COOK v. USAA CASUALTY INSURANCE COMPANY

CourtDistrict Court, D. Maine
DecidedFebruary 4, 2020
Docket1:16-cv-00207
StatusUnknown

This text of COOK v. USAA CASUALTY INSURANCE COMPANY (COOK v. USAA CASUALTY INSURANCE COMPANY) is published on Counsel Stack Legal Research, covering District Court, D. Maine primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
COOK v. USAA CASUALTY INSURANCE COMPANY, (D. Me. 2020).

Opinion

UNITED STATES DISTRICT COURT DISTRICT OF MAINE JENNIE M. COOK, ) ) Plaintiff ) ) v. ) 1:16-cv-00207-JCN ) USAA CASUALTY ) INSURANCE COMPANY, ) ) Defendant ) MEMORANDUM OF DECISION ON MOTION FOR SUMMARY JUDGMENT In this action, Plaintiff alleges that Defendant breached an insurance contract and unfairly resolved her insurance claim after her house was damaged by a fire. (First Amended Complaint, ECF No. 8.) The matter is before the Court on Defendant’s motion for summary judgment. (ECF No. 100.) Following a review of the record, and after consideration of the parties’ arguments, the Court grants in part and denies in part Defendant’s motion. PROCEDURAL BACKGROUND Plaintiff filed her complaint in Maine Superior Court alleging a claim for breach of contract and an unfair claims settlement claim. (Complaint, ECF No. 1-2.) Defendant removed the case to federal court based on diversity jurisdiction. (Notice of Removal, ECF No. 1.) Plaintiff subsequently filed a motion to amend the complaint, which motion the Court granted. (Motion and Order, ECF Nos. 6 – 7.) In her amended complaint, Plaintiff alleged: (1) breach of contract claiming that she was entitled to the full repair or replacement value of the loss and to additional fair rental value payments; (2) unfair claims settlement practices; (3) negligence; and (4) negligent

misrepresentation regarding coverage for ordinances and building codes. (Amended Complaint, ECF No. 8.) In her response to the motion for summary judgment, Plaintiff sought to dismiss the negligence and negligent misrepresentation claims. (Opposition to Motion for Summary Judgment at 4, ECF No. 114.) After the close of discovery, Defendant filed a motion for summary judgment.

(Motion, ECF No. 100.) At the hearing on the motion, Plaintiff raised for the first time a potential jurisdictional issue. Plaintiff then filed a motion to amend the complaint, a motion to join an indispensable party, and a motion to remand the matter to state court. (Motions, ECF Nos. 125 – 127.) The Court denied the motions. (Order, ECF No. 157.) Plaintiff’s counsel subsequently moved to withdraw (Motion, ECF No. 165) and

Plaintiff moved to stay the proceedings. (Motions to Stay, ECF Nos. 159, 162.) The Court granted the motion to withdraw and denied the motion to stay, but the Court permitted Plaintiff the opportunity to file a motion to supplement her summary judgment filing. (Order, ECF No. 168.) Plaintiff then requested leave to amend her opposition to Defendant’s motion for summary judgment. (Fourth Amended Motion for Leave to File

Amended Opposition, ECF No. 191; Plaintiff’s Supplemented Opposition, ECF No. 190- 3.) The Court granted Plaintiff leave to amend her opposition. (Order, ECF No. 192). Defendant filed a memorandum in reply to the supplemental opposition.1 (Reply, ECF No. 194.) FACTUAL BACKGROUND

A. The Property and the Policy In October 2012, Plaintiff contacted Defendant to secure a Rental Dwelling Policy on real property located at 188 Veazie Street, Old Town, Maine (the Property). (Defendant’s Statement of Facts ¶ 1, ECF No. 101, hereinafter DSMF.) Plaintiff originally purchased the Property with her husband in 1984 as their primary residence. (Plaintiff’s Additional Statement of Material Facts ¶ 137, ECF No. 113, hereinafter PASMF.) Plaintiff

is a trained and experienced real estate appraiser, and she describes the Property as a beautiful, older, Victorian or Colonial home. (Id. ¶¶ 138 – 140.) Plaintiff made a number of improvements to the Property. (Id. ¶ 141.) During Plaintiff’s initial phone call with Defendant, Plaintiff discussed “characteristics of [the] house,” and Defendant’s representative then provided an estimated monthly premium and explained the application

process. (DSMF ¶ 2.) No other matters were discussed on this call. (Id.) On November 16, 2012, Defendant issued Policy No. 00278416380A, insuring the Property. (Id. ¶ 3.) The initial coverage was made conditional on an inspection. (PASMF ¶ 176.)

