Ross v. AARP, Inc.

CourtDistrict Court, Virgin Islands
DecidedMay 5, 2023
Docket1:19-cv-00057
StatusUnknown

This text of Ross v. AARP, Inc. (Ross v. AARP, Inc.) is published on Counsel Stack Legal Research, covering District Court, Virgin Islands primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Ross v. AARP, Inc., (vid 2023).

Opinion

DISTRICT COURT OF THE VIRGIN ISLANDS

DIVISION OF ST. CROIX ║ DARIN ROSS and FIONA ROSS, ║ ║ Plaintiffs, ║ 1:19-cv-00057-MEM-EAH ║ v. ║ ║ AARP, INC., AARP SERVICES, INC., ║ GRUPO COOPERATIVO SEGUROS ║ MULTIPLES, COOPERATIVA DE ║ SEGUROS MULTIPLES DE PUERTO ║ RICO, SEDGWICK CLAIMS ║ MANAGEMENT SERVICES, INC., ║ OVERSEAS INSURANCE AGENCY, INC., ║ VERICLAIM, INC., and BYRON ║ GILCHREST, ║ ║ Defendants. ║ ________________________________________________ ║

TO: Pamela L. Colon, Esq. For Plaintiffs Karen Ellis Carr, Esq. Eric Roman, Esq. Mattie Bowden, Esq. Andrew C. Simpson, Esq. For AARP, Inc. and AARP Services, Inc. Ann Cecile O’Neill, Esq. Eugenio W.A. Geigel-Simounet, Esq. For GCSM and CSMPR Richard H. Hunter, Esq. Joshua D. Lerner, Esq. Peter Tepley, Esq. Victor G. Sanabria, Esq. For Vericlaim, Sedgwick, and Gilchrest

MEMORANDUM OPINION THIS MATTER

comes before the Court on the Motion for Protective Order filed by Ross v. AARP Services, Inc. 1:19-cv-00057-MEM-EAH Memorandum Opinion Page 2 GRANT

the reasons that follow the Court will the motion and enter the AARP Defendants’ proposed protective order with the CoBuArtC’sK mGoRdOifUicNaDti on. I. Plaintiffs’ Allegations1 The Complaint in this case was originally filed in Superior Court in September 2019. Dkt. No. 1-1. Plaintiffs Darin and Fiona Ross alleged Itdhat they purchased a homeowner’s insurance policy in July 2017 for a home on St. Croix. . ¶ 17. The policy was effective July 18, 2017 through July 18, 2018, providing coverage with limits of $353,000 for windstorm damage to the dwellingI,d $45,000 for other structures, $15,000 for personal property, and $15,000 for loss of use. . ¶¶ 18, 20. Based on the advertising and branding of the insurance policy, Plaintiffs believed that the insurance was provided through the AARP Defendants; in fact, the insurance was through Real Legacy Assurance (“Real Legacy”), a wholly owned

subsidiary of Cooperativa de Seguros Multiples of Puerto IRdico (“CSMPR”), and member company of Grupo Cooperativo Seguros Multiples (“GCSM”). . ¶¶ 6, 7, 21-25. Additionally, 2 at the time Plaintiffs purchased the policy, Real Legacy “did not properly advise Plaintiffs in determining the true replacement cost value of their property need to meet the co-insurance

1 2 The factual background is taken from Plaintiffs’ allegations as stated in their initial Complaint; they do not reflect factual findings made by this Court. Because the Complaint alleged that Real Legacy was an agent and/or sSuebes eid.giary of the AAR P Ross v. AARP Services, Inc. 1:19-cv-00057-MEM-EAH Memorandum Opinion Page 3

requirement of the policy” and did not explain ”the effect of failure to insure theI dproperty in an amount of at least eighty percent (80%) of the true replacement cost value.” . ¶¶ 21-22. On SeptembeIdr 19 and 20, 2017, Hurricane Maria caused catastrophic damage to Plaintiffs’ pIrdoperty. . ¶¶ 53-54. Thus, on October 2, 2017, Plaintiffs notified Real Legacy of their loss. . ¶ 55. On October 23, 2017, Real Legacy hired Sedgwick Claims ManaIgdement Services, Inc. (“Sedgwick”) and Vericlaim, Inc. (“Vericlaim”) to adjust Plaintiffs’ loss. . ¶ 56. On that date, Vericlaim and Sedgwick advised Plaintiffs that they had assigned the adjustment to theiIrd agent, Alvaro del Santiago Barolome, who inspected the property on October 31, 2017. . ¶¶ 57-58. On November 13, 2017, Darin Ross texted Barolome to ask about the status of the adjustment, anIdd Barolome responded that it would take about a week because the damage was significant. . ¶¶ 59-60. On December 11, 2017, Barolome advised Plaintiffs via t Iedxt that his estimate was finished but that he needed receipts for the loss of use damages. . ¶ 61. Three days later, Barolome texted Plaintiffs the completed damages estimates: dwelling real cost value - $115,413.70; other structures real cost value - $34,340; personal property - $15,0Id00; loss of use - $4,200; all of the damages were fraudulent except for personal property. . ¶¶ 62-63. After receiving the estimates, Darin Ross texted Barolome for more information regarIdding their loss of use claim; Barolome directed him to contact AARP for policy information. . ¶¶ 64-65. Darin Ross asked Barolome to send to the estimate to Real Legacy; Barolome responded via text, Isdtating “but it will be faster if I sent directly the final report with a compromise settlement.” . ¶¶ 66-67. On December 12, 2017, Ross v. AARP Services, Inc. 1:19-cv-00057-MEM-EAH Memorandum Opinion Page 4

