J.R.A. Inc. v. Essex Insurance Co.

72 So. 3d 862, 2010 La.App. 4 Cir. 0797, 2011 La. App. LEXIS 676, 2011 WL 2137335
CourtLouisiana Court of Appeal
DecidedMay 27, 2011
Docket2010-CA-0797
StatusPublished
Cited by16 cases

This text of 72 So. 3d 862 (J.R.A. Inc. v. Essex 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
J.R.A. Inc. v. Essex Insurance Co., 72 So. 3d 862, 2010 La.App. 4 Cir. 0797, 2011 La. App. LEXIS 676, 2011 WL 2137335 (La. Ct. App. 2011).

Opinions

CHARLES R. JONES, Judge.

|, This is a Hurricane Katrina case. The Appellant/Defendant, Essex Insurance Company (Essex), appeals the district court judgment awarding the plaintiffs damages under a contract of insurance for damages to immovable property. The Cross Appellants/Plaintiffs, J.R.A., Inc., doing business as Jaeger’s Seafood (J.R.A.) and Allen Jaeger, the owner of J.R.A., Inc., have filed a cross appeal seeking review of the judgment of the district court denying their motion for new trial for re-argument only regarding statutory penalties. For the reasons set forth below, we: (1) grant the motion of the appel-lees to amend the judgment of the district court, (2) amend the judgment of the district court, (3) affirm the judgment as amended, and (4) remand. We also deny the cross appeal of the appellees.

Essex issued a policy of insurance, No. 1-CH9224 1, to J.R.A., as the sole insured, which covered damages to certain properties located at 1928 and 1904 West End Park in Orleans Parish. ' The subject policy allegedly covered damages arising out of a windstorm, but also allegedly excluded losses or damages for “flood, surface water, waves, tides, tidal waves, overflow of any body of water, or their spray, all whether driven by wind or not.”

1 gFor the property located at 1928 West End Park, the policy provided $600,000 Building Actual Cash Value (“ACV”) coverage and $100,000 Business Personal Property (“BPP” or contents) ACV coverage, both with 80% coinsurance requirements.

For the other property located at 1904 West End Park, the policy provided $100,000 Building ACV coverage with a 90% coinsurance requirement and $10,000 BPP ACV coverage with an 80% coinsurance requirement. The windstorm deductible was listed as $5,000.

Following Hurricane Katrina, which rendered both properties total losses, Ken Blum, J.R.A.’s insurance agent, prepared a Property Loss Notice dated September 6, 2005, and submitted it to Essex. As of September 29, 2005, Essex received the September 6, 2005 Property Loss Notice and initiated the claim adjustment process by assigning the claim to an independent adjuster.

On October 5, 2005, J.R.A.’s claim was assigned to Dreux Babin, an independent adjuster at Apple Adjusters, Inc. (“Apple Adjusters”). After receiving the claim and setting up the file, Mr. Babin called the contact for J.R.A., the Jackson-Vaughn Insurance Agency, on October 6, 2005. Essex then assigned the claim to an independent adjuster who attempted to make contact with J.R.A.’s contact person within 30 days of notice of the claim.

Unable to reach anyone at the Jackson-Vaughn Insurance Agency, Mr. Babin called again on October 13th, 25th, and 31st of 2005. On October 31, 2005, Mr. Babin was finally able to reach Mr. Blum at the Jackson-Vaughn Insurance Agency, and obtained contact information for Mr. Jaeger.

Mr. Babin attempted to contact Mr. Jae-ger on October 31st, November 3rd and [865]*8657th of 2005. Unable to reach Mr. Jaeger, Mr. Babin again followed up with |sMr. Blum at the Jaekson-Vaughn Insurance Agency for assistance on November 8, 2005. With the assistance of the Jaekson-Vaughn Insurance Agency, Mr. Babin was able to speak with Mr. Jaeger on November 8, 2005, and site inspections were set for November 10, 2005.

