CourtListener 10856260•In Re Ace American Insurance Company; Endurance American Specialty Insurance Company; Guideone National Insurance Company; Certain Underwriters at Lloyd's, London and Company Market, Subscribing to Policy No. Ptnam2206330; Starstone Specialty Insurance Company; Starr Specialty Lines Insurance Agency, LLC; And Shelf Opco Bermuda Ltd. for and on Behalf of Fidelis Insurance Bermuda Ltd.
In Re Ace American Insurance Company; Endurance American Specialty Insurance Company; Guideone National Insurance Company; Certain Underwriters at Lloyd's, London and Company Market, Subscribing to Policy No. Ptnam2206330; Starstone Specialty Insurance Company; Starr Specialty Lines Insurance Agency, LLC; And Shelf Opco Bermuda Ltd. for and on Behalf of Fidelis Insurance Bermuda Ltd.
CourtListener 10856260Tex8 mag 2026
Testo completo
Supreme Court of Texas
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No. 25-0461
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In re ACE American Insurance Company; Endurance American
Specialty Insurance Company; GuideOne National Insurance
Company; Certain Underwriters at Lloyd’s, London and
Company Market, Subscribing to Policy No. PTNAM2206330;
StarStone Specialty Insurance Company; Starr Specialty Lines
Insurance Agency, LLC; and Shelf OPCO Bermuda Ltd. for and
on behalf of Fidelis Insurance Bermuda, Ltd.,
Relators
═══════════════════════════════════════
On Petition for Writ of Mandamus
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Argued February 10, 2026
JUSTICE LEHRMANN delivered the opinion of the Court.
Appraisal clauses in insurance policies “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, 407 (Tex. 2011).
In this mandamus proceeding involving an insured’s claim under a
property-insurance policy, we are asked whether the trial court abused
its discretion in denying the insurers’ motion to compel appraisal under
the policy’s appraisal provision. The insured resists appraisal, largely
on the ground that the underlying dispute is about coverage, not the
“amount of loss.” While we do not rule out the existence of coverage
disputes, the record amply demonstrates that the parties’
disagreements are at least in part about the amount of loss. At this
stage of the proceedings, we see no basis on which to prohibit an
appraisal in the first instance. We therefore grant relief.
I. Background
Insured owns, leases, and manages commercial properties
nationwide. 1 During the relevant time period (March 1, 2022, to
March 1, 2023), Insurers collectively insured those properties via
various commercial-property policies. 2 The insured property at issue
here is a food-distribution warehouse in Dallas.
On June 12, 2022, a water line that supplied the warehouse’s
fire-suppression system ruptured below the building’s concrete slab,
causing considerable damage. Insured timely notified Insurers of the
claim. Insurers retained an independent adjuster to investigate the
claim, though Insured maintains that the adjuster’s involvement has
1 The parties use “Insured” to collectively describe three related
entities—Teachers Insurance and Annuity Association of America, Nuveen
Alternatives Advisors, LLC, and USCIF Pinnacle Building B LLC—all of
which are defendants in the underlying suit and real parties in interest here.
We will do the same.
2 Insurers include ACE American Insurance Company; Endurance
American Specialty Insurance Company; GuideOne National Insurance
Company; Certain Underwriters at Lloyd’s, London and Company Market,
Subscribing to Policy No. PTNAM2206330; StarStone Specialty Insurance
Company; Starr Specialty Lines Insurance Agency, LLC; and Shelf OPCO
Bermuda Ltd. for and on behalf of Fidelis Insurance Bermuda, Ltd. Insurers
are all plaintiffs in the underlying proceeding and relators here. We refer to
the related insurance policies collectively as the policy.
2
been “minimal” and that it “made a conscious choice to sit on the
sidelines.” Insured also asserts that no claim manager visited the site
until long after the repair work was completed.
