Caribbean I Owners' Ass'n v. Great American Insurance

619 F. Supp. 2d 1178, 2008 U.S. Dist. LEXIS 20406, 2008 WL 687381
CourtDistrict Court, S.D. Alabama
DecidedMarch 10, 2008
DocketCivil Action 07-0829-WS-B
StatusPublished
Cited by4 cases

This text of 619 F. Supp. 2d 1178 (Caribbean I Owners' Ass'n v. Great American Insurance) is published on Counsel Stack Legal Research, covering District Court, S.D. Alabama primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Caribbean I Owners' Ass'n v. Great American Insurance, 619 F. Supp. 2d 1178, 2008 U.S. Dist. LEXIS 20406, 2008 WL 687381 (S.D. Ala. 2008).

Opinion

ORDER

WILLIAM H. STEELE, District Judge.

This action comes before the Court on Defendant XL Specialty’s Motion to Dismiss Count II of Plaintiffs Complaint Pursuant to F.R.C.P. 12(b)(6) (doc. 12) and Plaintiffs Motion to Compel Appraisal and Stay Proceedings (doc. 28). Both Motions have been briefed and are ripe for disposition. 1

I. Background.

On November 28, 2007, plaintiff Carribean I Owners’ Association, Inc. (“Caribbean I”) filed its Complaint (doc. 1) in this District Court against defendants Great American Insurance Company of New York (“Great American”) and XL Specialty Insurance Company (“XL Specialty”). The Complaint alleges that both Great American and XL Specialty issued insurance policies to Caribbean I, then breached the terms of those policies in handling claims by Caribbean I for property damage sustained during Hurricane Ivan in September 2004. 2 Caribbean I joins only two causes of action herein. First, the Complaint interposes a claim for breach of contract (Count I) alleging that Great American wrongfully failed and refused to honor Caribbean I’s demand for appraisal in accordance with the terms of the Great American policy. Second, the Complaint contains an analogous breach of contract claim (Count II) alleging that XL Specialty likewise refused to participate in the appraisal process set forth in its applicable policy of insurance despite Caribbean I’s timely and proper demand for same.

With respect to Count I, the Complaint alleges that Caribbean I’s estimate of the wind-driven rain damage to its property differed from Great American’s adjustment of the loss; indeed, the Complaint states that Great American “determined that the loss sustained as a result of covered peril was less than the amount of the deductible,” on which basis it “den[ied] payment to Caribbean I.” (Complaint, ¶ 13.) By contrast, Caribbean I submitted to Great American “an estimate of the cost to repair the building, which included costs related to alleged construction deficiencies from the original construction.” (Id., ¶ 11.) On August 2, 2007, the Complaint alleges, Caribbean I notified Great American of its disagreement as to the amount of the covered loss and demanded appraisal pursuant to the terms of the policy of insurance issued by Great American. (Id., ¶ 14.) Despite this demand, Caribbean I maintains, Great American has refused to submit this dispute to appraisal, such that Caribbean I seeks an order from this Court requiring Great American to engage in the contractual appraisal process. (Id., ¶¶ 15-17.)

*1181 The allegations in Count II with respect to the XL Specialty policy are materially similar to those in Count I with respect to the Great American policy. Once again, the moving force of that cause of action is the defendant insurer’s alleged wrongful refusal to participate in the appraisal process delineated in its insurance policy. (Id., ¶¶ 19-25.) Count II includes a specific allegation that Caribbean I presented XL Specialty with “an estimate of the cost to repair the building, which included costs which related to alleged construction deficiencies from the original construction.” (Id., ¶ 19.) Similar to Count I, the Complaint alleges that XL Specialty performed an adjustment and concluded that the covered loss was substantially lower than plaintiffs estimate. 3 As with the Great American policy, Caribbean I alleges that it informed XL Specialty that it disagreed with the insurer’s calculation of the amount of the covered loss and demanded appraisal on August 2, 2007. (Id., ¶22.) The appraisal clause of the XL Specialty policy stated, in relevant part, as follows: “If You and We fail to agree as to the value of the property or amount of loss, damage or expense, each may, on the written demand of either, select a competent and impartial appraiser, and the appraisal shall be made at a reasonable time and place.... The appraisers shall then appraise the loss, stating separately the value at the time of loss and the amount of loss____” (Id. (emphasis added).) 4

Both Count I and Count II contain materially identical ad damnum clauses specifying that plaintiff seeks the following: (a) insurance benefits in an amount in excess of $75,000.00, plus interest and costs, to be determined pursuant to the appraisal provision of the insurance policy; and (b) an order requiring the insurer defendant to participate in the appraisal process, with entry of judgment by the Court upon determination through appraisal of the amount of the covered loss. (Id., at 5, 7.) Thus, it appears that the relief sought by plaintiff in this action is hinged on initiation of the appraisal process pursuant to both the Great American and the XL Specialty policies. Specifically, plaintiff wants the amount of its covered losses to be fixed via appraisal with respect to both policies, and then to have judgment entered in its favor in those amounts.

II. Legal Standard.

On a motion to dismiss for failure to state a claim upon which relief can be granted, the Court must view the complaint in the light most favorable to the plaintiff. Hill v. White, 321 F.3d 1334, 1335 (11th Cir.2003). Thus, “when ruling *1182 on a defendant’s motion to dismiss, a judge must.accept as true all of the factual allegations contained in the complaint.” Erickson v. Pardus, 551 U.S. 89, 127 S.Ct. 2197, 2200, 167 L.Ed.2d 1081 (2007). The rules of pleading require only that a . complaint contain “a short and plain statement of the claim showing that the pleader is entitled to relief.” Rule 8(a)(2), Fed. R.Civ.P. While a complaint attacked by a Rule 12(b)(6) motion need not be buttressed by detailed factual allegations, the plaintiffs pleading obligation “requires more than labels and conclusions, and a formulaic recitation of the elements of a cause of action will not do.” Bell Atlantic Corp. v. Twombly, 550 U.S. 544, 127 S.Ct. 1955, 1964-65, 167 L.Ed.2d 929 (2007). The rules of pleading do “not require heightened fact pleading of specifics, but only enough facts to state a claim to relief that is plausible on its face.” Id. at 1974; see also Financial Sec. Assur., Inc. v. Stephens, Inc., 500 F.3d 1276, 1282 (11th Cir.2007) (explaining that “factual allegations in a complaint must possess enough heft to set forth a plausible entitlement to relief’) (citation omitted). The Court’s inquiry at this stage focuses on whether the challenged pleadings “give the defendant fair notice of what the ... claim is and the grounds upon which it rests.”

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619 F. Supp. 2d 1178, 2008 U.S. Dist. LEXIS 20406, 2008 WL 687381, Counsel Stack Legal Research, https://law.counselstack.com/opinion/caribbean-i-owners-assn-v-great-american-insurance-alsd-2008.