Barolome sent PIdlaintiffs an email stating “I need you[r] agreement to send the estimate and make it faster.” . ¶ 68. On January 3, 2018, Barolome emailed Plaintiffs providing a written statement of the loss adjusted to $129,688.66; three dIdays later he asked Plaintiffs to “send [him] their agreement to submit to the company.” . ¶¶ 69-70. On February 12, 2018 Barolome emailed Plaintiffs stating “In that case, please let me know what amount you are willing to accept. I will send the report with no conformity to AARP.”; he also emailed agaIidn that day and asked if they would be willing to accept $177,773.70 before the deductible. . ¶¶ 71-72. On February 16,I d2018, Plaintiffs emailed Barolome and informed him that they had hired a public adjuster. . ¶ 73.That same day, Plaintiffs hired a firm to adjust their claim, and, in June 2018, the firm completed its report and estimated Plaintiffs’ damages at $538,667.71 for the dwelling loss, $77,647.25 for the structure loss, $15,000 for personal property, andId $15,000 for loss of use; nineteen days later Phoenix forwarded this report to Real Legacy. . ¶¶ 75-76. Thereafter, Sedgwick and VerIidclaim assigned Byron Gilchrest to work as a second adjuster to adjust Plaintiffs’ claim. . ¶ 77. Gilchrest did not complete his report until November 2018; the report acknowlIeddged that the damage to the guest house was over the other structure limit of the policy. . ¶ 78. Gilchrest proposed the following settlement: $265,000 for the dwelling loss; $45,000 other structure limits; $15,000 for personal property; and $15,000 for loss of use, but only if said loss was incurred or there was a signed Ross v. AARP Services, Inc. 1:19-cv-00057-MEM-EAH Memorandum Opinion Page 5 Id

contract. . ¶ 79. The report and settlIedment were fraudulent because they did not accurately state the amount of Plaintiffs’ losses. . ¶ 80. Because Real Legacy had suffered $110,000,000 in losses and was under-reinsured by $70,000,000, in September 2018, the Office of the Commissioner of Insurance of PIuderto Rico placed Real Legacy under regulatory supervision through a Rehabilitation Order. . ¶¶ 90-91. At the time of the Rehabilitation Order, Plaintiffs’ claim was one of eighty-two unpaid 3 pending claims in the Territory, because ISdedgwick, Vericlaim, and Gilchrest had prepared a false adjustment of Plaintiffs’ damages. . ¶¶ 94-95. By the time the AdjuIsdter Defendants submitted the final report to Real Legacy, it was already in “rehabilitationId.” . ¶ 97. Despite multiple written demands for payments, the claim has never been paid. . ¶ 98. In JanuaIrdy 2019, the Court of First Instance of San Juan ordered Real Legacy to liquidate its assets. . ¶¶ 99-100. Plaintiffs are still owed: $538,667.71 for dwelling loss; $77,I6d47.25 for other struIcIt. ure loPsrso; c$e1d5u,0r0a0l Hfoirs tpoerrys onal property; and $15,000 for loss of use. . ¶ 101. Plaintiffs brought claims of breach of contract, breach of the duty of good faith and fair dealing, bad faith, breach of fiduciary duty, fraud in the inducement, unfair trade practices, misrepresentation, and negligence against the AARP Defendants, GCSM, CSMPR,

3 Ross v. AARP Services, Inc. 1:19-cv-00057-MEM-EAH Memorandum Opinion Page 6

and Overseas. Plaintiffs brought a claim of tortious interference with contractual relations against the Adjuster Defendants.

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Ross v. AARP, Inc., Counsel Stack Legal Research, https://law.counselstack.com/opinion/ross-v-aarp-inc-vid-2023.