The insurance policy contains an appraisal provision authorizing
either party to “make written demand for an appraisal of the loss” in the
event that the parties “disagree on the amount of loss.” 3 On January 30,
2023, Insurers sent Insured a letter invoking their right of appraisal
3 The provision states in full:
As respects physical loss or damage to covered property, if the
[Insurer] and the Insured disagree on the amount of loss, either
may make written demand for an appraisal of the loss. As
respects any Time Element loss, if the [Insurer] and the Insured
disagree on the amount of net income and operating expense or
the amount of loss, either may make written demand for an
appraisal of the loss.
In this event, each party will select a competent and impartial
appraiser and notify the other of the appraiser selected within
20 days of such demand. The two appraisers will select an
umpire. If they cannot agree within 15 days upon such umpire,
either may request that selection be made by a judge of a court
having jurisdiction. Each appraiser will state the amount of
loss. If they fail to agree, they will submit their differences to
the umpire. A decision agreed to by any two will be binding as
to the amount of loss.
Each party will:
a. Pay its chosen appraiser; and
b. Bear the other expenses of the appraisal and umpire equally.
If there is an appraisal:
a. The Insured will still retain its right to bring a legal action
against the [Insurer], subject to the provisions of the Legal
Action Against The [Insurer] condition; and
b. The [Insurer] will still retain its right to deny the claim.
3
under the policy because, despite “certain undisputed payments” having
been made, “the parties are at an impasse with respect to the remaining
scope of damage and costs related to the Claim.” Insured declined to
participate in the appraisal process, asserting it was “premature and
unwarranted.” The parties then entered into a standstill agreement and
engaged in further negotiations but were unable to reach a resolution.
Accordingly, on June 14, 2024, Insurers sent a letter “reaffirm[ing] their
demand for appraisal.” Insured refused.
Insurers then filed suit and moved to compel appraisal, alleging
that the parties disagreed on the amount of loss. Specifically, Insurers
asserted that they “have paid the Insured all that is owed under the
[policy] in connection with the claim” but that “Insured is of the position
that additional funds are owed.” Insured counterclaimed for breach of
contract, Insurance Code violations, bad faith, and a declaratory
judgment, alleging among other things that Insurers “refus[e] to pay
what they owe,” failed to conduct a reasonable investigation, and
invoked appraisal to “coerce [Insured] into accepting [a] lowball
[settlement] offer.” The trial court denied Insurers’ motion to compel
appraisal. Insurers filed a petition for writ of mandamus in the court of
appeals, which denied relief.
II. Analysis
Appraisal clauses “are uniformly included in most forms of
property insurance policies.” State Farm Lloyds v. Johnson, 290 S.W.3d
886, 888 (Tex. 2009). Such clauses provide a means for insurers and
insureds to resolve disputes about the “amount of loss” for a covered
claim. Id. They are “generally enforceable, absent illegality or waiver.”
4
Universal Underwriters, 345 S.W.3d at 407. In Johnson, we reaffirmed
that appraisal is limited to damages and does not extend to determining
an insurer’s liability under the policy: “[t]he policy directs the appraisers
to decide the ‘amount of loss,’ not to construe the policy or decide
whether the insurer should pay.” 290 S.W.3d at 890.
Mandamus relief is appropriate to enforce an appraisal clause.
Universal Underwriters, 345 S.W.3d at 412 (explaining that erroneously
denying appraisal “would vitiate the insurer’s right to defend [the
insured’s] breach of contract claim”). However, Insured argues that
Insurers are not entitled to an appraisal here for several reasons. First,
Insured asserts that the parties’ disagreement centers not on the
amount of loss but on threshold issues of coverage, causation, and “the
very existence” of damage. Second, Insured argues that there is no
genuine disagreement about the amount of loss, as is necessary to
trigger the right to demand appraisal, because Insurers have yet to
clearly state their position on that issue. Finally, Insured contends that
Insurers engaged in a pattern of bad-faith, “coverage-avoiding conduct”
during the adjustment process, thereby excusing Insured from the
obligation to comply with the policy’s appraisal provision. We address
these arguments in turn.
