Cugini, Ltd. v. ARGONAUT GREAT CENT. INS.

889 So. 2d 1104, 2004 WL 2715895
CourtLouisiana Court of Appeal
DecidedNovember 30, 2004
Docket04-CA-795
StatusPublished
Cited by6 cases

This text of 889 So. 2d 1104 (Cugini, Ltd. v. ARGONAUT GREAT CENT. INS.) 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
Cugini, Ltd. v. ARGONAUT GREAT CENT. INS., 889 So. 2d 1104, 2004 WL 2715895 (La. Ct. App. 2004).

Opinion

889 So.2d 1104 (2004)

CUGINI, LTD., dba Andrea's Restaurant
v.
ARGONAUT GREAT CENTRAL INSURANCE COMPANY.

No. 04-CA-795.

Court of Appeal of Louisiana, Fifth Circuit.

November 30, 2004.

*1106 Patrick C. Kelley, Metairie, LA, for Plaintiff/Appellant.

John W. Waters, Jr., David E. Walle, New Orleans, LA, for Defendant/Appellee.

*1107 Panel composed of Judges SOL GOTHARD, JAMES L. CANNELLA, and SUSAN M. CHEHARDY.

JAMES L. CANNELLA, Judge.

The Plaintiff, Cugini, Ltd. (Cugini), d/b/a Andrea's Restaurant (Andrea's), appeals from a judgment on a claim for water damage against its insurer, Argonaut Great Central Insurance Company. We amend and affirm as amended.

The Defendant provided a standard commercial insurance policy to the Plaintiff, a restaurant located in Metairie, Louisiana and owned and operated by Chef Andrea Apuzzo (Chef Andrea). The policy was in effect from November 30, 2000 to November 31, 2001. On June 28, 2001, the Plaintiff discovered water seeping into its parking lot from an outside grease trap, a piece of equipment that filters greasy water flowing from the kitchen before going into the sewer pipe under the building. The Plaintiff immediately notified its insurance agent, John O'Brien (O'Brien) of Powell Insurance Agency, who went to the site and observed the water leaking around the trap. He immediately contacted the Defendant, though its claims manager in Illinois, James Ketchum (Ketchum) to see if the damage was covered. Based on the information at the time, Ketchum approved repairs. O'Brien instructed the Plaintiff to get a plumber to the site and an estimate. The Plaintiff contacted Dr. Pipe Plumbing (Dr. Pipe), which provided a written "estimate" before knowing exactly what would be required to fix the leak. The document was faxed to O'Brien. The document did not give a total estimated cost for the repairs, but described how much various items or labor would be charged if needed. Dr. Pipe then determined that the pipes under the building had broken, releasing sewer water into the soil. The water saturated the ground around the grease trap, causing the grease trap to tip over and break. On June 29, 2001, the Defendant sent an independent adjuster to evaluate the damage. He spoke to the Defendant's claims manager on July 3rd and issued a report on July 5, 2001, indicating that the damage was extensive. On July 17, 2001, the adjuster sent a civil engineer to inspect the damage to determine the cause of the problem. He concluded that the broken pipes that caused the water overflow were corroded from age.

On July 24, 2001, the Plaintiff received an invoice from Dr. Pipe for $31,576.00. The claim was then submitted to the Defendant. While waiting for the Defendant to pay the claim, the Plaintiff paid Dr. Pipe for the repairs. On October 1, 2001, the Defendant denied the claim, explaining that the policy excluded damage related to underground pipes. The Plaintiff responded with a letter disputing the Defendant's interpretation of the policy, again requesting payment of the claim. The Defendant again denied the claim.

The Plaintiff filed suit against the Defendant on December 17, 2001 to recover the costs of the repairs, as well as penalties and attorney's fees under La.R.S. 22:658 and 22:1220. The Plaintiff alleged that the Defendant specifically authorized the repairs on June 28, 2001, that the Plaintiff detrimentally relied on the authorization, that other provisions in the policy overrode the policy exclusions, and that the Defendant acted in bad faith in denying the claim.

A bench trial was held on September 22, 2003. At its conclusion, the trial judge found that the broken underground pipes had deteriorated over time and that the insurance policy did not cover underground pipe repairs and replacement. However, the trial judge requested memoranda briefing the issues of whether the replacement of the grease trap was covered under the policy and whether the *1108 principles of waiver and estoppel applied to provide coverage for the underground pipes. On October 30, 2003, the trial judge rendered a judgment in favor of the Plaintiff for $4,000 for the cost of replacing the grease trap only. Motions for New Trial filed subsequently were denied in November of 2003.

On appeal, the Plaintiff contends that the trial judge erred in failing to award the full amount of the claim. The Plaintiff further contends that the trial judge erred in failing to find that the Defendant acted in bad faith and was therefore subject to punitive damages and/or any other damages/penalties as provided in La.R.S. 22:658 and 22:1220. Third, the Plaintiff asserts that the trial judge erred in failing to find the Defendant arbitrary and capricious in failing to pay the claim.

O'Brien testified that when he went to the Plaintiff's site to observe the damages, he saw that a hole had been dug around the grease trap and that the trap was cracked and had tilted to the right. Water was pouring from under the building, eroding the soil away from the trap. He told Chef Andrea that he had to get it fixed to stop the leaking water. Chef Andrea wanted to know if the insurance would cover it. O'Brien was not sure. So, the two men went into the office and looked at the insurance policy. O'Brien still could not tell if it was covered and called the Defendant's Illinois office to find out. He was referred to Ketchum, the claims manager for Louisiana. Chef Andrea was in the room during the conversation. O'Brien told Ketchum that it looked like a broken pipe eroded some dirt under the grease trap, that they did not know where the water was coming from, and that the trap was on its side. He asked if the damages would be covered. According to O'Brien, "He said, yeah, go ahead, broken pipes are covered. Go ahead and have it fixed." O'Brien then told Chef Andrea to collect estimates and get the work going to have the problem fixed. The property loss notice he sent to the Defendant on that day states that the water eroded the soil under the grease trap causing the trap to shift and crack, and that the building needed a new grease trap.

When Chef Andrea received the estimate from Dr. Pipe, he gave it to O'Brien, who faxed it to Ketchum on July 5, 2001. That document did not state a total amount for the work, nor did it estimate the amount of work to be done. It listed standard industry costs for tunneling into the ground, breaking concrete, excavation, pipe and hanger repair and replacement, fill, and debris removal. According to Steve Chambers (Chambers), owner of Dr. Pipe, until the job commenced, there was no way to know how much the project would cost.

O'Brien went to the scene a week or so after his initial visit. At that time, he became concerned about the extent of the claim, because there was a lot of activity around the site. Several large trucks were parked in the lot and a number of workers were pumping mud from under the building as they tunneled. To him, it was a much larger job than thought on the day of the leak. O'Brien immediately used his cell phone to call Moulton Adjusting Services (Moulton) to alert the company to the fact that the job was getting extensive and to make sure they were "on top of this claim." He left a voice message. He did not have any further communication with Ketchum or anyone at Moulton. However, he told Chef Andrea to hurry with the bills and send them to the adjuster as soon as possible. At the end of July, O'Brien was informed for the first time that there were coverage problems and that the claim was denied, but the work, which took approximately four weeks, had already been completed by then.

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889 So. 2d 1104, 2004 WL 2715895, Counsel Stack Legal Research, https://law.counselstack.com/opinion/cugini-ltd-v-argonaut-great-cent-ins-lactapp-2004.