Newman v. American Home Assurance Company, Inc.

CourtDistrict Court, S.D. Florida
DecidedMarch 20, 2024
Docket1:22-cv-20979
StatusUnknown

This text of Newman v. American Home Assurance Company, Inc. (Newman v. American Home Assurance Company, Inc.) is published on Counsel Stack Legal Research, covering District Court, S.D. Florida primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Newman v. American Home Assurance Company, Inc., (S.D. Fla. 2024).

Opinion

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF FLORIDA

CASE No.: 22-cv-20979-JB

MICHAEL NEWMAN, as Personal Representative of the ESTATE OF JOEL NEWMAN, and EDITH NEWMAN,

Plaintiffs,

v.

AMERICAN HOME ASSURANCE COMPANY, INC.,

Defendant. ____________________________________/ ORDER ON CROSS-MOTIONS FOR SUMMARY JUDGMENT THIS CAUSE came before the Court on Plaintiffs’ Motion for Partial Summary Judgment (“Plaintiffs’ Motion”), ECF No. [170], and Defendant’s Motion for Summary Judgment (“Defendant’s Motion”), ECF No. [172]. Each party filed their respective Responses in Opposition and Replies, along with Statements of Material Facts, Opposing Statements of Material Facts, and Reply Statements of Material Facts. ECF Nos. [169], [173], [175], [209], [210], [211], [212], [233], [234], [235], [236]. Further, the Court heard oral argument on the Motions. ECF No. [269]. Upon due consideration of the Motions, the arguments of the Parties, the relevant legal authorities, and for the reasons explained below, Plaintiffs’ Motion for Partial Summary Judgment is GRANTED IN PART AND DENIED IN PART, and Defendant’s Motion for Summary Judgment is GRANTED IN PART AND DENIED IN PART. I. BACKGROUND Defendant American Home Assurance Company, Inc. (“American Home”) issued a homeowner’s policy to Joel and Edith Newman (the “Newmans”), which

insured their home during the period of September 22, 2016 to September 22, 2017 (the “Policy”). ECF No. [169] at ¶ 1. The Policy was marketed to high-net worth individuals by AIG’s Private Client Group1 and differs from standard form homeowners policies used by other insurers. Id. at ¶ 4-5. Two provisions regarding the scope of the Policy’s coverage are relevant here. First, the Policy provides coverage for “Additional Living Expenses” (“ALE”)

which “consist of Extra Living Expenses, loss of fair rental value, and forced evacuation expenses . . .” ECF No. [173] at ¶ 3. With respect to “Extra Living Expenses,” the Policy states that “[i]f a covered loss makes your residence uninhabitable, we cover any reasonable increase in living expenses incurred by you to maintain your household’s usual standard of living.”2 Id. With respect to “Fair Rental Value,” the Policy states that “[i]f you are not able to rent out your residence, or part of your residence, that you usually rent to others, because of a loss that is

covered by this policy, we will pay the fair rental value for the reasonable amount of

1 American Home is an underwriting company of AIG. ECF No. [173] at ¶ 2. 2 The Newmans secured alternative living arrangements by entering into a lease for an apartment in February 2019 at a monthly rental rate of $40,000.00. Id. at ¶ 25. Ultimately, the Newmans purchased that apartment in May 2021 for $10,500,000.00. Id. at ¶ 26. time necessary to restore your residence, or that part of your residence, to a habitable condition.” Id. Second, the Policy provides coverage for “Rebuilding to Code”, which states

that “[w]e will pay the extra expenses to obey any law or ordinance that regulates repair, rebuilding or demolition of damaged property caused by a covered loss . . . .” (“L&O”) Id. The limit for L&O coverage “[i]f the loss is to a house” is “up to 30% of the amount of coverage shown on the Declarations Page for that house.” Id. On or about October 12, 2017, American Home received notice of Plaintiffs’ claim arising from Hurricane Irma (the “Claim”). ECF No. [169] at ¶¶ 8-9. The

