Craig Roberts and Kristin Roberts v. Grinnell Select Insurance Company and Grinnell Mutual Reinsurance Company

Court of Appeals of Iowa·Decided July 22, 2026·No. 25-0562·Published

Opinion

IN THE COURT OF APPEALS OF IOWA _______________

No. 25-0562 Filed July 22, 2026 _______________

Craig Roberts and Kristin Roberts, Plaintiffs–Appellants, v. Grinnell Select Insurance Company and Grinnell Mutual Reinsurance Company, Defendants–Appellees. _______________

Appeal from the Iowa District Court for Greene County, The Honorable Ashley Sparks, Judge. _______________

REVERSED AND REMANDED _______________

Webb L. Wassmer (argued) of Wassmer Law Office, PLC, Marion, and Dominic F. Pechota, Decorah, attorneys for appellants.

Jack W. Leverenz (argued) of Carmoney Law Firm, PLLC, Urbandale, attorney for appellees. _______________

Heard at oral argument by Greer, P.J., and Buller and Sandy, JJ. Opinion by Sandy, J. Dissent by Greer, P.J.

1 SANDY, Judge.

This appeal turns on three words: “prejudicial to us.” The carrier wrote them into its own policy. The district court read them out.

Craig and Kristin Roberts (together, the “Robertses”) sued Grinnell Select Insurance Company and Grinnell Mutual Reinsurance Company (together, “Grinnell”) for breach of contract and bad faith after they allege the carriers refused to pay underinsured-motorist benefits following Craig’s collision with an underinsured driver. The carriers moved for summary judgment on the ground that the Robertses had breached the auto policy by failing to submit, before suit, to a physical examination, an examination under oath, and the production of certain documents. The district court agreed, presumed prejudice to the carrier, and dismissed all three claims.

We reverse and remand for further proceedings consistent with our holding that the contract language here does not permit Grinnell to rely on the presumption of prejudice discussed in cases like Simpson v. U.S. Fidelity & Guaranty Co., 562 N.W.2d 627 (Iowa 1997). On remand, the district court shall consider whether the summary-judgment record proves actual prejudice absent a presumption. The court’s review shall be limited to the arguments the parties made before appeal.

BACKGROUND FACTS AND PROCEEDINGS In November 2022, Craig was injured in a collision with an underinsured motorist, Abel Vargas, who ran a stop sign. Vargas’s liability carrier tendered its $300,000 limits. The Robertses then turned to their own coverage: a Grinnell Select auto policy with underinsured-motorist coverage, and a Grinnell Mutual umbrella policy with an underinsured-motorist endorsement. The combined limits were $1.25 million.

2 On March 25, 2024, the Robertses sent the carriers a twenty-two-page settlement opportunity letter demanding the policy limits. The letter attached Craig’s medical records and described the basis for the claim, including a $500,000 estimate for future medical expenses and a $300,000 estimate for past and future wage loss following early retirement.

On April 23, 2024, the carriers’ counsel responded by email. He explained that, given the “previously unidentified injuries outlined in the demand,” the carrier needed time and information to evaluate the claim. He proposed dates in May for a physical examination with a physician of the carrier’s choosing, dates in June for an examination under oath, and asked for a patient’s waiver, a list of Craig’s medical providers, a Social Security Administration waiver, and employment records.

The Robertses’ counsel responded the following day. He acknowledged the email and stated that the Robertses would be filing suit soon and would forward the petition for acceptance of service. He did not refuse any of the requests. He did not address them. No further communication has occurred. The carrier did not renew its requests. It did not warn that continued silence would be treated as a material breach. It did not state that coverage would be at risk.

On May 20, 2024, the Robertses filed their petition. The carriers answered. The parties exchanged initial disclosures, which included a patient’s waiver and a list of medical providers. On July 19, 2024, the district court approved a trial scheduling order setting trial for April 14, 2026. Written discovery could be served until January 14, and depositions could be taken until February 13.

3 The carriers served no interrogatories. They served no requests for production. They noticed no deposition of Craig Roberts. They noticed no independent medical examination under Iowa Rule of Civil Procedure 1.515. They made no renewed request, by any means, for any of the items their April 23 email had identified.

On October 31, 2024, the carriers moved for summary judgment. The motion did not allege prejudice. It argued that prejudice was presumed. The Robertses resisted, supplying an affidavit from their counsel attesting that he was aware of no prejudice and that all of the requested items could be—and were intended to be—provided through the ordinary discovery process. The carriers’ reply did not contradict the affidavit. It simply restated the presumption of prejudice.

The district court granted the motion. It read the policy as imposing conditions precedent to coverage; it found that the Robertses had not substantially complied with those conditions; it found no excuse or waiver; and it presumed prejudice. The court treated the policy’s express prejudice language as “consistent with” the Simpson framework rather than as an allocation of burden. The Robertses’ motion to reconsider was denied.

They now appeal.

STANDARD OF REVIEW We review the district court’s summary judgment ruling for the correction of legal error. Hagenow v. Am. Fam. Mut. Ins., 846 N.W.2d 373, 376 (Iowa 2014). Viewing the evidence in the light most favorable to the nonmoving party, “summary judgment is appropriate if the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material

4 fact and that the moving party is entitled to a judgment as a matter of law.” Id. (cleaned up).

DISCUSSION I. The Auto Policy

Part E of the Grinnell Select policy is captioned “Duties After an Accident or Loss.” It opens with a single sentence that controls everything that follows: “We have no duty to provide coverage under this policy if the failure to comply with the following duties is prejudicial to us.” (Emphasis added).

The clauses that follow list the duties the carrier invokes here— cooperation with the carrier’s investigation, submission to physical examinations and examinations under oath at the carrier’s reasonable request, and authorization to obtain medical and pertinent records. Part F, the general-provisions section, adds: “No legal action may be brought against us until there has been full compliance with all the terms of this policy.”

Two questions follow. The first is whether the prejudice condition in Part E matters. The second is whether, on this record, the carrier has met it.

A. The Text Controls.

We give effect to every word and every provision of a contract, and we assume in the first instance that no part of the agreement is superfluous. U.S. Bank, Nat’l Ass’n v. Bittner, 986 N.W.2d 840, 848 (Iowa 2023). “[A]n interpretation which gives a reasonable, lawful, and effective meaning to all terms is preferred to an interpretation which leaves a part unreasonable, unlawful, or of no effect.” Iowa Fuel & Mins., Inc. v. Iowa State Bd. of Regents, 471 N.W.2d 859, 863 (Iowa 1991).

5 The carrier drafted the “prejudice to us” condition.

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