Bankers Insurance Company v. Emiii Holdings, LLC

Louisiana Court of Appeal·Decided December 16, 2024·No. 2024-CA-0386·Published

Opinion

BANKERS INSURANCE * NO. 2024-CA-0386 COMPANY

*

VERSUS COURT OF APPEAL

*

EMIII HOLDINGS, LLC FOURTH CIRCUIT

*

STATE OF LOUISIANA

*******

APPEAL FROM

CIVIL DISTRICT COURT, ORLEANS PARISH NO. 2022-04489, DIVISION “H”

Honorable Monique E. Barial, Judge ******

Judge Dale N. Atkins

******

(Court composed of Judge Roland L. Belsome, Judge Daniel L. Dysart, Judge Dale N. Atkins)

J. Michael Nash Wayne R. Maldonado Brett F. Willie UNGARINO & MALDONADO, LLC 3850 North Causeway Blvd, Suite 1280 Metairie, LA 70002

COUNSEL FOR PLAINTIFF/APPELLEE, Bankers Insurance Company

Joseph Paul Rumage, Jr. THE LAW OFFICE OF PAUL RUMAGE P. O. Box 1174 Denham Springs, LA 70727

COUNSEL FOR DEFENDANT/APPELLANT, EMIII Holdings, L.L.C.

REVERSED AND REMANDED

DECEMBER 16, 2024

DNA

RLB

DLD

This dispute stems from an insurance claim filed after Hurricane Ida struck Louisiana on August 29, 2021.1 Appellant, EMIII Holdings, L.L.C. (“EMIII”), seeks review of the trial court’s February 12, 2024 judgment, which granted the Motion for Summary Judgment filed by Appellee, Bankers Insurance Company (“Bankers”); dismissed EMIII’s claims against Bankers (asserted in reconvention) with prejudice; and dismissed as moot Bankers’ Complaint for Declaratory Judgment. For the following reasons, we reverse the trial court’s February 12, 2024 judgment and remand this matter for further proceedings.

FACTUAL BACKGROUND AND PROCEDURAL HISTORY Bankers’ May 20, 2022 Complaint for Declaratory Judgment On May 20, 2022, Bankers filed a “Complaint for Declaratory Judgment”

(“Complaint”) in Civil District Court for the Parish of Orleans, wherein it named

1 This Court may take judicial notice of government websites. Hidalgo v. Bd. of Supervisors of La. State Univ. & Agric. & Mech. Coll. on Behalf of La. State Univ. Health Scis. Ctr.-New Orleans, 2024-0609, p. 3 (La. App. 4 Cir. 9/25/24), ___ So.3d ___, ___ n.1, 2024 WL 4284307, at *1 (citing State v. Debose, 2024-0217, p. 4 (La. App. 4 Cir. 6/13/24), 390 So.3d 971, 975). Accordingly, we take judicial notice of the National Ocean Service: National Oceanic and Atmospheric Administration’s website, which states that “Hurricane Ida made landfall as [a] Category 4 hurricane in Lafourche Parish near Port Fourchon, Louisiana . . . . Landfall occurred at 11:55 a.m. on August 29, 2021.” Hurricane Ida: NOS Fiscal Year 2021 Year in Review, NATIONAL OCEAN SERVICE: NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, https://oceanservice.noaa.gov/annualreport/2021/hurricaneida .html#:~:text=Hurricane%20Ida%20made%20landfall%20as,a.m.%20on%20August%2029% 2C%202021 (last visited Nov. 18, 2024).

