Missouri total-loss appraisal: how the appraisal clause works

Missouri regulates first-party automobile total losses through three layered authorities: the Unfair Claim Settlement Practices Act at Mo. Rev. Stat. § 375.1007, the implementing total-loss claims regulation at 20 CSR 100-1.050, and the vexatious-refusal-to-pay statute at Mo. Rev. Stat. § 375.420 (and § 375.296 for life and health). Mo. Rev. Stat. § 375.1007 — Improper Claim Practices. The statute defines acts that constitute improper claim practices when committed in conscious disregard of §§ 375.1000 to 375.1018 or their rules, or with such frequency as to indicate a general business practice (§ 375.1005), including: misrepresenting pertinent facts or policy provisions; failing to acknowledge with reasonable promptness pertinent communications; failing to adopt and implement reasonable standards for the prompt investigation of claims; refusing to pay claims without conducting a reasonable investigation; failing to affirm or deny coverage within a reasonable time after proof-of-loss requirements are completed; not attempting in good faith to effectuate prompt, fair, and equitable settlement when liability is reasonably clear; compelling insureds to institute litigation to recover amounts due by offering substantially less than the amounts ultimately recovered; and failing to promptly settle a claim under one portion of a policy in order to influence settlements under other portions. 20 CSR 100-1.050 — Standards for Prompt, Fair and Equitable Settlement of Claims. Missouri's claim-handling regulation imposes general timing and conduct standards on insurers (e.g., a 15-working-day acknowledge/deny window, a 30-day investigation-completion timeline for general claims) and supplies a small set of auto-specific provisions, including: a prohibition on steering third-party claimants to their own policy; a prohibition on requiring unreasonable travel; subrogation and deductible rules; estimate and after-market-parts disclosure rules; a "betterment or depreciation" rule requiring such reductions to be itemized and appropriate in amount; a repair-to-pre-loss-condition duty; and a rule that a cash settlement cannot be less than the repair amount other than in total-loss situations. Missouri has NOT adopted the NAIC Model Reg #902 closed-list valuation methods, a "30-day right of recourse," a mandatory sales-tax/fees-inclusion provision tied to a comparable vehicle, or a "loss-vehicle-specific documentation" deduction rule; those provisions appear in other states' regulations but not in 20 CSR 100-1.050. Mo. Rev. Stat. § 375.420 — Vexatious Refusal to Pay (Damage Claims). If it appears from the evidence that an insurer has refused to pay a loss without reasonable cause or excuse, the court or jury, in addition to the amount due under the policy and interest, may allow the plaintiff damages not to exceed twenty percent of the first $1,500 of the loss, plus ten percent of the amount of the loss in excess of $1,500, and a reasonable attorney's fee. The remedy applies to insurance against personal property damage, including auto total-loss claims. The "without reasonable cause or excuse" standard is the operational test. Mo. Rev. Stat. § 301.010(55) — Salvage Vehicle Definition; 80% Threshold. The 80% repair-to-fair-market-value threshold for salvage branding is at § 301.010(55) (the "Salvage vehicle" definition), not § 301.193. The threshold applies only when the vehicle was damaged during a year that is no more than six years after the manufacturer's model-year designation. § 301.193 itself governs abandoned-property titling procedures and certain insurer claims-adjustment titling for abandoned salvage; it does not codify the 80% threshold.

Missouri's vexatious-refusal-to-pay remedy is Mo. Rev. Stat. § 375.420 (and the parallel life and health version at § 375.296). The Missouri Supreme Court in DeWitt v. American Family Mutual Insurance Co., 667 S.W.2d 700 (Mo. banc 1984), confirmed that the "without reasonable cause or excuse" standard is fact-intensive and that an insurer's failure to investigate or its reliance on a position without legal or factual support supports a vexatious-refusal finding.