Alexander v. Farmers Insurance

219 Cal. App. 4th 1183, 162 Cal. Rptr. 3d 455, 2013 WL 5308722, 2013 Cal. App. LEXIS 761
CourtCalifornia Court of Appeal
DecidedSeptember 23, 2013
DocketB239840
StatusPublished
Cited by7 cases

This text of 219 Cal. App. 4th 1183 (Alexander v. Farmers Insurance) is published on Counsel Stack Legal Research, covering California Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Alexander v. Farmers Insurance, 219 Cal. App. 4th 1183, 162 Cal. Rptr. 3d 455, 2013 WL 5308722, 2013 Cal. App. LEXIS 761 (Cal. Ct. App. 2013).

Opinions

[1185]*1185Opinion

BIGELOW, P. J.

Frances Marc Alexander and Thomas and Anna Downie (Respondents) brought a class action lawsuit against Farmers Insurance Company, Inc.,1 and Fire Insurance Exchange alleging illegal adjusting practices. In particular, Respondents alleged that Farmers failed to comply with the method for determining actual cash value set forth in the Insurance Code2 for a partial loss in a fire. Farmers moved to compel an appraisal of Respondents’ claims, contending that the dispute centered on the value of Respondents’ loss. The trial court denied Farmers’s motion without prejudice to renewing it at a later stage of the litigation. We affirm the trial court’s ruling.

FACTUAL AND PROCEDURAL HISTORY

Respondents were insured under Farmers homeowners policies when they each suffered partial losses to their homes and personal belongings due to fire in 2009 and 2010. They submitted property claims to Farmers, identifying the damaged property and the estimated actual cash value of each item. Respondents disputed Farmers’s adjustment of their claims, complaining that Farmers’s method of calculating depreciation was illegal under the Insurance Code.

I. Relevant Provisions of the Insurance Code

Section 2070 requires that all fire policies in California be on a standard form, which is set forth in section 2071. The standard form fire policy requires the insurer to pay “the actual cash value of the property at the time of loss.” In the event of a loss, the insured must give written notice to the insurer and “furnish a complete inventory of the destroyed, damaged and undamaged property, showing in detail quantities, costs, actual cash value and amount of loss claimed.” Actual cash value is determined by the following calculation under the statute: “In case of a partial loss to the structure, or loss to its contents, the amount it would cost the insured to repair, rebuild, or replace the thing lost or injured less a fair and reasonable deduction for physical depreciation based upon its condition at the time of the injury or the [1186]*1186policy limit, whichever is less. In case of a partial loss to the structure, a deduction for physical depreciation shall apply only to components of a structure that are normally subject to repair and replacement during the useful life of that structure.” (§ 2051, subd. (b)(2).)

In the California Code of Regulations enforcing fair claims settlement practices, the Insurance Commissioner has explained, “When the amount claimed is adjusted because of betterment, depreciation, or salvage, all justification for the adjustment shall be contained in the claim file. Any adjustments shall be discemable, measurable, itemized, and specified as to dollar amount, and shall accurately reflect the value of the betterment, depreciation, or salvage. Any adjustments for betterment or depreciation shall reflect a measurable difference in market value attributable to the condition and age of the property and apply only to property normally subject to repair and replacement during the useful life of the property. The basis for any adjustment shall be fully explained to the claimant in writing.” (Cal. Code Regs., tit. 10, § 2695.9, subd. (f).)

If the parties fail to agree on the actual cash value or the amount of loss, they are required to participate in an appraisal. Once an appraisal demand is made and accepted, each party selects a “competent and disinterested” appraiser. (§ 2071.) Each party’s appraiser will state separately the actual cash value and loss of each item. If they disagree, they will submit their differences to a competent and disinterested umpire whom they have jointly selected. (§ 2071.) “Appraisal proceedings are informal unless the insured and this company mutually agree otherwise. For purposes of this section, ‘informal’ means that no formal discovery shall be conducted, including depositions, interrogatories, requests for admission, or other forms of formal civil discovery, no formal rules of evidence shall be applied, and no court reporter shall be used for the proceedings. The appraisers shall then appraise the loss, stating separately actual cash value and loss to each item; and, failing to agree, shall submit their differences, only, to the umpire. An award in writing, so itemized, of any two when filed with this company shall determine the amount of actual cash value and loss. Each appraiser shall be paid by the party selecting him or her and the expenses of appraisal and umpire shall be paid by the parties equally.” (§ 2071.)

“An appraisal provision in an insurance policy constitutes an agreement for contractual arbitration. [Citations.]” (Doan v. State Farm General Ins. Co. (2011) 195 Cal.App.4th 1082, 1093 [125 Cal.Rptr.3d 793] (Doan)-, see Louise Gardens of Encino Homeowners’ Assn., Inc. v. Truck Ins. Exchange, Inc. (2000) 82 Cal.App.4th 648, 658 [98 Cal.Rptr.2d 378] [“[a]n agreement to [1187]*1187conduct an appraisal contained in a policy of insurance ... is considered to be an arbitration agreement subject to the rules statutory contractual arbitration law”].) Accordingly, “[a]ppraisal hearings are a form of arbitration and are generally subject to the rules governing arbitration.” (Kacha v. Allstate Ins. Co. (2006) 140 Cal.App.4th 1023, 1031 [45 Cal.Rptr.3d 92]; see Devonwood Condominium Owners Assn. v. Farmers Ins. Exchange (2008) 162 Cal.App.4th 1498, 1505 [77 Cal.Rptr.3d 88] [“appraisal award proceedings are subject to the arbitration provisions outlined in the California Arbitration Act . . .”].) However, while “arbitrators are frequently, by the terms of the agreement providing for arbitration, . . . given broad powers [citation], . . . appraisers generally have more limited powers.” (Jefferson Ins. Co. v. Superior Court (1970) 3 Cal.3d 398, 403 [90 Cal.Rptr. 608, 475 P.2d 880], italics omitted (Jefferson).)

Specifically, “ ‘[t]he function of appraisers is to determine the amount of damage resulting to various items submitted for their consideration.’ ” (Jefferson, supra, 3 Cal.3d at p. 403; see Safeco Ins. Co. v. Sharma (1984) 160 Cal.App.3d 1060, 1063 [207 Cal.Rptr. 104] [“appraisers have the power only to determine a specific question of fact, ‘namely, the actual cash value of the insured [item]’ ”].) It is “ ‘not their function to resolve questions of coverage and interpret provisions of the policy.’ ” (Jefferson, supra, at p. 403; see Kirkwood v. California State Automobile Assn. Inter-Ins. Bureau (2011) 193 Cal.App.4th 49, 58-59 [122 Cal.Rptr.3d 480] (Kirkwood) [“[appraisers have no power to interpret the insurance contract or the governing statutes”]; Doan, supra, 195 Cal.App.4th at p. 1094 [“ ‘[m]atters of statutory construction, contract interpretation and policy coverage are not encompassed within the ambit of [an insurance] appraisal’ ”].) Likewise, an appraisal panel generally lacks the authority “to determine whether an insured lost what he [or she] claimed to have lost or something different.” (Safeco, supra, at p. 1065.)

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Cite This Page — Counsel Stack

Bluebook (online)
219 Cal. App. 4th 1183, 162 Cal. Rptr. 3d 455, 2013 WL 5308722, 2013 Cal. App. LEXIS 761, Counsel Stack Legal Research, https://law.counselstack.com/opinion/alexander-v-farmers-insurance-calctapp-2013.