Newmans and American Home each retained professionals to investigate the damage to the Newman’s home and exchanged competing estimates to repair the damage. Those initial estimates were millions of dollars apart. In particular, in May 2018, the Newmans estimated the cost to repair their home to be $1,977,875.22, which later increased to approximately $2.4 million. ECF No. [173] at ¶ 7(o). By September 2018, the estimate again increased when the Newmans submitted a partial estimate to American Home of $7,369,419.00. Id. at [173] at ¶ 7(p). For its part, American Home

estimated the repair costs for the home to be $498,571.91, later increasing their estimate to $981,274.00. ECF No. [42] at ¶ 36; [173] at ¶ 7(s). Having been unable to agree on the amount of loss, American Home demanded an appraisal of the loss pursuant to the terms of the Policy.3 Specifically, the Policy

3 Prior to appraisal, American Home made two payments to the Newmans for the Claim: one payment of $202,575.91 in March 2018 and another payment of $482,702.99 in April 2019. ECF No. [173] at ¶¶ 7(j), 7(t). provides in pertinent part that “[i]f you and we fail to agree on the amount of loss, either may . . . [d]emand an appraisal of the loss. In this event, each party will choose a competent appraiser . . . [and] [t]he two appraisers will choose an umpire.” ECF

No. [173] at ¶ 5. The Policy further provides that if the parties’ chosen appraisers fail to agree on the amount of the loss, “they will submit their differences to the umpire [and] [a] decision agreed to by an two will set the amount of the loss.” ECF No. [42-1] at § IV, M. A. The Appraisals On March 4, 2020, the appraisal panel issued an award to the Newmans

totaling $9,179,272.15 (the “Dwelling Award”), which American Home paid. Id. at ¶¶ 14-15. With respect to appraisal of ALE and contents of the home, the Dwelling Award stated, “YET TO BE APPRAISED.” Id. at ¶ 14. With respect to L&O benefits, the Dwelling Award stated, “AS INCURRED PER THE POLICY AND FLORIDA LAW.” Id. On September 15, 2020, the appraisal panel awarded the Newmans $1,400,000.00 in ALE benefits (the “ALE Award”), which American Home paid. Id. at ¶¶ 18-19.

After the Dwelling Award was issued, the Newmans notified American Home that “[b]ecause the now-confirmed cost to repair the Newmans’ home exceeds 50% of the structure’s appraised value of $13,000,000.00, the Newmans will be required to ensure that all aspects of their now 25-year old home are up to the current state and local building codes and ordinances under the ‘50% rule’,” and they have “encountered several issues which will trigger law and ordinance coverage.” Id. at ¶ 17. The Newmans invoked the Policy’s appraisal provision to determine the L&O portion of their loss (the “L&O Appraisal”). Id. at ¶ 20. American Home agreed to participate in the L&O Appraisal, which involved a

new appraisal panel, including a new umpire and a new appraiser hired by American Home. ECF No. [169] at ¶¶ 15, 20. On December 22, 2021, the appraisal panel awarded the Newmans $5,827,300.84 for L&O benefits (the “L&O Award”). ECF No. [173-13] at 2. The Declaration of Appraisal accompanying the L&O Award states that “[t]his appraisal was for the potential Ordinance or Law related values.” Id. Further, the umpire’s email transmitting the L&O Award states that “[a]s we all

agreed, this appraisal is unusual since [L&O] has not been ordered by the jurisdiction and [L&O] costs have [not] been incurred.” ECF No. [173] at ¶ 22. American Home paid the Newmans $4,617,632.40 of the L&O Award based on the applicable policy limits. Id. at ¶ 23. When making this payment, American Home took the position that that there were “significant issues” with the L&O Award and noted that there was a “lack of proof that the building code expenses were incurred especially since the award uses the term ‘Potential’ to describe the ordinance or law

values.” Id.; ECF No. [211] at 8 n.6. The corporate representative of American Home explained its decision to pay the L&O Award this way: “[w]hether or not it was fully due, fully compensable pursuant to the terms of the policy or pursuant to whether or not the appraisal was right, [AIG Claims] knew the payment was due at a certain amount of time.

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