ALPINE COUNTRY CLUB v. SOMPO AMERICA INSURANCE COMPANY

CourtDistrict Court, D. New Jersey
DecidedAugust 7, 2024
Docket2:23-cv-00043
StatusUnknown

This text of ALPINE COUNTRY CLUB v. SOMPO AMERICA INSURANCE COMPANY (ALPINE COUNTRY CLUB v. SOMPO AMERICA INSURANCE COMPANY) is published on Counsel Stack Legal Research, covering District Court, D. New Jersey primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
ALPINE COUNTRY CLUB v. SOMPO AMERICA INSURANCE COMPANY, (D.N.J. 2024).

Opinion

UNITED STATES DISTRICT COURT DISTRICT OF NEW JERSEY

ALPINE COUNTRY CLUB, Civil Action No. 23-43 (CCC) (MAH) Plaintiff,

v. OPINION SOMPO AMERICA INSURANCE COMPANY, Defendant

I. INTRODUCTION This matter comes before the Court on Alpine Country Club’s (“Plaintiff”) motion to file an amended Complaint. Mot. to Amend, Mar. 19, 2024, D.E. 76. Sompo America Insurance Company (“Defendant”) opposes the motion. Opp’n, Apr. 1, 2024, D.E. 78. Plaintiff filed a reply in further support of its motion. Reply, Apr. 8, 2024, D.E. 84. The Court has carefully considered the parties’ submissions without oral argument pursuant to Fed. R. Civ. P. 78 and Local Civ. R. 78.1(b). For the reasons set forth below, Plaintiff’s motion to amend is denied. II. BACKGROUND1 This action arises out of a commercial property insurance policy (the “Policy”) dispute between the policyholder, Plaintiff, and the insurer, Defendant, regarding damages sustained to Plaintiff’s property. The Policy insures Plaintiff against “‘all risk of direct physical loss or damage to covered property’ unless specifically and unambiguously excluded from the Policy.” Policy,

1 The Court writes primarily for the parties and sets forth only the pertinent allegations relevant to this motion. Ex. C, D.E. 76-5, at 24. The Policy provides approximately $40 million in liability limits for loss arising from a “Named Storm” and a $500,000 sublimit2 for loss arising from a “Flood.”3 Id. at 16. Plaintiff alleges that, on September 1, 2021, historic rainfall from Tropical Storm Ida

damaged Plaintiff’s clubhouse and several outdoor facilities. Compl., Jan. 5, 2023, D.E. 1, at ¶¶ 11-12. Plaintiff filed a claim with Defendant on September 2, 2021, seeking approximately $10 million in insurance coverage for “cleanup, repair, and business interruption costs.” Id. at ¶¶ 13- 14. Defendant’s independent adjuster visited Plaintiff’s property on September 7, 2021. Opp’n, D.E. 78, at 4. Defendant also retained Halliwell Engineering Associates, Inc. (“HEA”) to investigate the cause of Plaintiff’s property damage. Id. In total, Defendant and HEA prepared three separate reports assessing Plaintiff’s property damage: (1) an October 22, 2021 draft report (“First Report”); (2) an October 26, 2021 report (“Second Report”); and (3) a June 17, 2022 report (“Supplemental Report”). HEA junior engineer Jacqueline Kerstetter first “inspected Plaintiff’s

property 29 days after the [Date of Loss (‘DOL’)] on September 30, 2021, and again on October 13, 2021.” Opp’n, D.E. 78, at ¶ 12. Ms. Kerstetter “prepared a draft report of her findings” in the

2 A sublimit refers to “a liability limit in an insurance policy for a particular risk that is below the aggregate liability limit of the policy.” Sublimit, MERRIAM-WEBSTER DICTIONARY (11th ed. 2003).

