JACKSON v. SPINNAKER INSURANCE COMPANY

CourtDistrict Court, W.D. Pennsylvania
DecidedJanuary 28, 2025
Docket2:22-cv-01244
StatusUnknown

This text of JACKSON v. SPINNAKER INSURANCE COMPANY (JACKSON v. SPINNAKER INSURANCE COMPANY) is published on Counsel Stack Legal Research, covering District Court, W.D. Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
JACKSON v. SPINNAKER INSURANCE COMPANY, (W.D. Pa. 2025).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF PENNSYLVANIA

) DONALD JACKSON )

) Plaintiff, )

) Civil Action No. 22-1244 v. ) Judge Nora Barry Fischer

) SPINNAKER INSURANCE COMPANY, )

) Defendant. ) )

MEMORANDUM OPINION

I. INTRODUCTION Currently pending before the Court is Defendant’s Motion for Summary Judgment (Docket No. 49) in this breach of contract action. Plaintiff’s Complaint seeks coverage allegedly owed through the homeowners insurance policy (the “Policy”) in effect on June 10, 2021 when the subject property (the “Property”) was destroyed by fire. (Docket No. 1-4). Defendant Insurer seeks summary judgment on Plaintiff’s coverage claim on alternative grounds: (a) the Property was not Plaintiff’s “residence” and thus this loss was not covered under the Policy and/or (b) the Policy coverage was rendered void by Plaintiff’s misrepresentations during Defendant’s investigation of said loss (violation of its “Concealment or Fraud” provision).1 Defendant also seeks summary judgment on Plaintiff’s claim of bad faith.

1 Although Defendant’s Brief in Support of its motion asserts that Plaintiff made “material misrepresentations . . . in his application and/or during the investigation of the claim”, Defendant clarified during oral argument and in subsequent briefing that it seeks summary judgment on grounds of material misrepresentation only as to the latter. (Docket No. 50 at 2; Docket No. 62 at 37-38) (“[F]or summary judgment purposes, we’ve relied upon fraud during the course of the investigation.”). It intends, however, to pursue its position as to application misrepresentations (e.g., that the Property was Plaintiff’s “primary residence" and neither “vacant” nor “unoccupied”) at trial. (Docket No. 62 at 20-21) (“[W]hether or not [Plaintiff] had intent to deceive in his application, we recognize as a disputed fact and we have not waived that. We will argue that at trial.”). Cf. infra, n. 4. Upon careful consideration of the parties’ submissions and the evidence of record, and for the reasons set forth below, Defendant’s motion is granted as to Plaintiff’s claim of bad faith and otherwise denied. In brief, the Court observes that Defendant issued to Plaintiff, as insured, a fairly standard homeowners policy which (a) identifies the Property and (b) insures in its specified amounts and

circumstances a “residence premises” defined in pertinent part as “[t]he one-family dwelling where [insured] reside[s]”. (Docket No. 57-10 (Insurance Policy for Subject Property)).2 The Court concludes, in accordance with Pennsylvania law as interpreted and applied by the courts of this Circuit, that “residence” is itself an unambiguous term, residency was a condition precedent to Plaintiff’s coverage, and the record presents material fact questions from which the factfinder(s) could reasonably conclude that the Property was Plaintiff’s residence. It further concludes that the record presents material fact questions from which the factfinder(s) could also conclude that, the vagaries and apparent inconsistencies/revisions of some of Plaintiff’s representations notwithstanding, the Policy coverage was not void by fraudulent

misrepresentation in the investigation (e.g., by willful and knowing misrepresentation of material fact). However, the Court concludes that the same material fact questions,3 and the related

2 The Policy’s definition alternatively includes “[t]he [two- to four]-family dwelling where [insured] reside[s] in at least one of the family units” or “that part of any other ‘building’ where [insured] reside[s]” and which is “shown as the ‘residence premises’ in the Declarations”. The Court notes that the use of hyphenation in the Policy definition of residence as a “one-family” (or also a “two-, three- or four-family”) dwelling and the Policy’s other provisions foreclose an assertion that such language covered an insured’s “one family dwelling” (i.e., the sole and/or primary place of residence) rather than a single- (or, e.g., two- to four-) family dwelling. As the parties’ briefings correctly reflect, a more restrictive policy generally clearly denotes that it covers its subject property only as the insured’s “primary residence” and that it is not intended to provide coverage for a “residence” that may be seasonal or secondary. See also infra, Section VI.

3 The unusually extensive fact questions arise from the (sometimes surprising) (a) absence of supportive evidence typically provided by parties to residential insurance coverage litigation and (b) gaps and inconsistencies of record, particularly those pervading Plaintiff’s multiple oral interviews and testimony. Cf. Docket No. 50 at 2 (Defendant’s “investigation was extensive due [in part] to Plaintiff's changing and evolving story about where he was living [and] the condition of the subject property.”). existence of reasonable cause to inquire into both (a) Plaintiff’s residence at the Property and (b) his many gaps and variations/errors in memory, preclude a finding of bad faith in Defendant’s investigation or denial of coverage. An appropriate Order will follow. II. PROCEDURAL BACKGROUND Plaintiff’s Complaint – filed in the Court of Common Pleas of Allegheny County on

August 17, 2022 and removed by Defendant to this Court shortly thereafter – is comprised of two counts: Count I, alleging breach of contract regarding his covered loss and Count II, alleging a statutory bad faith claim pursuant to 42 Pa.C.S. § 8371. (Docket No. 1-4). Its core allegation is that Plaintiff is owed policy coverage for the Property, its contents, and his loss of use. (Id. at ¶¶ 35-41). Defendant’s Answer was filed September 8, 2022 and “significant discovery ensued”. (Docket No. 49 at ¶ 4). Defendant’s Motion for Summary Judgment and Brief in Support were filed on August 20, 2024 (Docket Nos. 49-50), followed by the parties’ Brief in Opposition, Replies and Sur- Replies. (Docket Nos. 54, 59, 60). Defendant’s Concise Statement of Material Facts and

Appendix, together with Plaintiff’s Counterstatement and Appendix, and the parties’ further responses followed. (Docket Nos. 51-52, 55-58). Evidentiary submissions were also provided as exhibits to several of the filings; oral argument was heard on October 25, 2024 (Docket No. 62 (Transcript)); and Defendant’s motion is ripe for disposition. III. FACTUAL BACKGROUND A. Policy Application and Coverage Denial Plaintiff completed Defendant’s online Homeowners Insurance Application on November 17, 20204 and Defendant issued a Homeowners Insurance Policy at No. HPA405265900,

4 The application form – completed online during the first year of the pandemic – consists of approximately two pages of fill-in-the-box basic information and another of coverage elections, together with an additional four pages effective November 25, 2020 to November 25, 2021, for “residence premises” located at 1000 Blythedale Road, Elizabeth, Pennsylvania. The Policy covers the dwelling and other structures, personal property and loss of use. The Property, purchased sight-unseen on October 9, 2020 and conveyed by Sheriff’s sale deed on November 5th, suffered a fire loss on June 10, 2021.5 Plaintiff made a claim under the Policy and met with Defendant’s claim investigator on July 31st.

By letter dated February 25, 2022, Plaintiff’s claim was denied because (a) the Property did not qualify as his “residence premises”, defined as “the one family dwelling where you reside”, and (b) the Policy was void due to his material misrepresentations. (ECF No. 1-4, ¶¶ 3-9 and Exhibit B at pp. 102-106).

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JACKSON v. SPINNAKER INSURANCE COMPANY, Counsel Stack Legal Research, https://law.counselstack.com/opinion/jackson-v-spinnaker-insurance-company-pawd-2025.