First Guaranty Bank v. Pelican State Mutual Insurance Co.

590 So. 2d 1306, 1991 La. App. LEXIS 3218, 1991 WL 255268
CourtLouisiana Court of Appeal
DecidedNovember 22, 1991
DocketNo. 90 CA 1724
StatusPublished
Cited by4 cases

This text of 590 So. 2d 1306 (First Guaranty Bank v. Pelican State Mutual Insurance Co.) 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
First Guaranty Bank v. Pelican State Mutual Insurance Co., 590 So. 2d 1306, 1991 La. App. LEXIS 3218, 1991 WL 255268 (La. Ct. App. 1991).

Opinion

CRAIN, Judge.

Billy F. Hawkins and his wife, Robbie Sue Mason Hawkins, purchased by credit deed a commercial building and the immovable property on which it was located. The purchase price was $315,250. Hawkins paid $50,000 in cash and signed two promissory notes payable to sellers in the sums of $209,000 and $56,250 respectively. The property was purchased from Mr. and Mrs. Glen Reid and Mr. and Mrs. Glen Gabriel Reid. The Reids had several years earlier executed a promissory note in the sum of $200,000 and a mortgage on the property in favor of First Guaranty Bank (Bank). Thus, the Bank held the first mortgage on the property purchased by Hawkins from the Reids.

Hawkins established a restaurant on the premises, the Open Hearth Steak House. The restaurant was in operation for about three months when in the early morning hours of October 25, 1987, the building and its contents were damaged by fire. Hawkins had previously obtained two commercial fire insurance policies on the premises which were in effect at the time of the fire: one from Pelican State Mutual Insurance Company (Pelican) and another from Certain Companies and/or Certain Underwriters at Lloyds, London (Lloyds). The policy limits on both policies were identical ($37,-500 for contents and $100,000 on the building.)

The Bank instituted an action against the insurers for payment of its claim as mortgagee, and Hawkins intervened. The insurers paid to Glen Reid and the Bank the aggregate sum of $158,577. The Reids and the Bank in turn partially assigned their claims against the Hawkinses to the insurers. Defendants, as partial assignees, instituted a third party action against the Hawkinses. Upon the Bank's motion its action against the insurers was dismissed. Trial proceeded on the intervention and the third party action. After trial on the merits the jury returned a special verdict finding that defendants did not establish that the fire was caused by arson, nor did defendants establish that Hawkins was ultimately responsible for its cause. The jury further found that defendants were not entitled to recover from Hawkins for their payments to the mortgagees. Hawkins was awarded $18,000 for damage to the structure (which was in addition to that previously paid to the mortgagees) and $75,000 for damage to the contents. No statutory penalties and attorney’s fees were awarded to Hawkins. Judgment was rendered in conformity with the special verdict. From this judgment defendant insurers appeal alleging as error the court’s refusal to allow the jury to consider defendants’ defense of fraud and false swearing; the jury’s determination that defendants had not established an arson defense; the judgment casting all defendants for the full amount of the judgment rather than casting defendants in judgment in proportion to their various policy limits.

JURY CONSIDERATION OF DEFENSE OF FRAUD AND FALSE SWEARING

In this assignment of error defendants contend that Hawkins intentionally, [1308]*1308fraudulently and falsely inflated his claim for damages on the contents and that his actions in so doing gives rise to the defense of fraud and false swearing which can operate to void the entire policy. Defendants requested that pursuant to La.R.S. 22:692.1, the court submit to the jury a special interrogatory on this issue. Defendants urge that the trial court’s refusal to do so, despite defendants’ objections, constitutes reversible error.

La.R.S. 22:691(F)(2) prescribes the standard provisions of a fire insurance contract, and provides in pertinent part:

Concealment, fraud — This entire policy shall be void if, whether before or after a loss, the insured has willfully concealed or misrepresented any material fact or circumstance concerning this insurance or the subject thereof, or the interest of the insured therein, or in case of any fraud or false swearing by the insured relating thereto.

La.R.S. 22:692.1 provides:

Assertion of a defense of material misrepresentation made by an insured subsequent to loss by fire as to the value of the contents of a residence or business shall not entitle an insurer to void total coverage of the policy based on such misrepresentation, unless a court of competent jurisdiction determines and adjudicates otherwise.

Pursuant to statutory authority the named insured’s fraud and false swearing regarding the value of the contents when submitting a claim on a fire insurance policy is a valid defense available to the insurer and may serve to void total coverage of the policy and is a factual determination which must be made by the trier of fact. The trial judge refused to submit this issue to the jury because of a mistaken interpretation of the applicable law, i.e., the insurer must have detrimentally relied upon such intentional misrepresentation. We find nothing in the statutes and the jurisprudence which requires detrimental reliance by the insurer in order for the insurer to avail itself of this defense. Thus the trial judge erred in not submitting this issue to the jury.

If a jury is prevented from rendering a verdict on a pertinent finding of fact, the reviewing court may render a judgment on the record if the record is otherwise complete. Steinbach v. Barfield, 428 So.2d 915 (La.App. 1st Cir.), writ denied, 435 So.2d 431 (La.1983).

The policy limits of each policy was $37,-500 for contents and $100,000 on the building. Hawkins submitted two identical proof of loss statements (one to Pelican and one to Lloyds) estimating the cash value of the contents and building at $408,324 and the whole loss and damages at $408,324. Hawkins also submitted to defendants an inventory of the contents listing either the cash value or replacement value of each item. Hawkins claimed damages for the full $137,500 limits of each policy. Defendants do not contest that the contents were valued at approximately $155,000 as indicated in the inventory.

Hawkins stated that it was his understanding that defendants requested an inventory or list of all contents and their replacement costs which is what he provided. He further stated that several items on the inventory list were not completely destroyed and were reusable (although some of these items would have to be repaired before reuse). He did not intend to indicate that each item included in the inventory list was totally destroyed, although almost everything was damaged to some extent, even if by water or smoke. The estimated value of these excepted items was $50,000. These are the items which defendants contend were the subject of the fraud and false swearing by Hawkins in his alleged attempt to inflate the insurance claim from which defendants contend total coverage on the policies should be voided.

Misrepresentations in a proof of loss will void coverage “only if the insured knowingly and intentionally makes such misrepresentations with the intent to deceive and defraud the insurer. Fraud will never be presumed from acts which may be accounted for on the basis of honesty and good faith.” Clifton v. Louisiana Farm Bureau Casualty Insurance Company, [1309]*1309510 So.2d 759, 762 (La.App. 1st Cir.1987). After de novo review of the evidence, we find that defendants did not meet their burden of proving that Hawkins intentionally attempted to defraud defendants.

The uncontested value of the lost or destroyed contents was at least $100,000. The combined policy limits coverage on contents total $75,000 which is $25,000 less than the actual content damages suffered by Hawkins.

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Cite This Page — Counsel Stack

Bluebook (online)
590 So. 2d 1306, 1991 La. App. LEXIS 3218, 1991 WL 255268, Counsel Stack Legal Research, https://law.counselstack.com/opinion/first-guaranty-bank-v-pelican-state-mutual-insurance-co-lactapp-1991.