On that date, Mr. Babin conducted site inspections of the two building locations and took photographs. There was nothing left of either building except some pilings in Lake Pontchartrain at 1928 West End Park. During the inspections, Mr. Babin asked Mr. Jaeger for flood insurance information including the policies, coverages and amounts of recovery. Mr. Babin also asked Mr. Jaeger for relevant information regarding how the buildings were built; what they were made out of; the ages of the buildings; the square footage of the buildings; the plans and specifications for the buildings; pre-loss photographs of the interior and exterior of the buildings; and inventory lists of the BPP or contents along with supporting documentation (e.g., business records, audits, vendor receipts and tax records) to show the existence, value and age of the BPP.

On December 6, 2005, Mr. Babin followed up with Mr. Jaeger, who explained that he was having a hard time finding any documentation on either building. Additionally, although Mr. Jaeger admitted to recovering flood insurance money, he never sent Mr. Babin any of the flood insurance information. Mr. Babin again followed up with Mr. Blum at the Jaekson-Vaughn Insurance Agency to see if he could help Mr. Jaeger locate supporting documentation.

Since no structures remained at either site, Apple Adjusters, through Mr. Babin, retained Kevin Vanderbrook of VECO Consulting for engineering expertise. Based on his visual inspection of the building locations and observations of the surrounding area, Mr. Vanderbrook concluded that the cause of |4loss was a combination of storm surge and wind, but could not quantify the amount of wind damage to either building. As noted in his report, at the time of Mr. Vanderbrook’s January 30, 2006, inspection of the building locations, wind and storm surge information was not available. Mr. Vanderbrook also did not have access to any aerial or satellite photographs of either building; there were no drawings, plans, photographs, or any measurements of either building, nor had J.R.A. produced any flood insurance claim information. Mr. Vanderbrook explained that his January 31, 2006, report represented the best that he could offer given the limited information available to him at the time, but that the report was inconclusive in quantifying the amount of wind damage.

On February 10, 2006, Mr. Babin again followed up with Mr. Jaeger for information regarding the buildings. Again, Mr. Jaeger explained that he was having difficulty locating any building information.

On March 14, 2006, Mr. Babin finally received limited building information regarding 1928 West End Park. Specifically, Mr. Blum, on behalf of J.R.A., sent Mr. Babin a 1995 fire loss adjustment prepared by GAB Robins that purported to provide measurements for 1928 West End Park. Neither J.R.A. nor its insurance agent ever sent Mr. Babin any documentation regarding 1904 West End Park.

Based on the alleged lack of building and flood insurance recovery information from J.R.A., Mr. Babin was unable to quantify the wind damage to either building. However, after receiving VECO Consulting’s report, Mr. Babin made three preliminary recommendations: (1) make an unconditional tender of $50,000 for [866]*866building damage to 1928 West End Park; (2) make an unconditional tender of $10,000 for building damage to 1904 West End Park; and (3) retain Madsen, Knep-pers & Associates, Inc. (MK & A) for further analysis.

|¡¡Mr. Babin made the unconditional tender recommendations for building damage because VECO Consulting concluded that the building damage was caused by a combination of storm surge and wind, so there had to be some amount of wind damage. However, because VECO Consulting’s report was inconclusive regarding the amount of wind damage, the independent adjuster recommended seeking a more detailed analysis of the loss from MK & A. Nevertheless, Essex made the two suggested unconditional tenders of $50,000 and $10,000 to J.R.A., and retained MK & A.

Essex then contracted with Dave Van Derostyne, an expert in structural engineering with MK & A, a national engineering consulting firm, to determine the cause of loss and extent of the wind damage to both 1928 and 1904 West End Park.

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72 So. 3d 862, 2010 La.App. 4 Cir. 0797, 2011 La. App. LEXIS 676, 2011 WL 2137335, Counsel Stack Legal Research, https://law.counselstack.com/opinion/jra-inc-v-essex-insurance-co-lactapp-2011.