1 The Court granted Defendant an opportunity to reply to Plaintiff’s amended opposition; Defendant objects to Plaintiff’s effort to amend not only her responsive legal argument, but also her responses to Defendant’s statement of material facts. (ECF No. 194.) As to Plaintiff’s attempt to amend her response to Defendant’s statement of material facts, Defendant’s arguments are not without merit. Plaintiff’s amended opposition response includes a significant number of paragraphs which apparently change her position on many of Defendant’s factual statements, referring to a separate document, “Cook’s amended denial of USAA’s Statement of Fact,” which document does not appear in the record. Furthermore, the paragraphs in which Plaintiff’s position is changed regarding Defendant’s factual statements do not comply with Local Rule 56. Nevertheless, the Court has considered Plaintiff’s amended legal arguments. On November 28, 2012, Mueller Inspections performed an inspection of the Property, which inspection revealed a series of “Condition Concerns,” including extensive moss growth, particularly on the roof, as well as a crumbling chimney. (DSMF ¶ 4.) In

March 2013, Plaintiff had a series of phone calls with an underwriter for Defendant in which they “talked about just the conditions and just some other safety conditions,” and the underwriter addressed her questions related to increased coverage limits based on the inspection and repairs that would be needed in order to maintain coverage. (Id. ¶ 5.) After the inspections, Defendant increased the cost of replacement to $444,000. (PASMF ¶ 177.)

Tenants occupied the Property from July 2012 through July 2013. (DSMF ¶ 6.) The Property was vacant between from July 2013 to the date of the fire in September 2013. (Id. ¶ 7.) During this time, Plaintiff lived in Virginia. (Id. ¶ 11.) B. The Fire On September 24, 2013 at approximately 7:00 a.m., a fire was reported at the

Property. (Id. ¶ 16.) The Fire Department determined that the fire was confined to an area of approximately six square feet on the second-floor rear portion of the Property. (Id. ¶ 18.) The Fire Department estimated that “not much water” (less than 1,000 gallons) was used to extinguish the fire, and they were able to suppress it in a short period of time. (Id. ¶ 19.) The Fire Department’s report reflects that only one story of the Property suffered any minor or serious damage, and that there was no heat damage on the first floor. (Id. ¶

20.) C. Water Mitigation and Initial Claim Estimate At approximately 4:15 p.m. on September 24, 2013, Plaintiff called Defendant and advised that the Fire Department was performing water mitigation at that time. (Id. ¶ 21.)

Paul Davis Restoration (Davis) was a participant in Defendant’s Property Direct Repair Program, the details of which program Defendant outlined in a letter to Plaintiff. (Id. ¶ 22.) On September 25, 2013, at 8:23 a.m., Plaintiff called Defendant, during which call the nature of Defendant’s relationship with Davis was explained; Plaintiff consented to the retention of Davis to perform post-fire mitigation services. (Id. ¶ 23.)

On September 25, 2013, Plaintiff and Davis entered into a contract to perform post- fire mitigation services. (Id. ¶ 24.) Joe Ouellette, a Davis representative, inspected the Property and documented its condition with a series of photographs. (Id. ¶ 25.) Plaintiff returned to Virginia on September 26, 2013. (Id. ¶ 26.) On September 27, 2013, Mr. Ouellette advised Defendant that the claim was a

“fairly large loss.” (Id. ¶ 27.) On the same day, the matter was assigned to Dennis McLaughlin, a general adjuster who handles losses in excess of $50,000. (Id. ¶ 28.) Mr. Ouellette advised Mr. McLaughlin that there was extensive fire damage in the second-floor back bedroom and hallway and “heat and smoke damage throughout the house.” (Id. ¶ 29.) Mr.

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Bluebook (online)
COOK v. USAA CASUALTY INSURANCE COMPANY, Counsel Stack Legal Research, https://law.counselstack.com/opinion/cook-v-usaa-casualty-insurance-company-med-2020.