Court Opinion

ID: 9680473
Source: CourtListenerOpinion
Date Created: 2023-08-24 07:32:21.618225+00
Date Added: 2024-06-11T18:17:28.773976
License: Public Domain

ON MOTION FOR REHEARING
In her motion for rehearing, Trevino contends that Allstate cannot rely on the policy provisions requiring the insured to forward suit papers because this provision was not put in issue in the trial court. She insists that she had no burden to show compliance with this provision unless it was put in issue by Allstate. Her argument is based on two provisions of Rule 94 of the Texas Rules of Civil Procedure, (1) the requirement that a responsive pleading allege affirmatively any “matter constituting an avoidance or affirmative defense” and, (2) the provision that in a suit on an insurance contract, the insurer is not allowed to raise an issue that the loss is due to a risk or cause within any of the exceptions to the general liability specified in the contract unless the particular exception is alleged in a responsive pleading. We conclude that neither of these provisions is applicable.
MATTERS OF AVOIDANCE OR AFFIRMATIVE DEFENSE
Whether a particular fact is a matter of avoidance or defense turns on the burden of proof. Normally the plaintiff has the burden to prove all facts essential to liability, including proof of performance of all conditions precedent. Nonperformance of a condition precedent may be considered a matter of “avoidance” or “defense” in the sense that it bars recovery even though the truth of the plaintiff’s allegations may be established. See Dairyland County Mutual Ins. Co. v. Roman, 498 S.W.2d 154, 157 (Tex.1973). In this sense, of course, failure to establish one of several essential elements of any cause of action bars recovery even though all other elements may be established. The pertinent inquiry is whether compliance with a condition precedent is a matter that plaintiff must prove as an essential element of his case. The law is clear that performance of a condition precedent is an essential element of the plaintiff’s case on which the plaintiff has the burden of proof unless he alleges performance of all conditions precedent and the defendant fails to deny specifically performance of the conditions, as re quired by rule 54. Texas International Airlines v. Wits Air Freight, 608 S.W.2d 828 (Tex.Civ.App.—Dallas 1980, no writ); City. of Galveston v. Shu, 607 S.W.2d 942, 945 (Tex.Civ.App.—Houston [1st Dist.] 1980, no writ); Bunch Electric Co. v. Tex-Craft Builders, Inc., 480 S.W.2d 42, 47 (Tex.Civ.App.—Tyler 1972, no writ); see Dairyland County Mutual Ins. Co. v. Roman, 498 S.W.2d 154, 157 (Tex.1973) (“defense” of failure to give notice of accident was not available to company because the insured pleaded generally that all conditions precedent had been performed and the insurer *13failed to deny specifically). Under these authorities, having made no such general allegation, Trevino cannot claim the benefit of the presumption provided by rule 54. Consequently the forwarding of suit papers is not a matter of avoidance or affirmative defense, but a fact she must prove as an essential element of her case.

Exception to General Coverage

Neither is Trevino relieved of her burden of pleading and proving compliance with the condition precedent by the provision of rule 94 excusing the claimant in a suit on an insurance contract from negating exceptions to liability in the absence of a defensive pleading of a particular exception. The text of this provision is as follows:
Where the suit is on an insurance contract which insures against certain general hazards, but contains other provisions limiting such general liability, the party suing on such contract shall never be required to allege that the loss was not due to a risk or cause coming within any of the exceptions specified in the contract, nor shall the insurer be allowed to raise such issue unless it shall specifically allege that the loss was due to a risk or cause coming within a particular exception to the general liability; provided that nothing herein shall be construed to change the burden of proof on such issue as it now exists.
Because of this requirement, even though the burden of proof is on the claimant to negate policy exceptions, that proof is waived by the company’s failure to plead the exception it relies on to defeat recovery. T.I.M.E., Inc. v. Maryland Casualty Co., 157 Tex. 21, 300 S.W.2d 68, 73 (Tex.1957). This provision is not applicable here, however, because the policy requirement of forwarding suit papers does not concern a “risk or cause coming within a particular exception to the general liability.” This policy requirement is applicable, whatever risk or cause may have resulted in the loss. It is a condition precedent to recovery on the policy rather than an exception relieving the company from liability for losses caused by particular hazards that would otherwise fall within the general hazard insured against. Consequently, no burden is cast on the insurer to plead specifically unless the claimant alleges compliance with this requirement or pleads generally the performance of all conditions precedent, as allowed by rule 54.
This conclusion is supported by decisions holding that the insurer’s burden to plead exceptions under this provision of rule 94 does not extend to matters affecting the insurer’s general obligation, on which the claimant has the burden of proof. Bethea v. National Casualty Co., 307 S.W.2d 323, 325 (Tex.Civ.App.—Beaumont 1957, writ ref’d); Preferred Life Insurance Co. v. Stephenville Hospital, 256 S.W.2d 1006, 1010 (Tex.Civ.App.-Eastland 1953, no writ). Analogous authority may be found in decisions holding that rule 93(m), requiring a sworn plea of failure to give notice of a claim, does not apply to noncompliance with a policy requirement that the insured give prompt notice of any accident alleged to be within coverage of the policy. National Surety Corp. v. Diggs, 272 S.W.2d 604, 612 (Tex.Civ.App.—Fort Worth 1954, writ ref’d n.r.e.); Lone Star Finance Co. v. Universal Automobile Ins. Co., 28 S.W.2d 573, 575 (Tex.Civ.App.—Galveston 1930, no writ) (construing earlier statute); cf. City of Beaumont v. Fuentez, 582 S.W.2d 221, 223 (Tex.Civ.App.—Beaumont 1979, no writ) (claimant who did not plead compliance with charter requirement of notice did not invoke pleading requirement of rule 93(m)).
Motion for rehearing overruled.