A. Scope of Appraisal: Coverage vs. Amount of Loss
We begin with a discussion of Johnson, in which we provided
guidance on evaluating whether a disagreement between an insurer and
an insured falls within the scope of an appraisal clause. See 290 S.W.3d
at 891–94. In that case, a hailstorm damaged Johnson’s roof, and the
parties disputed the extent of the damage, with State Farm asserting
5
that only the ridgeline needed repairing at an estimated cost of $500 and
Johnson asserting that the entire roof needed replacing at a cost of more
than $13,000. Id. at 887. Johnson demanded appraisal, but State Farm
refused, asserting that the parties’ dispute concerned causation and not
“amount of loss.” Id. at 887–88. Johnson sued for a declaratory
judgment compelling appraisal. Id. The trial court granted summary
judgment for State Farm, but the court of appeals reversed and rendered
judgment compelling State Farm to participate in the appraisal process.
Id. at 888, 895. We affirmed, agreeing with the court of appeals that
appraisal was required. Id. at 895.
In so holding, we reaffirmed that appraisal binds the parties to
have the extent or amount of loss determined in a particular way, but
the question of liability remains for the courts. Id. at 890. The dispute
in Johnson was not about what caused the property damage—the record
indicated nothing other than hail, which the policy covered. Id. at 891.
Instead, the parties essentially disputed how many shingles were
damaged and needed replacing, which was a question for the appraisers
because it necessarily affected the replacement cost and, in turn, the
amount of loss. Id. Similarly, we held that the extent to which damaged
property may be repaired or should be replaced is an “amount of loss”
question. Id. Moreover, we explained, separating loss due to a covered
event from a property’s preexisting condition is a task for the appraisers.
Id. at 892–93 (citing Gulf Ins. Co. v. Pappas, 73 S.W.2d 145 (Tex.
App.—San Antonio 1934, writ ref’d)).
In sum, “[a]ny appraisal necessarily includes some causation
element, because setting the ‘amount of loss’ requires appraisers to
6
decide between damages for which coverage is claimed from damages
caused by everything else.” Id. at 893. Further, the fact that an
appraisal may “turn[] out to involve not just damage but [also] liability
questions . . . does not mean appraisal should be prohibited as an initial
matter.” Id. (emphasis added). Accordingly, “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. Johnson thus demonstrates that
a party who seeks to avoid appraisal in the first instance on the ground
that the dispute falls outside the scope of the appraisal provision, as
Insured does here, must clear a significant hurdle.
Applying those principles, we hold that the parties’ dispute is at
least in part about the amount of loss and that potential coverage
disputes do not defeat a contractual right to appraisal. Insurers do not
argue, and the record does not reflect, that the claimed property damage
was caused by anything other than the water-main rupture, a covered
peril. Instead, Insurers largely contend that Insured spent more than
was necessary to return the warehouse to its pre-flood state and is trying
to recover those allegedly inflated costs.
For example, Insurers have paid Insured approximately
$1.2 million to remediate mold damage, which they contend is the
appropriate value of the mold claim, while Insured contends that it is
entitled to the policy’s full mold sublimit of $10 million. Regardless of
who is right, that dispute is over the amount of loss.
Insured asserts that the mold issue implicates coverage because
Insurers have taken the position that further payments for mold
7
damage hinge on whether another, unrelated insurance policy also
provides mold coverage. That argument fails for two reasons. First, the
record indicates that Insurers’ position, at least throughout the court
proceedings, has been that they value the mold claim at $1.2 million, the
amount already paid. In that case, the possibility of additional coverage
from other insurers has no bearing on whether Insurers must pay more.
Second, any disagreement about allocation of mold losses does not
render the “amount of loss” portion of the dispute irrelevant. Once the
appraisers value the loss stemming from mold damage, any disputes
about allocation of that loss among insurers can be resolved by the court.
Insured also asserts that the parties disagree about whether the
mold-remediation work should have been performed on a
time-and-materials basis rather than the fixed price provided by the
contractor whose bid Insured accepted. We fail to see how that
disagreement amounts to a coverage dispute. Ultimately, the parties
disagree about the cost of remediating the mold damage caused by the
water-main rupture. That is squarely an issue for the appraisers.
