Evelyn V. Keyes, Justice.
In this insurance coverage dispute, relator, Liberty Insurance Corporation ("Liberty"), filed this petition for writ of mandamus seeking to vacate the trial court's order denying Liberty's motion to compel appraisal.
We conditionally grant the petition for writ of mandamus.
Liberty issued an insurance policy, effective March 5, 2013, to Hallbeck that provided coverage for his home located in Cypress ("the Policy"). Among other provisions, the Policy included the following appraisal clause:
The Policy also included a provision stating, "A waiver or change of a provision of this policy must be in writing by us to be valid."
On June 6, 2013, a storm hit the Cypress area. Hallbeck filed a claim with Liberty
Hallbeck filed the underlying proceeding against Liberty in December 2014, asserting causes of action for breach of contract, violations of the Insurance Code, and violations of the Deceptive Trade Practices Act. In a demand letter, Hallbeck specified that he sought $62,325.88 in actual damages, $3,900 in expenses, and $30,000 in attorney's fees.
Liberty answered and asserted a general and specific denial, as well as several affirmative defenses. Liberty also expressly reserved its appraisal rights, stating: "By appearing and answering herein, Defendant does not waive, and expressly reserves[,] its right under the policy to demand an appraisal for determination of the actual cash value and the amount of loss with respect to the property damage claims of the Plaintiff asserted in this lawsuit." Liberty also responded to Hallbeck's demand letter and stated, "Nothing herein should be considered a waiver of Defendant's right to [invoke] appraisal in this matter."
After an unsuccessful attempt to mediate this dispute, Liberty sent Hallbeck a letter on April 2, 2015, invoking the appraisal clause in the Policy. This letter informed Hallbeck of the person Liberty had chosen as its appraiser and requested that he appoint his own appraiser within twenty days.
When Hallbeck did not appoint his own appraiser, Liberty moved the trial court to abate the proceedings and compel appraisal. Liberty argued that the appraisal clause in the Policy required the parties, upon written demand, to submit to the appraisal process when the parties fail to agree on the "amount of loss." Liberty contended that the appraisal clause was satisfied in this case because Hallbeck made a claim under the Policy that the damage to his house was caused by a covered event but Liberty disagreed and determined that the storm did not cause the damage to Hallbeck's house. Liberty argued that Texas courts routinely enforce appraisal clauses and require insureds to participate in the appraisal process when invoked by the insurer, and it argued that the Texas Supreme Court has held that appraisal clauses should be enforced even when the insurer has already denied the claim and a dispute over coverage exists because the insurer could be wrong about coverage. Liberty argued that it did not waive its right to enforce the appraisal clause when it denied Hallbeck's claim.
Hallbeck responded to Liberty's motion to compel appraisal and argued that Liberty waived its right to enforce the appraisal clause when it denied his claim. Hallbeck argued that the parties did not disagree over the "amount of loss" because Liberty denied that a "loss" under the Policy occurred at all.
The trial court denied Liberty's motion to compel appraisal. The trial court did not specify the reasons for its decision in the order. This mandamus proceeding followed.
Generally, to be entitled to mandamus relief, the relator must demonstrate
Appraisal clauses are commonly found in homeowners' insurance policies and "provide a means to resolve disputes about the amount of loss for a covered claim." In re Universal Underwriters of Tex. Ins. Co., 345 S.W.3d 404, 406-07 (Tex. 2011) (orig.proceeding); Johnson, 290 S.W.3d at 888-89 ("Virtually every property insurance policy for both homeowners and corporations contains a provision specifying `appraisal' as a means of resolving disputes about the `amount of loss' for a covered claim."); Franco v. Slavonic Mut. Fire Ins. Ass'n, 154 S.W.3d 777, 786 (Tex. App.-Houston [14th Dist.] 2004, no pet.) ("The effect of an appraisal provision is to estop one party from contesting the issue of damages in a suit on the insurance contract, leaving only the question of liability for the court."). Absent illegality or waiver, these clauses are generally enforceable. In re Universal Underwriters, 345 S.W.3d at 407; In re Slavonic Mut. Fire Ins. Ass'n, 308 S.W.3d 556, 559 (Tex. App.-Houston [14th Dist.] 2010, orig. proceeding) ("Where an insurance contract mandates appraisal to resolve the parties' dispute regarding the value of a loss, and the appraisal provision has not been waived, a trial court abuses its discretion and misapplies the law by refusing to enforce the appraisal provision."). "Appraisals can provide a less expensive, more efficient alternative to litigation, and ... they `should generally go forward without preemptive intervention by the courts.'" In re Universal Underwriters, 345 S.W.3d at 407 (quoting Johnson, 290 S.W.3d at 895).
Although the Texas Supreme Court has rarely addressed the issue of waiver of an appraisal clause, it has held:
Id. (quoting Scottish Union & Nat'l Ins. Co. v. Clancy, 71 Tex. 5, 8 S.W. 630, 632 (Tex.1888)). Waiver requires intent: either the intentional relinquishment of a
Here, the facts are undisputed. Hallbeck submitted a claim for property damage to Liberty. After an adjuster inspected the property, Liberty sent Hallbeck a letter in which it stated,
This letter also included a statement that the letter "should not be construed as a waiver or estoppel of any of the terms, conditions or defenses afforded by the policy or applicable law." Hallbeck sent a demand letter to Liberty and filed suit against Liberty for breach of contract and DTPA violations. Liberty reserved its right to invoke the appraisal process in both its original answer and in its response to Hallbeck's demand letter. After the parties attempted mediation, Liberty invoked the appraisal clause of the Policy. Hallbeck did not select an appraiser or participate in this process, and Liberty moved the trial court to compel an appraisal.
