Allstate Ins. Co. v. Irwin

• Decision Date: 21 May 2021
• Docket Number: No. 19-0885,19-0885
• Citation: 627 S.W.3d 263
• Court: Texas Supreme Court
• Parties: ALLSTATE INSURANCE COMPANY, Petitioner v. Daniel Wes IRWIN, Respondent

627 S.W.3d 263

ALLSTATE INSURANCE COMPANY, Petitioner

v.Daniel Wes IRWIN, Respondent

No. 19-0885

Supreme Court of Texas.

Argued January 7, 2021

Opinion Delivered: May 21, 2021

Lisa Ann Songy, Beth D. Bradley, Dallas, Matthew P. Rigney, for Amici Curiae American Property Casualty Insurance Association, Insurance Council of Texas, National Association of Mutual Insurance Companies.

Scot Graves Doyen, Dale Wainwright, Charles R. ‘Skip’ Watson Jr., Austin, for Amicus Curiae Farmers Texas County Mutual Insurance Company.

Michael DeNuccio, San Antonio, for Amicus Curiae Defense Counsel of San Antonio.

Jim M. Perdue Jr., Houston, Steven R. Samples, for Amicus Curiae Texas Trial Lawyers Association.

Melissa A. Lorber, Austin, for Amicus Curiae State Farm Mutual Automobile Insurance Company.

Amber Winer-Gebhart, Thomas Andrew Crosley, San Antonio, Shawn Mechler, for Respondent.

Jacquelyn Ann Chandler, Dallas, Wallace B. Jefferson, Austin, William J. Boyce, Rachel Anne Ekery, Houston, Roger Higgins, Dallas, Elizabeth Lee Thompson, Houston, John M. Causey, Conroe, for Petitioner.

Justice Devine delivered the opinion of the Court, in which Justice Lehrmann, Justice Boyd, Justice Blacklock, and Justice Busby joined.

Underinsured motorists have liability insurance but not enough to pay for all the damage they have caused. Underinsured motorist coverage is insurance designed to fill the gap between the insured's damages from an accident and the other driver's ability to pay. Sounds simple enough, but presenting a claim to your insurance carrier for underinsured motorist benefits is not like other claims under an automobile liability insurance policy.

In Brainard v. Trinity Universal Insurance Co. , we held that an underinsured motorist (UIM) carrier "is under no contractual duty to pay benefits until the insured obtains a judgment establishing the liability and underinsured status of the other motorist." 216 S.W.3d 809, 818 (Tex. 2006). If not otherwise determined, however, a judgment establishing these prerequisites to coverage may be obtained in a direct action against the insurance carrier. See id. (citing State Farm Mut. Auto. Ins. Co. v. Matlock , 462 S.W.2d 277, 278 (Tex. 1970) ). The question here is whether an insurance carrier's liability for benefits under the UIM policy may be established in a declaratory judgment action. See TEX. CIV. PRAC. & REM. CODE §§ 37.001 –.011. The court of appeals determined that the Uniform Declaratory Judgments Act can be used for this purpose and affirmed the trial court's judgment to the same effect. 606 S.W.3d 774 (Tex. App.—San Antonio 2019). We agree and affirm as well.

I

On April 5, 2016, Daniel Irwin was injured in a vehicular accident with an underinsured motorist. At the time of the accident, Allstate Insurance Company insured Irwin's truck. Irwin's policy included UIM coverage up to $50,000. Irwin settled with the other driver for her $30,000 policy limits, and followed the settlement with a letter to Allstate, seeking his UIM policy limits of $50,000. Allstate offered to settle for $500. Believing Allstate's offer inadequate, Irwin sued. In this direct action against his UIM carrier, Irwin sought a determination of his damages from the accident, a declaratory judgment that he was entitled to recover under his UIM policy, and attorney's fees. Irwin's pleadings invoked the Uniform Declaratory Judgments Act (UDJA) for all relief.

Allstate's answer denied Irwin's claim to UIM benefits under the policy, both generally and specifically, and demanded a jury trial. Before trial commenced, the parties stipulated to Irwin's coverage under the UIM policy and to Allstate's entitlement to an offset from Irwin's $30,000 settlement with the other driver. The case was tried to a jury, with Allstate contesting Irwin's evidence of causation and damages.

The jury found Irwin's damages from the accident to be $498,960.36. This sum included his medical expenses, physical pain and mental anguish, physical impairment, and lost earnings. Irwin moved for entry of judgment. Allstate objected to Irwin's proposed judgment insofar as it awarded attorney's fees or invoked the UDJA, but otherwise agreed that it owed its UIM policy limits and court costs, both of which it tendered to Irwin. The trial court's judgment acknowledged Allstate's payment of its policy limits and court costs and awarded Irwin his attorney's fees.

Allstate appealed the award of attorney's fees. The court of appeals affirmed the award, holding that the UDJA was properly invoked to determine Irwin's entitlement to UIM benefits under the policy and a proper basis for the award of attorney's fees. 606 S.W.3d at 778–80. Allstate appeals, complaining that Irwin's use of the UDJA to determine his contractual rights and to seek attorney's fees in a UIM case impermissibly circumvents this Court's decision in Brainard.

