MacIntyre & Edwards, Inc. v. Rich

599 S.E.2d 15, 267 Ga. App. 78
CourtCourt of Appeals of Georgia
DecidedMarch 22, 2004
DocketA03A2418, A03A2419
StatusPublished
Cited by17 cases

This text of 599 S.E.2d 15 (MacIntyre & Edwards, Inc. v. Rich) is published on Counsel Stack Legal Research, covering Court of Appeals of Georgia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
MacIntyre & Edwards, Inc. v. Rich, 599 S.E.2d 15, 267 Ga. App. 78 (Ga. Ct. App. 2004).

Opinions

JOHNSON, Presiding Judge.

These interlocutory appeals involve insufficient homeowner’s insurance coverage for a fire loss. The appeals concern the duties of an insurer and an insurance agent to notify an insured of policy changes, and the responsibility of the insured to read policy documents. In these appeals, the insurance company, its adjuster, and the insurance agency challenge the trial court’s denial of their motions for summary judgment.

Scott and Margaret Rich own real estate and personal property in Thomasville. Scott Rich has been employed as a director of corporate insurance for Flowers Foods, Inc. since 1977. In that role, Scott Rich places insurance coverage, negotiates renewals, and handles claims. He is considered Flowers’ "expert” on insurance matters.

In 2000 the Riches requested that insurance agency MacIntyre & Edwards, Inc., place their homeowner’s coverage with Glen Falls Insurance Company. Per Scott Rich’s request, the policy provided for an unlimited guaranteed replacement cost. In the fall of 2000, Glen Falls notified Leroy Edwards of MacIntyre & Edwards that renewal policies for 2001 would have limits or caps on coverage. For the Riches, this meant that they would be insured for 125 percent of the location limit1 of $922,000; this capped their coverage at $1,152,500. Edwards received the notice but did not review it and did not relay the information to the Riches.

When Scott Rich received his renewal documents in the mail, he glanced at the documents, but did not read them except to verify that the location was correct and the automobiles were listed as insured. He admitted that he never reads his insurance policy or renewals. His wife did not review the documents at all.

In April 2001 the property was largely destroyed by fire. The insurer was notified. According to the Riches, Glen Falls adjuster Jonathan Smith declined to place tarps over the property. Since Scott Rich was under the impression that the house had guaranteed replacement coverage and that Glen Falls was going to restore it to its previous condition, he did not insist on any protective coverings being placed over the structure.

[79]*79Shortly after the fire, Scott Rich read the renewal documents and realized that a cap had been placed on the replacement coverage. He called his insurance agent, Leroy Edwards, who told him not to worry because the cap in the policy had been rescinded and would not be enforced. Adjuster Smith responded to Edwards’ request for a policy endorsement regarding the waiver of the cap with a letter setting forth an example of how the Riches’ loss would be calculated. From this Edwards and Scott Rich concluded that the Riches had unlimited replacement coverage. The property remained unprotected from the date of the loss through July 2001. In July 2001 Smith informed Edwards that there was in fact a cap on the Riches’ coverage. Edwards in turn informed Scott Rich of the cap.

The Riches brought suit against the insurance company (Glen Falls), the company’s adjuster (Smith), and the insurance agency (MacIntyre & Edwards). As to Glen Falls and Smith, the Riches alleged that because they relied on the insurer’s representations regarding coverage, they did not feel compelled to do everything possible to protect the property at their own expense. The Riches claim that this caused more than $250,000 in unnecessary damage to the residence. As to MacIntyre & Edwards, the Riches argue that the agency failed to inform them of the change in coverage from unlimited to capped coverage, that the agency knew that the Riches wanted unlimited replacement coverage, and that as a result of the agency’s failure to inform the Riches of the changes in the renewal policy, the Riches suffered damages in excess of $250,000. The defendants moved for summary judgment. The motions were denied in separate orders. Both orders were certified for immediate review and separate applications for immediate review followed. We granted both applications. For the reasons that follow, we reverse the judgment of the trial court in both cases.

Case No. A03A2418

1. MacIntyre & Edwards contends that the trial court misinterpreted the law regarding the duty of an insured to read his or her insurance policy, and thus found irrelevant factual issues to be material for summary judgment purposes. MacIntyre & Edwards argues that because the renewal package received by the Riches contained an endorsement clearly referencing a 125 percent cap on guaranteed replacement cost and a memorandum explaining the cap, the Riches cannot blame the agency for their own failure to discover that the renewal policy from Glen Falls did not provide for unlimited replacement coverage.

In general, an insured has an obligation to read and examine an insurance policy to determine whether the coverage desired has been [80]*80furnished.2 If an examination of the policy would have made it readily apparent that the desired coverage was not issued, the policyholders’ failure to examine the policy bars recovery against the insurer or its agent for negligent failure to provide coverage.3

The renewal package Scott Rich received in December 2000 contains an endorsement instituting a 125 percent cap on guaranteed replacement cost, and a memorandum explaining several coverage changes including the 125 percent cap. The endorsement contained in the package places a cap on guaranteed replacement cost. The endorsement states, in relevant part:

[I]f at the time of the loss the residence value indicated on the Coverage Summary is less than the current replacement cost, we will:
a. Increase the residence value to equal the smallest of:
(1) the current replacement cost; or
(2) 125% of the residence value shown on the coverage summary.

The accompanying memorandum begins with a large, bold heading stating “It’s Important For You To Know,” and then, in large bold capital letters: “THERE HAVE BEEN SOME CHANGES TO YOUR RENEWAL POLICY.” The memorandum then states:

In order to keep your insurance premiums as low as possible, some of the coverages that apply to your policy have been revised with your renewal. The highlights of these changes are as follows:
G1-14165-D Amendment of Home and Dwelling Fire Provisions
We have changed the maximum amount of coverage you now have for your home to 125% of the replacement amount shown on the Coverage Summary. Previously, this amount was unlimited.

Scott Rich did not read the new endorsement or explanatory memorandum. He admitted that had he read the renewal page, he [81]*81would have understood the cap. Margaret Rich did not read the documents at all. It is clear that the Riches breached their duty to examine the renewal documents.4

The Riches, however, rely upon the exception to the rule requiring them to read their policy. The exception is that if an agent holds himself out to be an expert in insurance, and the insured relies upon the agent’s expertise to identify the insured’s needs and procure the correct amount of type of coverage, i.e., do more than just issue a policy, the insured is relieved of the responsibility to minutely examine the policy.5

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MacIntyre & Edwards, Inc. v. Rich
599 S.E.2d 15 (Court of Appeals of Georgia, 2004)

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Bluebook (online)
599 S.E.2d 15, 267 Ga. App. 78, Counsel Stack Legal Research, https://law.counselstack.com/opinion/macintyre-edwards-inc-v-rich-gactapp-2004.