Another coverage issue, Insured asserts, is whether increased
costs resulting from compliance with Dallas County building codes are
covered. However, Insurers do not dispute that the policies cover
increased costs due to compliance with local ordinances. Rather, they
assert that the building codes were implicated because Insured
conducted more extensive repairs than were necessary, triggering
additional compliance requirements and costs. Again, the scope of the
needed repairs—which would include the costs traceable to compliance
with building codes—is an issue for the appraisers. To the extent that
8
discrete disagreements exist regarding coverage for any particular cost
of regulatory compliance, we see no reason an appraisal would foreclose
a court from resolving those issues. See Johnson, 290 S.W.3d at 894
(noting that “in most cases appraisal can be structured in a way that
decides the amount of loss without deciding any liability questions”).
More broadly, Insured asserts that the parties fundamentally
disagree on the scope of the policy’s coverage of the “replacement cost”
of damaged property and maintains that an appraisal cannot be
conducted without a court’s addressing what that cost entails. However,
just as the parties do not dispute coverage for mold remediation and
building-code compliance, they do not dispute coverage for the
replacement cost of damaged property. Rather, they dispute whether
Insured paid more than was necessary to replace damaged property.
Insured may be correct that the crux of the parties’ disagreement is over
“complex engineering and construction methodologies,” but that does
not remove the dispute from an appraiser’s purview. An appraiser
would be well within the “amount of loss” lane in concluding that
replacing the damaged property required less expensive techniques and
materials than those used by the engineers and contractors Insured
hired, as would an appraiser who concludes that those same techniques
and materials were necessary. See Pappas, 73 S.W.2d at 146 (refusing
to set aside an appraisal award where the appraisers concluded that a
damaged building could be restored to its original condition by
reconstructing some parts of the interior and replacing others, contrary
to the insured’s position that “complete reconstruction or replacement of
the whole interior” was necessary to restore it). And Insured “cannot
9
avoid appraisal at this point merely because there might be a causation
question that exceeds the scope of appraisal.” Johnson, 290 S.W.3d at
893 (emphasis added).
Finally, Insured asserts that resolving the dispute will encompass
“highly technical engineering and construction issues that appraisers
are not appropriately equipped or qualified to address.” Insured
provides no support for that assertion, which has no bearing on whether
the dispute at issue involves coverage rather than the amount of loss.
In any event, the appraisal provision contains no exception for disputes
that involve complex technical issues.
We need not, and therefore do not, hold that no coverage disputes
remain to be resolved. 4 We hold only that any such coverage disputes
do not render an appraisal improper in the first instance. Indeed, we
said in Johnson that even “[w]hen an insurer denies coverage,
appraisers can still set the amount of loss in case the insurer turns out
to be wrong.” Id. at 894. Because we cannot say that “the ‘amount of
loss’ will never be needed,” we cannot agree with Insured that
“preemptive intervention by the courts” is warranted. Id. at 895.
B. Genuine Disagreement About Amount of Loss
Insured next argues that no genuine disagreement between the
parties exists as to the amount of loss—as is necessary to trigger a
party’s right to appraisal—because Insurers’ position on that amount
4 Insured also asserts there is a coverage issue regarding its entitlement
to lost rent. We need not address that argument because, assuming it has
merit, it does not demonstrate that “the ‘amount of loss’ will never be needed.”
Johnson, 290 S.W.3d at 895.
10
has been “inconsistent and constantly shifting.” As an initial matter, we
note that in seeking to compel appraisal in the trial court, Insurers
squarely took the position that they “have paid the Insured all that is
owed under the [policy] in connection with the claim.” They continue to
take that position in this Court. To the extent a definitive position on
the amount of loss is required, Insurers have provided it.
Even if they had not, Insured cites no authority for the
proposition that such a definitive position is needed for the parties to
have a genuine disagreement. To “disagree” is, quite simply, “to fail to
agree.” Disagree, MERRIAM-WEBSTER’S COLLEGIATE DICTIONARY (11th
ed. 2003). Assuming Insurers’ valuation of the claim has changed over
time, it is nevertheless abundantly clear that they have consistently
viewed the amount of loss as significantly less than Insured does. The
appraisal provision requires nothing more. 5
C. Prior Material Breach
Finally, Insured argues that Insurers’ failure to adjust the claim
timely and in good faith, failure to pay amounts owed, and assertions of
unfounded coverage defenses amount to prior material breaches of the
policy, excusing Insured from complying with the appraisal provision.
