PJC Business

DTPA/I NSURANCE C ODE

PJC 102.26

Finding “the date the claim was required to be paid” to determine when inter est penalty begins on “forces of nature” real property claims governed by section 542.060(c). The interest penalty for violations in handling claims for damage to real property and improvements caused by “forces of nature” begins “on the date the claim was required to be paid.” Tex. Ins. Code § 542.060(c). For questions and comments on the statute’s requirements for payment, see PJC 102.27 and 102.28. PJC 102.27 sub mits the insurer’s failure to pay what the insurer agreed to pay in its written notice to the claimant accepting the claim in whole or in part. Tex. Ins. Code § 542.057. PJC 102.28 submits the insurer’s failure to pay the claim within sixty days of receiving “all items, statements, and forms reasonably requested and required under Section 542.055.” Tex. Ins. Code § 542.058. The comments provide questions for determining the dates when the triggering event occurred, from which can be determined “the date the claim was required to be paid.” Determining if insurer is “liable for a claim under an insurance policy.” To be liable for breach of any of the duties imposed by the Prompt Payment of Claims Act, the insurer must be “liable for a claim under an insurance policy.” Tex. Ins. Code § 542.060(a); Progressive County Mutual Insurance Co. v. Boyd , 177 S.W.3d 919, 922 (Tex. 2005). If there is a factual dispute whether the insurer is liable for the claim under the policy, the issue must be submitted to the jury. See PJC 101.56–101.60. Act of insurer’s agent is act of insurer. Notice to a person acting as an agent for the insurer is notice to the insurer, and thus the date the agent receives notice of the claim is the date the insurer receives notice of the claim. Protective Life Insurance Co. v. Russell , 119 S.W.3d 274, 287–88 (Tex. App.—Tyler 2003, no pet.) (citing Tex. Ins. Code art. 21.02, now Tex. Ins. Code §4001.051, which lists the acts that constitute acting as an agent for an insurer, and holding that “[n]otice to an agent, received while the agent is acting within the scope of his authority, constitutes notice to the princi pal[]”). See also Tex. Ins. Code § 542A.001(1), defining “agent” as “an employee, agent, representative, or adjuster who performs any act on behalf of an insurer.” When an agent is acting on behalf of an insurer in dealing with a claim, the jury should be instructed as follows: You are instructed that Don Davis includes [ name of agent ]. Act of claimant’s agent is act of claimant. Notice to the insurer by a person act ing as an agent for the claimant is notice by the claimant. Dunn v. Southern Farm Bureau Casualty Insurance Co. , 991 S.W.2d 467, 473 (Tex. App.—Tyler 1999, pet. denied) (holding that notice given by claimant’s attorney is notice given by claimant because “what a principal does through an agent, he does himself”). When an agent is acting on behalf of the claimant in dealing with the insurer, the jury should be instructed as follows: You are instructed that Paul Payne includes [ name of agent ].

187