Pilgrim v. State Farm Fire & Cas. Ins. Co.

950 P.2d 479
CourtCourt of Appeals of Washington
DecidedDecember 18, 1997
Docket38549-6-I
StatusPublished
Cited by28 cases

This text of 950 P.2d 479 (Pilgrim v. State Farm Fire & Cas. Ins. Co.) is published on Counsel Stack Legal Research, covering Court of Appeals of Washington primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Pilgrim v. State Farm Fire & Cas. Ins. Co., 950 P.2d 479 (Wash. Ct. App. 1997).

Opinion

950 P.2d 479 (1997)

Keith PILGRIM and Renae Pilgrim, husband and wife, and the marital community composed thereof, Appellants,
v.
STATE FARM FIRE & CASUALTY INSURANCE COMPANY, foreign insurance corporation; and Gailann Stargardter and John Doe Stargardter, husband and wife, and the marital community composed thereof, Respondents.

No. 38549-6-I.

Court of Appeals of Washington, Division 1.

September 22, 1997.
Publication Ordered December 18, 1997.

*480 Robert G. Nylander, Cutler & Nylander PS, Seattle, for Appellants.

W. George Bassett, Graham & Dunn, Seattle, for Respondents.

WEBSTER, Judge.

This case concerns the cooperation clause in an insurance contract and the legislature's recent efforts to diminish fraud in the making of insurance claims. Here, the Pilgrims, who were in the process of selling their home, reported a theft of approximately $15,000 in personal property from their home to the police; the investigating officer found no evidence of forced entry. When filing an itemized claim with State Farm Insurance, the Pilgrims claimed approximately $148,000 in stolen personal property. When analyzing the claim, State Farm questioned whether the Pilgrims had sufficient income to purchase the property that they claimed had been stolen. It demanded personal financial information necessary to prove or disprove its suspicion that the claim was fraudulent. Although the insurance policy required the Pilgrims to provide State Farm with records and documents as requested, the Pilgrims refused to turn over their tax returns and financial documents relating to their businesses. State Farm denied coverage for breach of the cooperation clause, and the Pilgrims sued. The trial court held that the Pilgrims' refusal to cooperate excluded coverage, and we affirm.

I.

FACTS

In fall 1993, Keith and Renae Pilgrim wanted to sell their King County house and move to eastern Washington. During the time the house was on the market, the Pilgrims returned home after dinner with friends one October evening to find that their home had been burglarized.[1] A King County police officer investigated, and determined that force had not been used to get inside the home.[2] The officer reported that "everything was left neat, except the jewelry box on the bed."[3] The Pilgrims made a preliminary list of missing property, assigning value to most of the listed items; they alleged that approximately $15,000 worth of items had been stolen.[4] They also immediately notified State Farm Insurance, with whom they had homeowner's insurance that included defined peril personal property coverage. Keith Pilgrim gave State Farm a statement.[5] The Pilgrims began working to uncover and document *481 the extent of their loss.[6]

The police officer called Keith a month later. Because the theft did not involve forced entry, the Pilgrims were selling their house, and the officer believed that they were having financial difficulties and had submitted a high claim, he told Keith that it "made him wonder."[7] When he directly asked if Keith had filed a false claim, Keith answered negatively.[8] The record contains no support for the officer's assertion that the Pilgrims were having financial difficulties.

Keith Pilgrim sent State Farm two signed inventory forms describing the stolen property, its replacement cost, and its actual cash value. The replacement cost on those December 1993 and January 1994 forms totaled $70,372.94 and $78,083.18 respectively.[9] The personal property limit under the Pilgrim's policy was $127,800, and State Farm advanced the Pilgrims $15,000 on their claim.[10]

The following April, without being under oath, and accompanied by their attorney, Keith and Renae answered the claim specialist's questions. State Farm requested authorization to obtain credit reports; the record contains no response.[11] When scheduling examinations under oath, State Farm requested, in addition to several other types of documents, personal income tax returns (1990-93), documents relating to their personal financial condition in the twelve months preceding the loss, documents relating to the financial condition of businesses in which they had an ownership interest at the time of the loss, and any financial statements prepared over the past four years.[12] State Farm subsequently told the Pilgrims that the information related to their financial status, their ability to have acquired the items claimed as stolen, and "any possible motive for falsifying or overvaluing their claimed losses."[13] The Pilgrims refused to produce the documents unless State Farm executed a confidentiality agreement.[14] That agreement would have prohibited State Farm from divulging, to third parties including the police, information received from the Pilgrims.[15]

Later, in fall 1994, the Pilgrims informed State Farm that many types of documents that it sought were not "known to exist." For example, the Pilgrims were not involved in any litigation that had settled during the year preceding the loss.[16] As to the financial documents that State Farm requested, the Pilgrims produced their W-2 forms for 1990-1993, but refused to produce anything else in light of State Farm's refusal to sign the confidentiality agreement.[17] Eventually, State Farm canceled the examinations under oath.[18]

The Pilgrims filed this action against State Farm in early October 1994, seeking a coverage declaration, attorney fees, and damages pursuant to the Consumer Protection Act. Before they served the complaint, State Farm denied the Pilgrims theft claim. After receiving the complaint, State Farm counterclaimed for restitution of the $15,000.[19]

State Farm moved for summary judgment, contending that the Pilgrims breach of the policy's cooperation and concealment clauses compelled dismissal.[20] It relied entirely on its own attorney's affidavit authenticating documents. The documents laid out the reasons that State Farm suspected fraud, and the Pilgrims' failure to cooperate:

• An investigating police officer told Keith that the circumstances "made him wonder" *482 and asked Keith if he had filed a false report.

• The Pilgrims refused to authorize third parties to give State Farm documents. On the other hand, because the record contains only a credit bureau authorization, we do not know whether State Farm sought other records.

• The discrepancy between the initial valuation of stolen items to police ($14,760) and the itemized claim to State Farm ($148,000).

• The Pilgrims refused to produce personal income tax returns (1990-93), documents relating to their personal financial condition in the twelve months preceding the loss, documents relating to the financial condition of businesses in which they had an ownership interest at the time of the loss, and financial statements (2/15/89 — 05/94), and produced only their W-2's for 1990-93. The W-2's demonstrated that the Pilgrims had a joint annual gross income ranging from $57,500 to $61,500 in 1991-93.[21]

In response, Keith Pilgrim detailed his dealings with State Farm, accused it of rude, adversarial behavior, and denied that he and his wife had any financial problems.[22]

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Bluebook (online)
950 P.2d 479, Counsel Stack Legal Research, https://law.counselstack.com/opinion/pilgrim-v-state-farm-fire-cas-ins-co-washctapp-1997.