Blum v. Cherokee Insurance Company

336 So. 2d 894, 1976 La. App. LEXIS 3901
CourtLouisiana Court of Appeal
DecidedSeptember 14, 1976
Docket7333
StatusPublished
Cited by20 cases

This text of 336 So. 2d 894 (Blum v. Cherokee Insurance Company) is published on Counsel Stack Legal Research, covering Louisiana Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Blum v. Cherokee Insurance Company, 336 So. 2d 894, 1976 La. App. LEXIS 3901 (La. Ct. App. 1976).

Opinion

336 So.2d 894 (1976)

Albert BLUM
v.
CHEROKEE INSURANCE COMPANY.

No. 7333.

Court of Appeal of Louisiana, Fourth Circuit.

May 18, 1976.
Order Granting Rehearing July 29, 1976.
On Rehearing September 14, 1976.

*896 Edward S. Bopp and Ronald A. Welcker, Arabie, for plaintiff-appellee.

Emile L. Turner, Jr., New Orleans, and Malcolm B. Robinson, Jr., Metairie, for defendant-appellant.

Before REDMANN, LEMMON, GULOTTA, STOULIG and SCHOTT, JJ.

LEMMON, Judge.

The principal issue in this appeal is whether plaintiff's suit against his insurer for hail damage to his residence was timely filed.

The pertinent provision in plaintiff's insurance policy read:

"Suit. No suit or action on this policy for the recovery of any claim shall be sustainable in any court of law or equity unless all the requirements of this policy shall have been complied with, and unless commenced within twelve months next after inception of the loss." (Emphasis supplied)[1]

Plaintiff allegedly discovered the roof damage on March 9, 1972, when water leaked through the ceiling of his den and onto the carpet. He found damage to several sections of his roof and immediately notified his agent, Ralph Alvarez, who called the information to General Adjustment Bureau, who in turn dispatched Nolan Allain to investigate the claim.[2]

When Allain visited the premises on March 27, plaintiff's son showed him the interior damage to the ceiling. Unaware that the roof had been repaired, Allain denied the claim on the basis that only windstorm damage was covered by the policy and he found no damaged areas in the roof above the den.

At plaintiff's request, Allain reinspected the roof on May 9, 1972, whereupon plaintiff informed him that the roof damage had been repaired and pointed out numerous shiny new shingles. Allain then told plaintiff to forward the bills, and he would submit them to the company for possible reconsideration of the previous denial.[3]

Plaintiff testified that he (at unidentified times) inquired by telephone many times about the claim and was told by Allain *897 that he was waiting to hear from the company. In this regard Allain testified without contradiction that he did not receive the bills from plaintiff until November, 1972.

The next event identifiable in the record by date was a letter dated April 5, 1973 (almost one month after the year had elapsed), from Allain to plaintiff, advising that he had written the company for instructions as to his claim. On May 7, 1973 Alvarez wrote to Allain, reminding him that three weeks earlier he had indicated the claim would be finalized and urging immediate action.

Thereafter, Allain took a written statement from plaintiff in September, 1973. The next month the insurer authorized Allain to offer to compromise the claim for 50% of the amount demanded. Plaintiff rejected the offer and eventually filed this suit in July, 1974.

Defendant filed an exception of prescription, which was tried and overruled by the trial court on the basis that the settlement offer (more than one year after the loss) invalidated the policy requirement that suit be filed within one year of the inception of the loss. After a subsequent trial on the merits, judgment was rendered in favor of plaintiff.

In this court defendant argues as to prescription that the trial court erred in excluding from evidence a signed non-waiver agreement because the document was undated. Defendant's purpose in obtaining plaintiff's consent to this agreement was to allow investigation and negotiation without an admission of liability or a waiver of any policy terms. We perceive no detriment to defendant, however, by the exclusion of this document. R.S. 22:651 (which was not called to the trial judge's attention) clearly provides the same protection that defendant sought in obtaining the agreement.[4]

We construe R.S. 22:651 to mean simply that mere investigation or negotiation do not alone constitute a waiver of an insurer's right to claim the benefits of an applicable policy provision. Nevertheless, such actions by an insurer can constitute part of an implied waiver or of a lulling process. Between the cases involving mere negotiations and those involving outright promises to pay, there are a myriad of cases in the hazy area, each of which must be decided on its own facts and circumstances.

Thus, the crucial determination in the present case is whether the overall actions of the insurer's claims adjuster, during the year after the casualty, led plaintiff to reasonably believe the insurer would not require compliance with the policy provision that suit must be filed within a year.[5]

*898 This record contains absolutely no proof, direct or circumstantial, that plaintiff withheld suit in reliance on any words or actions by the insurer or its adjuster. During the year following the loss there was no admission or recognition of liability; no assurances of payment; no late request for additional information or for time to investigate the claim further; no intentional delay of adjustment beyond the limitation period; and no prolonged or continuous negotiations, lasting through most of the limitation period, which might tend to hold out a reasonable hope of amicable adjustment. See cases annotated in 29 A.L.R.2d 636 (1953).

Furthermore, plaintiff did not even mention in his testimony that he was aware of the time limitation, nor did he give any reason for disregarding the limitation. His entire evidence of lulling during the year after the loss was testimony that the adjuster told him in May he would submit the bills and recommend payment. Apparently no one did anything further until plaintiff forwarded the bills six months later.

There was no further evidence (identifiable as to date) that the insurer made any other representations or took any other action (before the March anniversary date) on which plaintiff could have reasonably concluded the claim would be paid without the necessity of filing suit. Plaintiff vaguely testified as to telephone conversations in which the adjuster told him he was waiting to hear from the company, but there was no testimony these conversations took place before the adjuster's April, 1973 letter advising plaintiff he had written the company for instructions. Furthermore, these innocuous conversations (even if before the anniversary date) could not reasonably have induced plaintiff to withhold filing suit or seeking legal advice.

In order to find waiver or lulling in this case, we would be required to hold that mere pendency of a claim effects a waiver of the time limitation. This we are unwilling to do, particularly in view of the fact that the legislature established the time limitation and declared that the limitation would not even be affected by investigation or negotiation. The time limitation in the policy is not a period within which the insurer must deny the claim, but rather one in which the insured must assert the claim judicially. Unless the insurer in some manner leads the insured to reasonably believe the time limitation has been waived while the claim is under consideration or in some other way acts so as to induce the insured to withhold suit, the suit must be filed within the prescribed period even if the claim is still pending.

The case of Brocato v. Sun Underwriters Ins. Co. of N.Y., 219 La. 495, 53 So. 2d 246

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Bluebook (online)
336 So. 2d 894, 1976 La. App. LEXIS 3901, Counsel Stack Legal Research, https://law.counselstack.com/opinion/blum-v-cherokee-insurance-company-lactapp-1976.