Douglas Wood and Carolyn Wood v. Foremost Insurance Company

471 F.3d 931, 2006 U.S. App. LEXIS 31886, 2006 WL 3802168
CourtCourt of Appeals for the Eighth Circuit
DecidedDecember 28, 2006
Docket06-1904
StatusPublished

This text of 471 F.3d 931 (Douglas Wood and Carolyn Wood v. Foremost Insurance Company) is published on Counsel Stack Legal Research, covering Court of Appeals for the Eighth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Douglas Wood and Carolyn Wood v. Foremost Insurance Company, 471 F.3d 931, 2006 U.S. App. LEXIS 31886, 2006 WL 3802168 (8th Cir. 2006).

Opinion

*933 BENTON, Circuit Judge.

A tornado damaged Douglas and Carolyn Wood’s roof. They made a claim under their homeowner’s policy. The Woods contend that Foremost Insurance Company did not promptly settle. They seek compensation for damage to their property; penalties and attorney’s fees under the Vexatious Refusal to Pay Claim statute; damages for injuries suffered by Mr. Wood when he fell from the roof while trying to repair it; and interest. The district court granted summary judgment to Foremost. The Woods appeal.

I.

After the tornado on May 6, 2003, the Woods immediately filed a claim. On May 17, a roofing company estimated repairs at $7,753. The Woods say they promptly forwarded the estimate to Foremost, which it refused. Foremost denies receiving a written estimate until November 4; the Woods claim that they thrice submitted the estimate to Foremost after the initial refusal.

Foremost inspected the Woods’ property on May 20, and delivered a check for $2,722 on May 21. The Woods told Foremost that it had not satisfied the policy. On June 17, Foremost paid an additional $1,267. With the roof still damaged and snow forecast, on November 23 Mr. Wood was injured when he fell from the roof while laying a tarp. Foremost inspected the roof on November 24, and sent another $3,338. On January 14, 2004, Foremost inspected the home’s interior, and two weeks later paid an additional $4,530. After three inspections and four payments over eight months, the Woods’ claim was settled (minus depreciation and the deductible).

II.

This court reviews de novo a grant of summary judgment. Wallace v. DTG Operations, Inc., 442 F.3d 1112, 1117 (8th Cir.2006). Summary judgment is appropriate when there is no genuine issue as to any material fact and the moving party is entitled to a judgment as a matter of law. Fed.R.Civ.P. 56(c). The evidence is viewed most favorably to the nonmoving party. Hitchcock v. FedEx Ground Package Sys., Inc., 442 F.3d 1104, 1106 (8th Cir.2006).

III.

The insurance policy reads, “We [Foremost] will make settlement within 30 days after we receive an acceptable proof of loss from you and the amount of loss is determined as provided in the policy.” The policy does not define an “acceptable proof of loss,” and thus is ambiguous as to when payment was due. When interpreting an insurance policy, Missouri courts follow the principle of contra proferentem, and construe any ambiguity against the insurer. See Krombach v. Mayflower Ins. Co., 827 S.W.2d 208, 210 (Mo. banc 1992).

Mr. Wood says he submitted an estimate to Foremost on May 20, and three times thereafter. Foremost denies receiving a written estimate from the Woods until November 4. For purposes of summary judgment, this court assumes that Foremost received an estimate from the Woods on May 20. Equally, any ambiguity as to an “acceptable proof of loss” is resolved against Foremost. Thus, a reasonable jury could find that Foremost was obligated to settle within 30 days after May 20 — which did not happen. A reasonable jury could find that Foremost breached the policy.

Foremost emphasizes that the Woods’ claim is now settled, with full com *934 pensation for all damages (including mold, corrosion, and water damage to the home’s interior). This argument ignores that the Woods also seek damages under the Vexatious Refusal to Pay Claim statute, sections 375.296 and 375.420 RSMo. If an insurance company refuses to pay a claim “without reasonable cause or excuse,” then a jury may award “damages not to exceed twenty percent of the first fifteen hundred dollars of the loss, and ten percent of the amount of the loss in excess of fifteen hundred dollars.... ” Section 375.420 RSMo. The statute also allows interest and attorney’s fees. Id. Viewing the facts most favorably to the Woods, a reasonable jury could find Foremost liable under the Vexatious Refusal statute. See Dhyne v. State Farm Fire & Cas. Co., 188 S.W.3d 454, 458-59 (Mo. banc 2006) (upholding a jury verdict imposing liability under this statute after a three-month delay by the insurance company).

