Cotton States Mutual Insurance v. Walker

500 S.E.2d 587, 232 Ga. App. 41, 98 Fulton County D. Rep. 1464, 1998 Ga. App. LEXIS 482
CourtCourt of Appeals of Georgia
DecidedMarch 19, 1998
DocketA97A2136
StatusPublished
Cited by3 cases

This text of 500 S.E.2d 587 (Cotton States Mutual Insurance v. Walker) is published on Counsel Stack Legal Research, covering Court of Appeals of Georgia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Cotton States Mutual Insurance v. Walker, 500 S.E.2d 587, 232 Ga. App. 41, 98 Fulton County D. Rep. 1464, 1998 Ga. App. LEXIS 482 (Ga. Ct. App. 1998).

Opinion

Beasley, Judge.

Chris and Melissa Walker sued Cotton States Mutual Insurance Company to recover under their homeowner’s policy of insurance. This appeal addresses the legal validity of the trial court’s denial of Cotton States’ motion for summary judgment.

On May 6, 1995, when the Walkers’ home was insured under a general homeowner’s policy of insurance issued by Cotton States, fire destroyed the house and its contents. Among the provisions of the policy were requirements that: in the event of a loss, the Walkers send to Cotton States a signed, sworn proof of loss containing certain specified information; the proof of loss be sent within 60 days after Cotton States’ request; and a prohibition against the Walkers’ filing suit against Cotton States unless they had complied with all provisions of the policy.

1. The entire record is considered de novo when reviewing denial of a motion for summary judgment to determine whether or not genuine issues of material fact exist which would preclude summary judgment or whether, given the undisputed facts, the movant is entitled to judgment as a matter of law. Cambridge Mut. Fire Ins. Co. v. Okonkwo, 218 Ga. App. 59, 61 (1) (460 SE2d 302) (1995). If a defendant who will not bear the burden of proof at trial points to an absence of evidence to support plaintiff’s case, the plaintiff, to avoid summary judgment, may not rest on his pleadings, but must point to specific evidence giving rise to a triable issue. Lau’s Corp. v. Haskins, 261 Ga. 491 (405 SE2d 474) (1991).

The trial court was right. There are issues of fact to be decided by a jury.

First of all, the policy does not include the provision necessary to prevent suit solely on the basis that the Walkers failed to file proof of loss within 60 days after the insurer’s request. Case law establishes that “a mere failure to furnish proper proofs of loss within the 60-day period will not work a forfeiture of the policy unless there is an express stipulation to that effect. [Cits.]” (Emphasis omitted.) Progressive Mut. Ins. Co. v. Burrell Motors, 112 Ga. App. 88 (1) (143 SE2d 757) (1965). The opinion on motion for rehearing in that case emphasizes that an express stipulation is required and that a statement that full compliance with all requirements in the policy is nec[42]*42essary is not enough. Accord Farm Bureau Mut. Ins. Co. v. Bennett, 114 Ga. App. 623, 624 (2) (152 SE2d 609) (1966); Parris v. Great Central Ins. Co., 148 Ga. App. 277, 278 (1) (251 SE2d 109) (1978); Canal Ins. Co. v. Savannah Bank &c. Co., 181 Ga. App. 520, 521 (2) (352 SE2d 835) (1987).

The requirement for proof of loss is set out in the portion of the policy spelling out “Your Duties After Loss.” It does not state that unless this is accomplished within the 60 days, the insurer will have no liability for payment. Nor does the provision regarding “Suit Against Us” include an express forfeiture stipulation but simply states that “No action can be brought unless the policy provisions have been complied with and the action is started within one year after the date of loss.” This is insufficient, as the cases cited above hold. Nowhere in the policy is there the express stipulation that allows forfeiture of benefits if the proof of loss is late.

Consequently, Cotton States was not entitled to summary judgment on the ground that the proof of loss was filed beyond the time provided in the policy and thereby constituted a forfeiture of payment of the claim.

2. Even if this were not so, the issue would remain whether the insurer’s agent, Barbara Stewart, waived the 60-day requirement for sending the proof of loss called for by the policy in paragraph 2 (g) of the section entitled “Conditions.”

By letter dated and mailed June 27, 1995, Special Claims Representative Stewart notified one of the insureds, Chris Walker, that the insurer had received notice of the fire at his residence on the sixth day of the previous month. One of the requests made was for submission of a completed proof of loss form, which was enclosed, in accordance with paragraph 2 (g).

Prior to that letter, and upon instruction from their attorney, the insureds had prepared an inventory of the contents of their home destroyed by the fire. It gave a listing, arranged by room and category, of each item of personal property, the age of each item and the cost of each. One of the express duties imposed on an insured in paragraph 2 of the policy Conditions is: “prepare an inventory of damaged personal property showing the quantity, description, actual cash value and amount of loss.”

Melissa Walker, for herself and as agent for her husband Chris, met with Claims Representative Barbara Stewart at the office of the Walkers’ attorney on July 7. Stewart recorded the interview. The inventory was presented to her, but she rejected it because it was not on the form which had been sent to Chris and she gave another copy of it to Melissa. According to Melissa, Stewart advised that “every bit” of the inventory had to be redone because “it was not in the proper format.” She instructed Melissa to “shop around and double-[43]*43check on all the prices to make sure everything was accurate ... to go into further detail and to do more research on it.” Melissa had done that to an extent but had not gone into great detail in finding actual prices and had not called people who had given them gifts to find out those prices.

Of critical importance on the issue of waiver is the following further testimony of Melissa with respect to the instructions Stewart gave to her at that meeting. She testified that Stewart “told [her]. . . to take [her] time and that [she] didn’t háve to be in any big hurry, because it would take plenty of research to do it.” Melissa confirmed that it did take a lot of research, and that she “had to go into great detail.” She repeated later: “Like I said, she just told me to take my time, that it would take plenty of time to go into great detail.” Considering that the three-bedroom house and all the contents of the house and garage and breezeway were lost, a jury could find such testimony credible. After all, ten days had already passed since the request was sent to Chris, which would have left only fifty, and Melissa herself would have had sixty more, counting the meeting as the time when the insurer made the request to her.

The form was worked on and finally completed and dated May 1, 1996, and sent. In explanation of the long time it took to complete the form, Melissa pointed out in her affidavit that the insurer “placed virtually impossible conditions on what would suffice for the proof of loss, to wit: finding the place of purchase of personal property which was given to [her] and her husband as gifts; the purchase price of those gifts; the depreciated value of personal property which has no market for resale.” Considering this and what had been said at the meeting, Melissa had no doubt that the Walkers complied with Stewart’s instructions.

As stated above, the policy provides as a condition that “No action can be brought unless the policy provisions have been complied with and the action is started within one year after the date of loss.” The insurer never did send a written request for proof of loss to Melissa, one of the two insureds, but the representative did hand her a form at the meeting she attended for herself and her husband.

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Bluebook (online)
500 S.E.2d 587, 232 Ga. App. 41, 98 Fulton County D. Rep. 1464, 1998 Ga. App. LEXIS 482, Counsel Stack Legal Research, https://law.counselstack.com/opinion/cotton-states-mutual-insurance-v-walker-gactapp-1998.