Court Opinion

ID: 9763767
Source: CourtListenerOpinion
Date Created: 2023-08-29 02:55:13.878607+00
Date Added: 2024-06-11T07:29:49.562711
License: Public Domain

ENOCH, Justice,
concurring.
I agree with the result in this case and join in Parts I and IV of Justice Spector’s opinion, but write separately to note that the mere authority of an agent to explain the terms of a policy does not render an insurer liable for all of that agent’s representations. Several states have limited the insurer’s liability to interpretations of the policy that are plausible or not patently absurd. See Mutual Benefits Life Ins. Co. v. Bailey, 55 Del. 215, 190 A.2d 757 (1963) (noting that an insured may rely upon a plausible interpretation by an agent); Flamme v. Wolf Ins. Co., 239 Neb. 465, 476 N.W.2d 802, 807-08 (1991) (stating that insured could rely on agent’s interpretation of policy that is plausible and not in patent conflict with the printed policy); Farley v. United Pacific Ins. Co., 269 Or. 549, 525 P.2d 1003, 1006 (1974) (quoting Couch on Insurance and finding that representative of insurer’s agent had ostensible authority to interpret the insurance contract unless the agent’s interpretation is “patently absurd” from the insured’s perspective).
I note that in Texas reliance is not an independent element of recovery under the DTPA. Weitzel v. Barnes, 691 S.W.2d 598, 600 (Tex.1985). However, it is obvious that “reliance on the deceptive act or conduct is necessarily a factor of producing cause.” Id. at 602 (Gonzalez, J., dissenting). I would conclude that producing cause is present only where the agent’s explanation of the policy’s coverage is not patently absurd, which necessarily results in the insured’s reliance on the agent’s explanation being reasonable. See, e.g., Lewis v. Citizens Agency of Madelia, Inc., 306 Minn. 194, 235 N.W.2d 831 (1975) (finding coverage where agent misrepresented to widow the type and amount of coverage on a policy and she relied on the agent’s expertise); Crawley v. American Public Life Ins. Co., 603 So.2d 835 (Miss.1992) (estopping insurer from denying coverage where agent represented to divorced father that his chil*101dren, who lived with their mother, would be covered).
In this case, though, we are unable to examine whether Harrell’s representations were in fact the producing cause of Coats’ damages because the reasonableness of Harrell’s explanation is not presented to us for review. Consequently, I join in the Court’s judgment.