EMIII as the sole defendant and explained that EMIII owned property insured by Bankers under Builders’ Risk Policy No. 17-0400025453-5-01 (hereinafter referred to as “the insurance policy”). According to Bankers’ Complaint, EMIII reported a loss from Hurricane Ida at the insured premises located at 2324 Reverend John Raphael Jr. Way in New Orleans, LA 70113 (“2324 Rev. John Raphael Jr. Way”) but failed to provide Bankers with information or to complete an examination under oath as requested by Bankers in its investigation of the claim. Bankers listed the dates it attempted via email to request claim-related documents and schedule EMIII’s examination under oath as January 20, 2022; February 1, 2022; February 15, 2022; and February 25, 2022. Additionally, Bankers listed the dates it attempted via written correspondence to request claim- related documents and schedule EMIII’s examination under oath as March 25, 2022; April 13, 2022; and May 2, 2022. Attached as exhibits to Bankers’ Complaint were copies of the aforementioned emails and written correspondence. Bankers contended that EMIII’s failure to cooperate constituted a breach of the terms and conditions of the insurance policy. Accordingly, Bankers requested that the trial court find that no coverage existed and declare coverage “void as the failure to cooperate ha[d] materially prejudiced Banker’s [sic] investigation of this hurricane claim.”

Also attached to Bankers’ Complaint was a copy of the insurance policy, which listed the insured property as 2324 Reverend John Raphael Jr. Way. It listed the policy period as July 9, 2021, through October 9, 2021. It stated, in pertinent part:

PROJECT LOCATION: 2324 REVEREND JOHN RAPHAEL JR, NEW ORLEANS LA 70113

(single building only; with no permission to occupy in whole or in part)

PERMISSION TO OCCUPY (check one) [ X ] Permission to occupy is not granted.

....

AGREEMENT

In return for “your” payment of the required premium, “we” provide the coverage described herein subject to all the “terms” of the Builders’ Risk Coverage.

....

WHAT MUST BE DONE IN CASE OF LOSS ....

4. Examination - - “You” must submit to examination under oath in matters connected with the loss as often as “we” reasonably request and give “us” sworn statements of the answers. If more than one person is examined, “we” have the right to examine and receive statements separately and not in the presence of others.

5. Records - - “You” must produce records, including tax returns and bank microfilms of all canceled checks relating to value, loss, and expense and permit copies and extracts to be made of them as often as “we” reasonably request.

....

9. Cooperation - - “You” must cooperate with “us” in performing all acts required by this policy.

....

ADDITIONAL COVERAGE LIMITATIONS

1. Occupancy And Use -- We do not provide coverage under this policy if, without “our” prior written consent, a covered “building or structure” as described under Property Covered is:

a. occupied in whole or in part;

EMIII’s February 15, 2023 Exceptions, Answer, and Reconventional Demand On February 15, 2023, EMIII filed a pleading titled “Exceptions, Answer & Reconventional Demand” (“Reconventional Demand”). Therein, in addition to answering Bankers’ Complaint, EMIII asserted the exceptions of prematurity, peremption, no cause of action, and no right of action. Additionally, in its Reconventional Demand, EMIII contended that it had taken all actions required by the insurance policy; that its claim for loss filed with Bankers had not yet been resolved; and that it was entitled to compensation from Bankers as outlined in the insurance policy. Specifically, EMIII sought costs to repair the insured property; costs of damage mitigation; and other costs and expenses as allowed by law. EMIII requested that the trial court dismiss Bankers’ Complaint and render judgment in EMIII’s favor.

Bankers’ September 8, 2023 Motion for Summary Judgment On September 8, 2023, Bankers filed its Motion for Summary Judgment, wherein it contended that it was entitled to a summary judgment granting its declaratory judgment based on EMIII’s violation of two provisions of the insurance policy, namely (1) the no occupancy provision, and (2) the failure to cooperate with Bankers’ investigation of the claim.

In its Motion for Summary Judgment, Bankers explained that after Hurricane Ida made landfall on August 29, 2021, EMIII opened a claim for hurricane-related damages on September 9, 2021, for the property it owns at 2324 Rev. John Raphael Jr. Way. Bankers further explained that it had issued the insurance policy to EMIII covering 2324 Rev. John Raphael Jr. Way with a policy period from July 9, 2021, through October 9, 2021. According to Bankers, EMIII reported damage to the property’s roof, siding, doors, and windows, as well as

interior water damage. Bankers stated that an independent adjuster inspected the property on September 22, 2021, and October 9, 2021, and issued a report on November 5, 2021. The independent adjuster’s report listed the property as a two- story apartment building containing eight units with two of the units occupied and six under construction.

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