Schnell v. State Farm

98 F.4th 150
Court of Appeals for the Fifth Circuit·Decided April 2, 2024·No. 22-10662·Published·Cited by 11 cases

Opinion

Case: 22-10662 Document: 60-1 Page: 1 Date Filed: 04/02/2024

United States Court of Appeals for the Fifth Circuit ____________ United States Court of Appeals Fifth Circuit No. 22-10662 ____________ FILED April 2, 2024 Carl Schnell; Mary Ellen Schnell, Lyle W. Cayce Clerk Plaintiffs—Appellants,

versus

State Farm Lloyds,

Defendant—Appellee. ______________________________

Appeal from the United States District Court for the Northern District of Texas USDC No. 4:21-CV-558 ______________________________

Before Dennis, Engelhardt, and Oldham, Circuit Judges. James L. Dennis, Circuit Judge: After a hailstorm damaged their home’s tiled roof, Plaintiff- Appellants Carl and Mary Ellen Schnell filed insurance claims with their home insurer Defendant-Appellee State Farm Lloyds (“State Farm”). While State Farm accepted coverage for certain claims, it denied coverage for others, including the claim that the City of Fort Worth required the Schnells to replace their whole roof, rather than just the damaged tiles. The Schnells sued, and the district court granted summary judgment to State Farm. We VACATE in part, AFFIRM in part, and REMAND. Case: 22-10662 Document: 60-1 Page: 2 Date Filed: 04/02/2024

No. 22-10662

I. The Schnells owned a home in Fort Worth, Texas, which had a roof covered in concrete tiles manufactured by Monier Lifetile. On April 11, 2017, a wind and hailstorm damaged the Schnells’ roof. At the time of the storm, the Schnells had a homeowner’s insurance policy with State Farm. The Schnells’ insurance policy covered the typical “accidental direct physical loss” to their home. However, the Schnells’ policy also covered increased repair costs due to building code enforcement under the policy’s Building Ordinance or Law provision, known as “Option OL.” Option OL stated in relevant part: 2. Damaged Portions of Dwelling. When the dwelling covered under COVERAGE A – DWELLING is damaged by a Loss Insured we will pay for the increased cost to repair or rebuild the physically damaged portion of the dwelling caused by the enforcement of a building, zoning or land use ordinance or law if the enforcement is directly caused by the same Loss Insured and the requirement is in effect at the time the Loss Insured occurs. 3. Undamaged Portions of Damaged Dwelling. When the dwelling covered under COVERAGE A – DWELLING is damaged by a Loss Insured we will also pay for: a. the cost to demolish and clear the site of the undamaged portions of the dwelling caused by the enforcement of a building, zoning or land use ordinance or law if the enforcement is directly caused by the same Loss Insured and the requirement is in effect at the time the Loss Insured occurs; and b. loss to the undamaged portion of the dwelling caused by enforcement of any ordinance or law if:

2 Case: 22-10662 Document: 60-1 Page: 3 Date Filed: 04/02/2024

(1) the enforcement is directly caused by the same Loss Insured; (2) the enforcement requires the demolition of portions of the same dwelling not damaged by the same Loss Insured; (3) the ordinance or law regulates the construction or repair of the dwelling, or establishes zoning or land use requirements at the described pre-mises; and (4) the ordinance or law is in force at the time of the occurrence of the same Loss Insured; .... c. legally required changes to the undamaged portions of any specific dwelling features, dwelling systems or dwelling components caused by the enforcement of a building, zoning or land use ordinance or law, if: (1) the enforcement is directly caused by the same Loss Insured; and (2) the requirement is in effect at the time the Loss Insured occurs. We will not pay for legally required changes to specific dwelling features, dwelling systems or dwelling components that have not been physically damaged by the Loss Insured. On September 8, 2017, the Schnells submitted a claim to State Farm for the physical damage to their home from the storm. State Farm inspected the Schnell residence on October 5, 2017. That day, State Farm estimated covered damages totaling $5,144.99. This estimate included damage to roofing components and gutters; however, State Farm denied coverage for damaged roof tiles and certain other exterior roofing components, finding this damage “was not caused by wind or hail” but instead by wear and tear or rot, which was not covered. Because the estimated covered damages fell below the Schnells’ $9,879.00 deductible, State Farm issued no payment.

3 Case: 22-10662 Document: 60-1 Page: 4 Date Filed: 04/02/2024

Unsatisfied with State Farm’s estimate, the Schnells invoked appraisal, a process under the policy that allows appraisers appointed by each party, along with an umpire, to set the amount of loss, without consideration of causation or coverage. On March 3, 2020, the appraisers issued a final award estimating the total amount of loss as $165,848.66. This award consisted of $32,234.13 in “Building” damages—that is, costs to cover accidental direct physical loss to the home—and $133,614.53 in “Building Code” damages—that is, costs to cover the increased repair costs due to building code enforcement. The appraisal included “Building Code” damages because the Schnells’ homeowners association rejected their application to replace only their broken tiles, instead requiring them to replace the whole roof. Specifically, the Schnells discovered that the manufacturer of their roof tiles, Monier Lifetile, had been purchased by Boral Roofing, which did not make the same tile, and the homeowners association refused to allow spot repairs with the new Boral tiles. On April 2, 2020, State Farm sent a payment to the Schnells for $21,277.28, reflecting the $32,234.13 appraisal award for “Building” damages, less their $9,879.00 deductible. State Farm refused to pay the Building Code appraisal award, stating the application rejection by the homeowners association did not count as enforcement of an ordinance or law under Option OL since “[b]uilding codes are enacted and enforced by state and/or local governments.” As part of its payment, State Farm included the statement, “Please be advised, neither participation in the appraisal process nor subsequent payment of any sum of money constitutes or should be construed as an admission of liability by State Farm. State Farm is not waiving any of the policy’s coverage’s [sic], limitations, exclusion, or provisions, all of which are specifically reserved.” Following State Farm’s instruction that enforcement by state or local government is required to trigger Option OL coverage, the Schnells sought a

4 Case: 22-10662 Document: 60-1 Page: 5 Date Filed: 04/02/2024

permit to use Boral tiles for spot repairs on their roof from the City of Fort Worth. On September 9, 2020, Fort Worth Building Code Administrator Evan Roberts informed the Schnells by e-mail of the following determination under the building code: Based on Jeff’s email [sic] attached here is the determination we’ve made: If the existing concrete tiles do not interlock with the new tiles and proper water drainage cannot be achieved do you concur that they don’t meet: R102.7.1 Additions, alterations, repairs. Additions, alterations or repairs to any structure shall conform to the requirements for a new structure without requiring the existing structure to comply with the requirements of this code, unless otherwise stated. Additions, alterations, repairs and relocations shall not cause an existing structure to become unsafe or adversely affect the performance of the building. As the lack of a water channel will adversely affect the performance of the building. R904.2 Compatibility of materials. Roof assemblies shall be made of materials that are compatible with each other and with the building or structure to which the materials are applied. Since they do not inter lock [sic] they are not compatible with each other.

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Schnell v. State Farm, 98 F.4th 150 (5th Cir. 2024).

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