their conduct. See McKennon v. Nashville Banner Publishing Co., — U.S. -,
I would apply a similar analysis here. When an insurance company defends its misconduct on the basis of information discovered after the fact, an absolute rule barring any recovery undermines the objectives of the duty of good faith and fair dealing. The discovery of such information simply does not excuse the mishandling of the claim:
Once the bad faith has occurred, once the duty to use good faith in considering claims has been breached, the insurance company cannot later seek to justify its denial by gathering information which it should have had in the first place.
Aetna Life Ins. Co. v. Lavoie,
In the present case, Republic Insurance Company breached its duty by mishandling the Stokers’ claim, and its belated discovery of fine print in the policy should not immunize the company from all liability. I would adhere to existing law by holding Republic responsible for any damages caused by its misconduct. Because the present record contains no evidence of such damages, I join in the Court’s judgment; but I do not join in the majority’s unnecessary and unfortunate writing constricting the future recovery of bad faith damages.
. During oral argument on this cause, Petitioners’ counsel agreed that the damages issue is dispositive:
JUSTICE DOGGETT: ... [Without either disapproving, overruling, or qualifying Viles or Aranda, can your client not prevail in this case solely on the basis that there’s no evidence of damages?
ANSWER: Well, I think that — clearly that’s one of the points we've raised, Justice Doggett.
JUSTICE DOGGETT: You can get full and complete relief here on that basis, can't you?
ANSWER: Absolutely, because there's no distinct loss flowing from the acts of bad faith.
Oral argument of Joseph L. Hood, Counsel for Petitioners Republic Insurance Co. and Southwest Adjusting Services, October 19, 1994.
. The majority asserts that "none of the cases cited holds an insurer liable for denying a claim not covered by the policy.” Supra at 341. This is simply incorrect. For example, in Deese, an insured sought medical benefits that State Farm claimed were "not compensable under the terms of the insurance contract.”
