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Gilbert v. Rain and Hail Insurance

Court of Appeals of Texas, Second District, Fort Worth

February 23, 2017

JERRY M. GILBERT APPELLANT
v.
RAIN AND HAIL INSURANCE D/B/A ACE INSURANCE COMPANY, LLP APPELLEE

         FROM THE 89TH DISTRICT COURT OF WICHITA COUNTY TRIAL COURT NO. 177, 882-C

          PANEL: LIVINGSTON, C.J.; KERR and PITTMAN, JJ.

          MEMORANDUM OPINION[1]

          ELIZABETH KERR JUSTICE.

         Jerry M. Gilbert appeals from the trial court's judgment confirming an arbitration award in favor of Appellee Rain and Hail Insurance d/b/a Ace Insurance Company, LLP (R&H). We affirm.

         I. Background

         Gilbert is a wheat farmer. He made two claims-one in 2011 and another in 2012-on a Multiple Peril Crop Insurance Common Copy Insurance Policy issued to him by R&H. In his first claim, Gilbert alleged that heavy rains prevented him from planting a portion of his wheat crop, and in his second, he alleged that a wild-oat infestation damaged his wheat crop. After investigating, R&H denied both claims in August 2012.

         In its denial letter, R&H pointed Gilbert to paragraph 20 of the policy, entitled "Mediation, Arbitration, Appeal, Reconsideration, and Administrative and Judicial Review, " which provided in pertinent part:

(a) If you and we fail to agree on any determination made by us . . . the disagreement may be resolved through mediation . . . . If resolution cannot be reached through mediation, or you and we do not agree to mediation, the disagreement must be resolved through arbitration in accordance with the rules of the American Arbitration Association (AAA), except as provided in section[] 20(c) . . . .
(1) All disputes involving determinations made by us . . . are subject to mediation or arbitration. . . .
(b) Regardless of whether mediation is elected:
(1) The initiation of arbitration proceedings must occur within one year of the date we denied your claim or rendered the determination with which you disagree, whichever is later;
(2) If you fail to initiate arbitration in accordance with section 20(b)(1) and complete the process, you will not be able to resolve the dispute through judicial review;
(3) If arbitration has been initiated in accordance with section 20(b)(1) and completed, and judicial review is sought, suit must be filed not later than one year after the date the arbitration decision was rendered; . . .
(c) Any decision rendered in arbitration is binding on you and us unless judicial review is sought in accordance with section 20(b)(3). Notwithstanding any provision in the rules of the AAA, you and we have the right to ...

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