IV.

Before Foremost made its last two payments, Douglas Wood was injured when he fell from the roof while trying to lay a tarp in anticipation of a snowfall. The Woods seek compensation for his medical bills, lost income, physical and emotional pain, and for Mrs. Wood’s loss of consortium. The policy does not cover personal injury claims.

In Missouri, recovery “by the insured against the insurance company for the policy benefit ... is limited to that provided by the law of contract plus, if section 375.420 applies, the enhancements provided by the statute.” See Overcast v. Billings Mut. Ins. Co., 11 S.W.3d 62, 68 (Mo. banc 2000). “[A]n insurance company’s denial of coverage itself is actionable only as a breach of contract and, where appropriate, a claim for vexatious refusal to pay.” Id. at 69.

The Woods’ personal injury claim is limited by the law of contract in Missouri. Generally, only reasonably foreseeable damages are recoverable in a contract case. See Kansas City Bridge Co. v. Kansas City Structural Steel Co., 317 S.W.2d 370, 381 (Mo.1958).

According to the Woods, their injuries were reasonably foreseeable when the policy was issued. In addition to claiming that Foremost knew their difficult financial position, the Woods invoke the policy language: “If you have a loss, you must protect your dwelling, other structures or personal property from any further damage. If you fail to do so, any further damage will not be insured by this policy.” Accompanying Foremost’s checks was a warning to “cash this check promptly and use its proceeds to repair your damaged property,” or there will be no coverage for “any additional damage caused by your failure to repair or for unreasonably delayed repairs.”

The Woods cite no Missouri authority to support their argument that Mr. Wood’s fall was reasonably foreseeable. The most apposite precedent is Bassett v. Federal Kemper Insurance Co., 565 S.W.2d 823 (Mo.App.1978). In Bassett, the insurance company vexatiously refused paying a claim by retroactively cancelling the policy. The insured could not pay the repair shop, which refused to release the damaged car. The insured sued under the Vexatious Refusal statute for, among other things, $11 in replevin costs and $56 in lost wages.

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Related

Wallace v. Dtg Operations, Inc.
442 F.3d 1112 (Eighth Circuit, 2006)
West v. Jacobs
790 S.W.2d 475 (Missouri Court of Appeals, 1990)
Dhyne v. State Farm Fire & Casualty Co.
188 S.W.3d 454 (Supreme Court of Missouri, 2006)
Overcast v. Billings Mutual Insurance Co.
11 S.W.3d 62 (Supreme Court of Missouri, 2000)
Kansas City Bridge Co. v. Kansas City Structural Steel Co.
317 S.W.2d 370 (Supreme Court of Missouri, 1958)
Bassett v. Federal Kemper Insurance Co.
565 S.W.2d 823 (Missouri Court of Appeals, 1978)
Krombach v. Mayflower Ins. Co., Ltd.
827 S.W.2d 208 (Supreme Court of Missouri, 1992)
United Iron Works v. Twin City Ice & Creamery Co.
296 S.W. 109 (Supreme Court of Missouri, 1927)
Soukup v. Employers' Liability Assurance Corp.
108 S.W.2d 86 (Supreme Court of Missouri, 1937)
Weber Implement Co. v. Acme Harvesting Machine Co.
187 S.W. 874 (Supreme Court of Missouri, 1916)

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471 F.3d 931, 2006 U.S. App. LEXIS 31886, 2006 WL 3802168, Counsel Stack Legal Research, https://law.counselstack.com/opinion/douglas-wood-and-carolyn-wood-v-foremost-insurance-company-ca8-2006.