Giambrone v. Meritplan Insurance

117 F. Supp. 3d 259, 2015 U.S. Dist. LEXIS 100000, 2015 WL 4602869
CourtDistrict Court, E.D. New York
DecidedJuly 30, 2015
DocketNo. 13-CV-7377 (MKB)
StatusPublished
Cited by10 cases

This text of 117 F. Supp. 3d 259 (Giambrone v. Meritplan Insurance) is published on Counsel Stack Legal Research, covering District Court, E.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Giambrone v. Meritplan Insurance, 117 F. Supp. 3d 259, 2015 U.S. Dist. LEXIS 100000, 2015 WL 4602869 (E.D.N.Y. 2015).

Opinion

MEMORANDUM & ORDER

MARGO K. BRODIE, District Judge:

Plaintiffs Pietro Giambrone and Brigid Giambrone commenced the above-captioned action on October 24, 2013, against Defendant Meritplan Insurance Company (“Meritplan”) in the Supreme Court of the State of New York, County of Richmond. On December 27, 2013, Defendant removed the action to this Court. Plaintiffs alleged breach of contract and breach of the duty of good faith and fair dealing, arising from a dispute over whether an insurance policy issued by Defendant covers alleged damage to Plaintiffs’ property arising from Hurricane Sandy (“Sandy”).1 Additionally, Plaintiffs sought a declaratory judgment that the terms of their insur-[262]*262anee policy obligate Defendant to pay for the property damage alleged by Plaintiffs. On September 18, 2014, the parties stipulated to dismissal of all' claims ' except Plaintiffs’ breach of contract claim, on which Plaintiffs' seek compensatory damages. (Docket Entry No. 67.) On November 26, Defendant moved to disqualify Plaintiffs’ counsel, Verne Pedro, and hi's law firm, Ellis, Ged & Bodden P.A. (“EGB”), as conflicted. The Court heard oral argument on July 1, 2016, and denied Defendant’s motion to disqualify Mr. Pedro and EGB from representing Plaintiffs in this action. The Court explains its decision below.

I. Background

a. The Insurance Policy, claim and denial

In the action presently before .the Court, Plaintiffs are represented by Verne Á. Pedro, an- associate- at EGB. Defendant is represented by Joanna M. Roberto and Clayton' D.- Waterman of the law firm Goldberg Segalla LLP (“Goldberg Segal-la”).

Plaintiffs allege the following facts in their Complaint. Plaintiffs were issued a standard-form homeowner’s insurance policy by Defendant, bearing policy number 60430002, which was effective beginning on May 12, 2012 and ending on May 15, 2013 (the “Insurance Policy”).2 (Compí. f 1, annexed to Not. of Removal as Ex. 2, Docket Entry 1-2.) Plaintiffs’ home, located at 171 Androvette Avenue in Staten Island, New York (the “Property”), suffered “extensive damage” from wind-driven rain during Sandy. (Id. ¶ 3.) At the time of the storm, the Property was insured under the Insurance Policy which covered, among other things, injury to, destruction of, or loss of use of the Property resulting from wind and wind-driven rain. (Id. ¶¶ 7, 13-14.) Plaintiffs submitted a property damage claim under the Insurance Policy to Defendant, seeking payment for damage resulting from the storm.3 (Id. ¶ 16.) Defendant denied Plaintiffs’ claim, citing a provision in .the Insurance Policy excluding flood damage from coverage under the Insurance Policy. (Id. ,-¶ 17.) Plaintiffs allege that the damage to the Property caused by wind and wind-driven rain is separable from any flood damage to the Property, and thus covered 'by the Insurance Policy. (Id. ¶¶ 3, 18-19.) Plaintiffs contend that Defendant failed to investigate their insurance claim and adjust the claim properly, and has denied coverage without a reasonable basis for doing so. (Id. ¶¶ 20-21,23.)