See Mustang Pipeline Co. v. Driver Pipeline Co., 134 S.W.3d 195, 196
(Tex. 2004) (“It is a fundamental principle of contract law that when one
5 In evaluating whether a party has waived the right to appraisal by
unreasonably delaying a demand, reasonableness is measured from the point
of “impasse”—the parties’ awareness that “further negotiations would be
futile.” Universal Underwriters, 345 S.W.3d at 409. But an impasse is not the
same as a disagreement about the amount of loss, which is all that is required
for a party to demand appraisal. Id. at 408.
11
party to a contract commits a material breach of that contract, the other
party is discharged or excused from further performance.”). Courts have
uniformly rejected similar arguments, and for good reason. See, e.g., In
re Acceptance Indem. Ins. Co., 562 S.W.3d 645, 653 (Tex. App.—San
Antonio 2018, orig. proceeding); Michels v. Safeco Ins. Co. of Ind., 544
F. App’x 535, 540 (5th Cir. 2013) (applying Texas law), disapproved of
on other grounds by Int’l Energy Ventures Mgmt., L.L.C. v. United
Energy Grp., Ltd., 818 F.3d 193, 201 (5th Cir. 2016).
First, as noted, we have identified two specific, limited exceptions
(illegality and waiver) to the enforcement of an appraisal provision,
Universal Underwriters, 345 S.W.3d at 407, neither of which is at issue
here. 6 Second, as the court of appeals explained in Acceptance
Indemnity, the “prior breach” argument Insured raises “puts the cart
before the horse” because “to sustain this position, we would have to
determine in the first instance whether [Insurers] breached the
insurance policy.” 562 S.W.3d at 653; see also Michels, 544 F. App’x at
540 (describing the argument as “incompatible with the mandatory
contractual remedy and the strong public policy favoring appraisal
clauses”). As we explained in Johnson, appraisal is intended to take
6 An appraisal award may be set aside on the back end when there is
evidence of fraud, accident, or mistake. Pappas, 73 S.W.2d at 146. The courts
of appeals have recognized other situations in which the results of an otherwise
binding appraisal may be disregarded, including “when the award was made
without authority” and “when the award was not in compliance with the
requirements of the policy.” Lundstrom v. United Servs. Auto. Ass’n–CIC, 192
S.W.3d 78, 87 (Tex. App.—Houston [14th Dist.] 2006, pet. denied). We need
not address the possible grounds for setting aside an award, as appraisal has
not yet occurred.
12
place before suit is filed. 290 S.W.3d at 894. If an insured could avoid
appraisal by alleging a dispute over coverage or claims handling,
“appraisal clauses would be virtually a nullity.” Sanchez v. Prop. & Cas.
Ins. Co. of Hartford, No. CIV. A. H-09-1736, 2010 WL 413687, at *8 n.10
(S.D. Tex. Jan. 27, 2010); see Johnson, 290 S.W.3d at 893 (avoiding
construction of an appraisal provision “[t]hat would render appraisal
clauses largely inoperative”). 7
Accordingly, we hold that an insurer’s alleged bad faith in
handling a claim does not constitute an exception to the general
enforceability of an appraisal clause.
III. Conclusion
We hold that the trial court clearly abused its discretion in
denying appraisal and that Insurers lack an adequate remedy by appeal.
We conditionally grant Insurers’ petition for writ of mandamus and
direct the trial court to grant Insurers’ motion to compel appraisal. The
writ will issue only if the trial court does not comply.
Debra H. Lehrmann
Justice
OPINION DELIVERED: May 8, 2026
7 Insured argues that it has done more than merely allege bad faith: it
has presented evidence of bad faith. But at this stage of the proceedings,
neither breach nor bad faith has been tried or decided.
13
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