3 The Policy defines “Named Storm” as “a storm that, at any time, has been declared … to be a Hurricane, Typhoon, Tropical Cyclone, Tropical Storm, or Tropical Depression. Named storm shall include direct physical loss or damage including but not limited to … rain or water (not constituting a flood), whether the rain or water is driven by wind or not, that enters a building or structure insured under this Policy.” Policy, Ex. C, D.E. 76-5, at 77. The Policy defines “Flood” as “whether natural or manmade, flood waters, rapid accumulation of rain or water, surface water, waves, tide, tidal water … Physical loss or damage from flood associated with a storm or weather disturbance whether or not identified by name by any meteorological authority, is considered to be flood within the terms of this Policy.” Id. at 75. First Report, which was signed by senior HEA engineer Don Leffert. Id. The First Report concluded that Plaintiff’s water damage resulted from a Named Storm that displaced the fire suppression system line in the clubhouse basement. First Report, Ex. A, D.E. 57-1, at 8-9. Ms. Kerstetter found that

the force of flowing water through the vent displaced the riser pipes of the fire suppression system below the vent, causing joints in the pipes to separate. The water from the fire suppression system was then allowed to flow through these separated pipes and into the basement, adding to the water volume.

Id. Based on these findings, HEA concluded that the water damage was caused by rain or water that entered Plaintiff’s clubhouse from the fire suppression pipes. Id. As a result, HEA determined that Plaintiff’s property damage constituted a Named Storm. Policy, Ex. C, D.E. 76-5, at 77. Therefore, the First Report concluded that Plaintiff was entitled to coverage within the Policy’s limits. First Report, Ex. A, D.E. 57-1, at 8-9. But after receiving the First Report, Defendant’s claim specialist, Rachel Daniels, requested additional information regarding the First Report’s reference to water flowing from the fire suppression system. Sompo’s Claim Specialist Email to HEA, Ex. A, D.E. 78-1 (Oct. 22, 2021). Upon internal review, HEA determined that the pipe Ms. Kerstetter “identified [in the First Report] was not part of the fire suppression system but was instead part of the bypass line.” HEA’s Response Email, Ex. B, D.E. 78-2 (Oct. 25, 2021). HEA found that “the force of flowing water through the vent [did not displace the riser pipes of the fire suppression system as originally thought but instead] had separated the copper bypass water lines for the domestic water system.” As a result, water rapidly accumulated in Plaintiff’s basement, thereby constituting a “Flood” under the Policy. Second Report, Ex. B, D.E. 57-2, at 9; Policy, Ex. C, D.E. 76-5, at 75. HEA also noted the position of the bypass valves, explaining that “under normal operations, the valves to the [bypass line pipes] would be shut off; therefore, no water would have flowed out of the disconnected pipes on the [DOL].” Second Report, Ex. B, D.E. 57-2, at 8-9. Based on the position of the bypass pipes and valves, photographs, weather data, drainage plans, analysis of rainfall, and their knowledge of construction, HEA concluded that “the proximate cause of the observed damages to the subject building was due to overflowing water from the drainage pond for the storm

water drainage system of the golf course to the east of the subject building.” Id. at 8. Accordingly, Defendant and HEA issued a revised Second Report finding that a Flood, not a Named Storm, was the source of Plaintiff’s water damage. Id. Defendant shared its formal position with Plaintiff on November 15, 2021, and issued Plaintiff a $500,000 payment on November 31, 2021. Compl., Jan. 5, 2023, D.E. 1, at ¶ 15. Over the next ten months, Defendant continued to investigate Plaintiff’s claim in what Plaintiff characterizes as a ‘“sham’ investigation.” Id. ¶ 17. Defendant examined Plaintiff’s property on three separate occasions, allegedly forcing Plaintiff to expend valuable time, funds, and resources to accommodate the investigation. Id. At the conclusion of this investigation, Defendant sent the Supplemental Report to Plaintiff on July 19, 2022. The Supplemental Report

confirmed Defendant’s earlier findings that the loss arose from a flood, and thereby Plaintiff was limited to $500,000 Flood coverage under the Policy. Supplemental Report, Ex. B, D.E. 24-2, at 12. Plaintiff filed a Complaint on September 28, 2022 (“Earlier Action”). Compl., Civ. No. 22-5754, D.E. 1. The parties then agreed to participate in mediation, and Plaintiff dismissed the Earlier Action without prejudice. Voluntary Dismissal, Civ. No. 22-5754, D.E. 4. After unsuccessful attempts at mediation, Plaintiff filed this action on January 5, 2023.

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ALPINE COUNTRY CLUB v. SOMPO AMERICA INSURANCE COMPANY, Counsel Stack Legal Research, https://law.counselstack.com/opinion/alpine-country-club-v-sompo-america-insurance-company-njd-2024.