Plaintiffs initially sought a declaration that (1) the Property was damaged as a result of wind or wind-driven rain; (2) the damage is therefore covered under the [263]*263Insurance Policy; (3) the Insurance Policy is “triggered based on the date on which the damage occurred;” and (4) Plaintiffs are entitled to coverage, damages, and other relief as a result of Defendant’s breach of the Insurance Policy and breach of the duty of good faith and fair dealing. (Id. ¶ 5.) Plaintiffs now seek only compensatory damages for breach of the Insurance Policy, (Docket Entry No. 67.) '

b. The relationship between Defendant and QBE entities

Currently, Defendant’s insurance policies are owned and handled by QBE insurance Group Ltd. and “QBE subsidiaries.” (Decl. of Joanna M. Roberto in Support of Mot. to Disqualify Pis.’ Counsel, annexed to Def. Mem. as Ex. C (“Roberto Decl.”) ¶ 2.) QBE Insurance Corporation reinsures all policies underwritten by Meritplan and, in doing so, it “assumes all assets, liabilities and risks arising out of coverage under the Meritplan policies.” (Def. September 2014 Letter 1, Docket Entry No. 69.) At oral argument, counsel for Defendant further explained that QBE Insurance Corporation reinsures all Mer-itplan-issued policies, but maintains the policies under the Meritplan name. In June 2011, QBE Americas, Inc. (“QBEAI”) became the third-party claims administrator for Defendant. (Decl. of Kenneth Davidson4 in Support of Mot. to Disqualify Pis. Counsel, annexed to Def. Mem. as Ex. B (“Davidson Decl.”) ¶2.) As third-party administrator, QBEAI “supervises and manages all aspects of claims for several QBE insurers, affiliates and policies underwritten by other carriers ... including claims for Meritplan.” (Supp. Decl. of Kenneth Davidson in Further Support of Mot. to Disqualify (“Supp. Davidson Decl.”) . ¶ 3, Docket Entry No. 120.-2.) An affiliate of QBEAI, QBE FIRST Insurance Agency,' Inc. (“QBE FIRST”) became program manager for Defendant. (Davidson Decl. ¶ 2.) Together, QBEAI and QBE FIRST “assumed responsibilities and complete oversight for claims management and administration, adjusting, coverage and litigation management for Meritplan [insurance] policies.” (Id.) Meritplan has no independent duties with respect to handling the claims and litigation related to its insurance policies; “QBEAI manages the claims and the litigation strategies employed.” (Supp. Davidson Decl. ¶ 6.) Claims response and litigation strategies are determined by the same panel of counsel for Meritplan and other QBE-affiliates’ insurance policies, and the panel, of counsel tends to use uniform claims, cqverage and litigation strategies across policies. (Id. ¶¶-7-8.)

The Insurance Policy — at issue in this litigation — was underwritten by Meritplan and issued to Plaintiffs’ home mortgage lender, GMAC Mortgage, LLC. (Roberto Decl. ¶3; Ans. ¶¶ 24-25.) QBEAI and QBE FIRST have “at all times managed and assumed responsibility for all aspects of the [Plaintiffs’ Insurance] Policy, including the receipt of premiums and the administrations of claims submitted under the [Insurance] Policy.” (Davidson Decl. ¶ 5.) The legal department for QBEAI and QBE FIRST works in conjunction with Goldberg Segalla to oversee-the litigation in this action, “and remains responsible for any and all liabilities under the [Insurance] Policy.” (Id.; Supp. Davidson Decl. ÍI9.) Defendant contends that there is “one North American claims department which administers claims including litigations for QBE and non-QBE insurers which in-[264]*264eludes Meritplan.” (Def. Supp. Brief in Supp. of Mot. to Dismiss 3.) As counsel explained at oral argument, the same individuals frequently handle all of the legal claims for insurance policies issued by both QBE and non-QBE insurers and administrated and managed by QBEAI and QBE FIRST.

c. Mr. Pedro’s former employment at Goldberg Segalla

From November 1, 2010 through March 22, 2013, Mr. Pedro was employed as Special Counsel in Goldberg Segalla’s Global Insurance Services practice group. (Roberto Decl. ¶ 4; Aff. of Verne A. Pedro in Supp. of Pis.’ Opp’n to Def. Mot. to Disqualify, annexed to PL Opp’n (“Pedro Aff.”) ¶ 3.) As Special' Counsel, Mr.

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

Related

Cite This Page — Counsel Stack

Bluebook (online)
117 F. Supp. 3d 259, 2015 U.S. Dist. LEXIS 100000, 2015 WL 4602869, Counsel Stack Legal Research, https://law.counselstack.com/opinion/giambrone-v-meritplan-insurance-nyed-2015.