Liberty cites the Texas Supreme Court's decision in Johnson for the proposition that its denial of Hallbeck's claim did not amount to waiver of its appraisal rights under the Policy. In that case, after Johnson filed a claim under her homeowners' insurance policy, an adjuster for her insurance company, State Farm, determined that covered damage occurred, but that the repair costs were lower than the policy's nearly-$1,500 deductible. Johnson, 290 S.W.3d at 887. Johnson's roofing contractor, on the other hand, determined that the entire roof needed to be replaced and that the replacement cost would be in excess of $13,000. Id. Johnson requested an appraisal under the terms of her policy. Id. State Farm refused to participate, "asserting that the parties' dispute concerned causation and not `amount of loss.'" Id. at 888. Johnson filed a declaratory judgment seeking to compel appraisal. Id. The trial court granted summary judgment in favor of State Farm, ruling that no appraisal was warranted. Id. The Texas Supreme Court granted review "to decide whether the dispute here fell within the scope of this appraisal clause." Id.
The supreme court noted that appraisers "must always consider causation, at least as an initial matter" and that "[a]ny appraisal necessarily includes some causation element, because setting the `amount of loss' requires appraisers to decide between damages for which coverage is claimed from damages caused by everything else," such as normal wear and tear or a non-covered peril. Id. at 893. Thus, the court held that State Farm could not "avoid appraisal at this point merely because there might be a causation question that exceeds the scope of appraisal." Id. The court also noted that appraisals are intended to take place before suit is filed and that "in most cases appraisal can be structured in a way that decides the amount of loss without deciding any liability questions." Id. at 894. The court stated:
Id. (emphasis added). The court concluded, "But unless the `amount of loss' will never be needed (a difficult prediction when litigation has yet to begin), appraisals should generally go forward without preemptive intervention by the courts." Id. at 895.
Hallbeck cites the Amarillo Court of Appeals' decision in In re Acadia Insurance Co. for the proposition that "[i]t is clear that denying coverage under an insurance policy does, in fact, waive the right of the insurer to request an appraisal." 279 S.W.3d 777, 780 (Tex.App.-Amarillo 2007, orig. proceeding). However, as Liberty points out, the Amarillo Court decided In re Acadia Insurance Co. before the Texas Supreme Court issued Johnson, which recognized that appraisals may be helpful even after the insurer has denied the claim. See 290 S.W.3d at 894 ("When an insurer denies coverage, appraisers can still set the amount of loss in case the insurer turns out to be wrong. And when the parties disagree whether there has been any loss at all, nothing prevents the appraisers from finding `$0' if that is how much damage they find.").
The Texas Supreme Court has emphasized that "`[w]aiver requires intent, either the intentional relinquishment of a known right or intentional conduct inconsistent with claiming that right.'" In re Universal Underwriters, 345 S.W.3d at 407 (quoting In re Gen. Elec. Capital Corp., 203 S.W.3d at 316). Here, this case involves a dispute over causation, with Hallbeck claiming that the June 2013 storm damaged his property and Liberty expressing its belief that Hallbeck did not suffer any storm-related damages. Although Liberty denied Hallbeck's claim, Liberty also reserved its appraisal rights in multiple letters to Hallbeck and in filings with the trial court. See In re Slavonic Mut. Fire Ins. Ass'n, 308 S.W.3d at 562 ("In addition, shortly after the claim was filed in 2008, Slavonic sent the [homeowners] written notice that it did not waive its rights in a reservation of rights letter quoted above. This action clearly demonstrated Slavonic's intent not to waive its right to appraisal."). In the letter denying Hallbeck's claim for damages, Liberty stated, "This letter should not be construed as a waiver or estoppel of any of the terms, conditions or defenses afforded by the policy or applicable law." Similarly, in its response to Hallbeck's demand letter, Liberty stated, "Nothing herein should be considered a waiver of Defendant's right to [invoke] appraisal in this matter." Liberty also expressly reserved its right to invoke the appraisal process in its original answer: "By appearing and answering herein, Defendant does not waive, and expressly reserves[,] its right under the policy to demand an appraisal for determination of the actual cash value and the amount of loss with respect to the property damage claims of the Plaintiff asserted in this lawsuit." Liberty then participated in an unsuccessful mediation before invoking its right to appraisal.
We conclude that the trial court abused its discretion by denying Liberty's motion to compel appraisal and that Liberty has no adequate appellate remedy to correct this error. See In re Allstate Cnty. Mut. Ins. Co., 85 S.W.3d at 196 (holding that "[a] refusal to enforce the appraisal process here will prevent the defendants from obtaining the independent valuations that could counter at least the plaintiffs' breach of contract claims" and that trial court's error "denies the development of proof going to the heart of a party's case and cannot be remedied by appeal").
We sustain Liberty's sole issue.
We conditionally grant Liberty's petition for writ of mandamus. We order the trial court to vacate its October 16, 2015 order denying Liberty's motion to compel appraisal. The writ will only issue if the trial court fails to do so.