II

Brainard was a vehicular accident case that involved a similar underinsured motorist claim. As in this case, the insured sought UIM benefits from his insurance carrier after settling for the other driver's policy limits. Brainard , 216 S.W.3d at 811. The insured settled his tort claim before obtaining a judgment against the third-party tortfeasor. Id. at 811–12. Because there had been no determination of liability and damages in the underlying tort case, the carrier declined to pay the UIM claim. Id. at 811. The insured sued for breach of contract. In the ensuing lawsuit, a jury determined liability and damages in the underlying tort case. Id. at 812. Based on the jury's findings as to the third-party tortfeasor's liability and the insured's damages, the trial court rendered judgment for the insured, awarding UIM benefits under the policy and attorney's fees under Chapter 38 of the Civil Practice and Remedies Code. Id. ; see TEX. CIV. PRAC. & REM. CODE § 38.001(8) (authorizing the recovery of attorney's fees in a successful breach-of-contract suit).

In the appeal that followed, we reversed the award of attorney's fees, observing that the insurance carrier had not breached the policy by refusing to pay UIM benefits, absent the prerequisites for payment. Brainard , 216 S.W.3d at 818. We reasoned that the carrier was under no legal obligation to pay those benefits until the insured obtained a judgment establishing the liability and underinsured status of the other motorist. Id. Until those determinations are made, we explained, "no contractual duty to pay" arises and "no just amount [is] owed." Id. And, without a liquidated amount due under the contract, no basis existed for an award of attorney's fees under Chapter 38. Id. at 819. In passing, however, we noted that the insured is not required to litigate these issues against the third-party tortfeasor, but may instead settle the tort claim and litigate UIM coverage with the insurer. Id. at 818.

Brainard does not explain what form this litigation should take beyond commenting on the unique nature of the UIM contract, which conditions benefits "upon the insured's legal entitlement to receive damages from a third party." Id. UIM claims are, of course, "contractual in nature." Allstate Ins. Co. v. Bonner , 51 S.W.3d 289, 291 (Tex. 2001). "[A]lthough ultimate recovery in this type of action depends upon proof of damages due to the tort of an uninsured [or underinsured] third party, the cause of action against the insurer arises by reason of the written contract." Franco v. Allstate Ins. Co. , 505 S.W.2d 789, 791–92 (Tex. 1974). Thus, the litigation between the insured and his carrier is on the UIM contract but not for its breach, which cannot occur until the underlying conditions precedent of liability and damages are established. Brainard , 216 S.W.3d at 814–15.

Since our decision in Brainard , several courts have concluded that a declaratory judgment action is the appropriate remedy for determining the underlying tort issues that control the validity of an insured's UIM claim against his insurer. See, e.g., In re State Farm Mut. Auto. Ins. Co. , No. 01-19-00821-CV, 2020 WL 1264184, at *2 (Tex. App.—Houston [1st Dist.] Mar. 17, 2020, orig. proceeding) ; Allstate Fire & Cas. Ins. Co. v. Inclan , No. 13-19-00026-CV, 2020 WL 373061, at *2–3 (Tex. App.—Corpus Christi–Edinburg Jan. 23, 2020, pet. filed) (mem. op.); Allstate Ins. Co. v. Jordan , 503 S.W.3d 450, 455–56 (Tex. App.—Texarkana 2016, no pet.) ; Ochoa v. Allstate Fire & Cas. Ins. Co. , No. SA-20-CV-319-XR, 2020 WL 2129252, at *2 (W.D. Tex. May 5, 2020) ; Vasquez v. Liberty Mut. Fire Ins. Co. , No. 7:18-CV-44, 2018 WL 8805014, at *2–3 (S.D. Tex. Sept. 9, 2018) ; Woods v. Argonaut Midwest Ins. Co. , No. 6:15-CV-139, 2016 WL 3653518, at *5 (E.D. Tex. Mar. 18, 2016) ; Borg v. Metro. Lloyd's of Tex. , No. W:12-CV-256, 2013 WL 12091651, at *2 (W.D. Tex. Feb. 21, 2013).

III

Allstate contends that Irwin is not entitled to an award of attorney's fees in this case because it did not breach its contractual duty to pay UIM benefits. Allstate notes that "[n]either requesting UIM benefits nor filing suit against the insurer triggers a contractual duty to pay." Brainard , 216 S.W.3d at 818. Thus, Irwin did not establish his legal entitlement to policy benefits and trigger Allstate's duty to pay before proving the existence of liability and damages attributable to the underinsured motorist in the direct action. Because it promptly paid Irwin's UIM benefits after the jury verdict, Allstate maintains that it has satisfied its legal obligations and left no declaration for the court to pronounce. Allstate concludes that the UDJA therefore does not apply and that Irwin has improperly invoked it simply to collect his attorney's fees.

Irwin responds that, after Allstate failed to make a reasonable adjustment of his UIM claim, his only recourse was to sue and bind Allstate to a judgment that established the underlying conditions precedent to his UIM coverage. See id. (recognizing the unique character of the UIM contract, which conditions benefits on the ...