First Baptist Ch v. Church Mutual Ins

105 F.4th 775
CourtCourt of Appeals for the Fifth Circuit
DecidedJune 26, 2024
Docket23-30514
StatusPublished
Cited by8 cases

This text of 105 F.4th 775 (First Baptist Ch v. Church Mutual Ins) is published on Counsel Stack Legal Research, covering Court of Appeals for the Fifth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
First Baptist Ch v. Church Mutual Ins, 105 F.4th 775 (5th Cir. 2024).

Opinion

Case: 23-30514 Document: 59-1 Page: 1 Date Filed: 06/26/2024

United States Court of Appeals for the Fifth Circuit United States Court of Appeals Fifth Circuit ____________ FILED June 26, 2024 No. 23-30514 ____________ Lyle W. Cayce Clerk First Baptist Church of Iowa, Louisiana,

Plaintiff—Appellee,

versus

Church Mutual Insurance Company, S.I.,

Defendant—Appellant. ______________________________

Appeal from the United States District Court for the Western District of Louisiana USDC No. 2:21-CV-2472 ______________________________

Before Willett, Wilson, and Ramirez, Circuit Judges. Irma Carrillo Ramirez, Circuit Judge: First Baptist Church of Iowa, Louisiana (FB Church) sued Church Mutual Insurance Company, S.I. (CM Insurance) under an insurance policy, alleging failure to pay benefits for property damage caused by Hurricane Laura. After a bench trial, the district court found in favor of FB Church and awarded it damages, statutory penalties, attorney’s fees, and costs. CM Insurance appealed. We affirm in part and reverse in part. Case: 23-30514 Document: 59-1 Page: 2 Date Filed: 06/26/2024

No. 23-30514

I FB Church owns real property in Iowa, Louisiana, on which sit three buildings: (1) the main building (the church), (2) the parsonage, and (3) a vacant building. The church includes a sanctuary, fellowship hall, classrooms, nursery, kitchen, bathrooms, and offices. The property was insured under a commercial insurance policy issued by CM Insurance. It provided replacement cost coverage for the church, the parsonage, and all personal property on those premises with a blanket limit of $1,236,000, and actual cash value coverage for the vacant building with a $65,000 limit. The church and parsonage had a 5% deductible, and the vacant building had a $5,000 deductible. In the event of a covered loss, CM Insurance had the option to pay for the cost to repair or replace damaged property “as of the time of loss or damage.” On August 27, 2020, Hurricane Laura caused considerable damage to the property. The next day, FB Church reported the loss to CM Insurance. CM Insurance retained a third-party administrator, Engle Martin & Associates, LLC (CM Insurance’s Administrator), to adjust the loss on its behalf. On September 7, 2020, CM Insurance’s Administrator’s field adjuster, Wesley Ellis (Adjuster), met with FB Church’s pastor at the property for an initial inspection. Adjuster inspected and photographed the exterior and interior of the church and parsonage. On September 8, 2020, Adjuster sent CM Insurance a three-page Immediate Advice Report, along with the photographs, which estimated the total loss at $630,000, before deductibles. The report noted that the church’s roof, including the gable roof covered by shingles and the recently installed roof over the backside of the building, had significant damage. As a result, the interior of the building also suffered significant damage, including to the ceiling, insulation, electrical lighting, wall paneling, trim work, VCT tile, and

2 Case: 23-30514 Document: 59-1 Page: 3 Date Filed: 06/26/2024

carpet. The report also noted structural damage to the church’s supporting structural post as well as cracks throughout the brickwork on the front and rear elevation of the building. As for the parsonage, the laminate shingles, soffit, fascia, and shutters were damaged. Water had intruded throughout the dwelling, damaging the ceiling insulation and acoustic tiles, wall paneling, trim work, baseboards, and flooring. Given the magnitude of damage observed, the report recommended retention of an engineer to inspect the property for structural damage. Because the loss was immediately classified as a large loss in excess of $500,000, CM Insurance’s Administrator assigned Mike Fink, its executive general adjuster (Executive Adjuster), to oversee the claim going forward. On September 17, 2020, FB Church sent a bid totaling $9,195.33 for replacement of the parsonage’s roof. Adjuster reviewed the bid and used Xactimate, a computer software system commonly used by insurance adjusters to generate loss estimates, to estimate a replacement cost of $10,178.05, or $8,269.03 with depreciation. On September 22, 2020, Adjuster and Executive Adjuster sent CM Insurance a report with more information on the damages observed from the September 7, 2020 inspection of the church and parsonage. The report estimated the net loss after applying the deductible to be $560,150. This was based on the same $630,000 estimate of loss from the Immediate Advice Report. The report included Adjuster’s Xactimate estimate for replacing the parsonage roof and recommended accepting the $9,195.33 bid. It also noted that Bret O’Steen, an engineer and construction consultant with Young & Associates (Engineer), had been retained to assist in the claim. The report explained that the expected loss was approximately $630,000 and recommended that CM Insurance issue an advance payment of $50,000 to allow for commencement of repairs. It also advised CM Insurance of its obligation to pay claims under Louisiana Revised Statutes § 22:1892 (A)(1).

3 Case: 23-30514 Document: 59-1 Page: 4 Date Filed: 06/26/2024

Adjuster stopped working on the claim after this report was sent to CM Insurance. On September 22, 2020, Engineer visited the property and inspected all three buildings. On October 12, 2020, CM Insurance sent FB Church an advance payment of $100,000. On October 14, 2020, Engineer sent Executive Adjuster three separate reports, estimating the damage to the church at $244,984.16, the parsonage at $19,780.17, and the vacant building at $8,656.05, for total damages of $273,420.38. He generated the estimates on Xactimate, and used a September 2020 price list for materials to determine costs because the price list was created within a few days of the hurricane. Around this time, Executive Adjuster advised FB Church to use a licensed, bonded remediation company who had access to Xactimate for mitigation work because it would make the scope of work easier. Based on his recommendation, FB Church hired ServPro to perform drying and mitigation work. ServPro originally submitted an invoice for $59,664.42, followed up by a supplemental invoice for $16,994.34 for special equipment. Even though he believed the amounts were excessive, Executive Adjuster instructed FB Church to pay the original invoice, which it did. He then reached out to ServPro about the supplemental invoice and was told that it did not include additional mitigation work, and that an updated supplemental invoice would be sent in the future. On October 22, 2020, Executive Adjuster sent CM Insurance a report along with Engineer’s damage estimate reports and the estimates ServPro had provided FB Church for mitigation work. The report explained that the ServPro estimates appeared excessive, Engineer had reached out to ServPro about the invoices, and he told ServPro to move forward with mitigation and demolition in certain areas of the church. It also noted that Engineer’s team

4 Case: 23-30514 Document: 59-1 Page: 5 Date Filed: 06/26/2024

was scheduled to reinspect the property in three days because FB Church identified several items omitted from his estimates. The report began by listing the estimate of loss at $630,000. It then subtracted FB Church’s $69,850 deductible and CM Insurance’s payment of the $100,000 advance, bringing the net estimate of loss to $460,150. Despite the net estimate of loss, the report further subtracted $288,532.16 for depreciation of the buildings and FB Church’s business personal property. Accordingly, Executive Adjuster recommended paying only $171,617.84 more to FB Church. He also recommended paying an additional $10,000 because FB Church requested temporary office space, which was allowed under the policy, and the sublimit would likely be exhausted for this aspect of the claim.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Cite This Page — Counsel Stack

Bluebook (online)
105 F.4th 775, Counsel Stack Legal Research, https://law.counselstack.com/opinion/first-baptist-ch-v-church-mutual-ins-ca5-2024.