Pollock v. Federal Insurance Company

District Court, N.D. California·Decided April 1, 2025·No. 3:21-cv-09975·Unknown

Opinion

THOMAS POLLOCK, et al., Case No. 21-cv-09975-JCS Plaintiffs, v. ORDER GRANTING MOTION FOR LEAVE TO FILE AN AMENDED FEDERAL INSURANCE COMPANY, PLEADING Defendant. Re: Dkt. No. 189

Plaintiffs Thomas Pollock and Eileen Tabios bring this action against Defendant Federal Insurance Company (“Federal”) seeking compensation under a homeowners’ insurance policy issued by Federal on their property in St. Helena, California (“the Property”), which was damaged in the 2020 Glass Fire. Following a Court-ordered appraisal, which culminated in the issuance of an appraisal award on March 29, 2024, and the Court’s November 5, 2024 ruling declining Federal’s request to vacate the award, the parties engaged in a flurry of fact discovery. According to Federal’s counsel, Plaintiffs produced 52,000 documents -- approximately 90% of all of the documents they produced in fact discovery – on or after November 1, 2024. Godesky Decl., dkt. no. 189-2, ¶ 2. Although the fact discovery cut-off was January 6, 2025, the parties, by stipulation, have continued to conduct depositions. On January 3, 2025, Plaintiffs brought a Motion for Leave to File First Amended and Supplemental Complaint (“First Amended Complaint”), seeking leave to plead additional facts in support of their existing claims and to add a claim for Financial Elder Abuse under California Welfare and Institutions Code § 15610.30 based on the fact that Plaintiff Thomas Pollack is now before the Court is Federal’s Motion for Leave Under Federal Rules of Civil Procedure 15 and 16 To File an Amended Pleading (“Motion”), in which Federal seeks to assert in its answer to the First Amended Complaint new defenses and counterclaims for common-law fraud and breach of contract based on Plaintiffs’ alleged violation of the misrepresentation and concealment provision in Plaintiffs’ insurance policy. The Court finds that the Motion is suitable for determination without oral argument. For the reasons stated below, the Motion is GRANTED.1 A. The Appraisal On July 14, 2022, the Court ordered an appraisal “of the loss with respect to all manmade structures on the Property, but . . . exclude[ing] soil, landscaping, contents, and loss of use.” Order Granting Motion to Compel Arbitration, dkt. no. 47, at 22. On March 29, 2024, the appraisal panel issued its award. Declaration of Kurt Brown in Support of Defendant Federal Insurance Company’s Motion to Vacate Appraisal Award, dkt. no. 102-1 (“Brown Decl.”), Ex. 16 (“Appraisal Award”) at 1. The Appraisal Award concluded that the “[c]ost of repairs to return the Man-Made structures to their pre-loss condition as of the Date of Loss” was S32,122,214.15. Id. The panel found that the period of construction was 36 months and it valued “[i]nvestigation and pre-construction costs” at S1,048,215.43. Id. The Appraisal Award incorporates two exhibits; Exhibit A itemizes “value and loss to all man-made structures on the Property, excluding soil, landscaping, contents, and loss of use.” Id. Exhibit B “[i]s the statement of awarded preconstruction and investigative costs.” The Appraisal Award states that “[a]ll values arc determined as of the date of loss, based upon evidence submitted by the parties and the Panel’s site inspections.” Id. It contains the following disclaimer: This appraisal award is made without consideration or any coverage issues, policy limits, deductible amounts, prior payments, non- covered items, or other provisions of the policy which might affect the insurer’s liability. This appraisal award docs not establish coverage or the insurer’s liability to pay. Id. Federal subsequently brought a motion to vacate the Appraisal Award, dkt. no. 102 (“Motion to Vacate”), in which it argued, inter alia, that the Appraisal Award must be vacated under 9 U.S.C. § 10(a)(4) “because the panel exceeded the scope of its authority by improperly considering causation, by baselessly awarding over $1 million in investigation costs, and by determining a 36-month ‘period of actual construction’ without the power to do so.” Order Granting in Part and Denying in Part Defendant's Motion to Vacate Appraisal Award and Granting Plaintiff's Motion to Dismiss, dkt. no. 134 (“Order re Motion to Vacate”) (citing Motion to Vacate at 14, 20-24). The Court agreed with Federal as to the investigation cost award, which it vacated. Id. at 33-34. As to Federal’s challenge based on the panel’s causation findings, the Court concluded that “the panel did not act improperly to the extent that it appraised the loss as the ‘[c]ost of repairs to return the Man-Made structures to their pre-loss condition as of the Date of Loss[ ]’ ” because the award included disclaimers regarding coverage determinations consistent with California law. Id. at 29 (citing Lee v. California Cap. Ins. Co., 237 Cal. App. 4th at 1170). Nonetheless, the Court found that “under California law, where there are disputes about causation of loss in the context of insurance coverage case, the parties are entitled to have those disputes resolved by the court.” Id. Thus, the Court agreed with Federal that to the extent the Appraisal Award made any implicit findings regarding the disputed question of “what damage already existed versus what damage was caused by the” the Glass Fire, Federal is entitled to have that question decided in this proceeding by the Court or the jury. Id. at 12, 29. Finally, the Court rejected Federal’s assertion that the 36-month period of reconstruction finding in the Appraisal Award exceeded the panel’s authority. Id. at 32-33. B. Federal’s Proposed Answer To First Amended And Supplemental Complaint And Counterclaims In its Proposed Answer to First Amended and Supplemental Complaint and Counterclaims (“Proposed Answer”), Federal asserts two new affirmative defenses and counterclaims: 1) an affirmative defense and counterclaim for breach of contract based on alleged breach of the insurance policy’s concealment or misrepresentation provision;2 and 2) a counterclaim for common law fraud. Federal’s new defenses and counterclaims are based on the following representations by Plaintiffs it contends were false at the time they were made: 1) a statement on October 26, 2020 by Mr. Pollack to Federal “that because of the scale and scope of [their] property, [the] restoration and/or reconstruction process will likely take between 1 and 3 years[,]” Proposed Answer, dkt. no. 189-2, p. 23 at ¶ 21 (“the October 26, 2020 Statement”); 2) two proofs of loss submitted under penalty of perjury in August 2021 claiming that the cost to demolish and rebuild would exceed $85 million and that Plaintiff’s living expenses during the rebuilding period would exceed $15 million, id. pp. 25-26 at ¶ 34 (“the 2021 POLs”); and 3) statements in a September 27, 2021 letter from Plaintiffs’ counsel to Federal that identified the “purported basis for their $100.3 million ‘replacement value’ insurance claim: testing and conclusions purportedly provided by an industrial hygienist at Kaizen Safety Solutions, Dawn Bolstad-Johnson.”3 Id., pp. 26-26 at ¶¶ 37-38 (“the September 27 Letter”); see also id. ¶ 57 (listing statements that are the basis for Federal’s proposed breach of contract counterclaim). Federal alleges that at the time of the October 26, 2020 Statement, “no qualified expert had identified contamination or thermal damage from the Glass Fire” [ ] [a]nd while Plaintiffs had 2 In particular, the Policy states that “[w]e do not provide coverage if you or any covered person has intentionally concealed or misrepresented any material fact relating to this policy before or after the loss.” Dkt. no. 1-1 (Policy) at ECF p. 100. 3 Specifically, in the Proposed Answer, Federal alleges as follows:

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