Severin Hegel v. The First Liberty Insurance Corporation

778 F.3d 1214, 2015 U.S. App. LEXIS 3024, 2015 WL 821146
CourtCourt of Appeals for the Eleventh Circuit
DecidedFebruary 27, 2015
Docket14-10549
StatusPublished
Cited by48 cases

This text of 778 F.3d 1214 (Severin Hegel v. The First Liberty Insurance Corporation) is published on Counsel Stack Legal Research, covering Court of Appeals for the Eleventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Severin Hegel v. The First Liberty Insurance Corporation, 778 F.3d 1214, 2015 U.S. App. LEXIS 3024, 2015 WL 821146 (11th Cir. 2015).

Opinion

GILMAN, Circuit Judge:

This case involves an insurance-coverage dispute that began in 2011 between Seve-rin and Stephanie Hegel (the Hegels) and The First Liberty Insurance Corporation (First Liberty). The Hegels claim that First Liberty improperly denied their claim for a “sinkhole loss,” defined under their homeowner’s insurance policy as “structural damage to the building, including the foundation, caused by sinkhole activity.” First Liberty argues that the damage to the Hegels’ residence does not qualify as “structural damage,” a term that was not defined in either the policy or the version of the Florida sinkhole-insurance statute applicable to their claim. In February 2014, the district court granted summary judgment for the Hegels, finding that “structural damage” meant any “damage to the structure” and awarding them $166,518.17 in damages. First Liberty timely appealed.

For the reasons set forth below, we REVERSE the judgment of the district court and REMAND the case for further proceedings consistent with this opinion.

I. BACKGROUND

A. Factual background

1. The insurance policy and Florida’s sinkhole-insurance statute

The Hegels had a homeowner’s insurance policy with First Liberty for their Spring Hills, Florida residence, effective October 5, 2010. This policy insured against “Sinkhole Loss” as an exception to the policy’s exclusion for damage caused by earth movement. Under the policy, “Sinkhole Loss means structural damage to the building, including the foundation, caused by sinkhole activity.” (Emphasis added.) The policy, however, did not define the term “structural damage.”

The version of the Florida statute governing sinkhole insurance that was in effect in 2010 contained the same definition of “sinkhole loss” as the policy did, but similarly failed to define the term “structural damage.” See Fla. Stats. § 627.706(2)(c) (2005). Prior to the statute being substantially amended in 2005, however, the term “sinkhole loss” was defined as “actual physical damage to the property covered arising out of or caused by sudden settlement or collapse of the earth supporting such property.” Fla. Stats. § 627.706(3) (1981) (emphasis added).

The Florida Building Code (2004), on the other hand, defined “structural” as it relates to buildings:

For purposes of this code, “structural” shall mean any part, material or assembly of a building or structure which affects the safety of such building or structure and/or which supports any dead or designed live load and the removal of which part, material or assem *1217 bly could cause, or be expected to cause, all or any portion to collapse or fail.

Fla. Bldg.Code, Existing Buildings § 202 (2004). And a May 17, 2011 amendment to Florida Statutes § 627.706 eventually provided a detailed, technical definition of “structural damage,” itself referencing the Florida Building Code:

(2)(k) “Structural damage” means a covered building, regardless of the date of its construction, [that] has experienced the following:

1. Interior floor displacement or deflection in excess of acceptable variances as defined in ACI 117-90 or the Florida Building Code, which results in settlement related damage to the interior such that the interior building structure or members become unfit for service or represents a safety hazard as defined within the Florida Building Code;

2. Foundation displacement or deflection in excess of acceptable variances as defined in ACI 318-95 or the Florida Building Code, which results in settlement related damage to the primary structural members or primary structural systems that prevents those members or systems from supporting the loads and forces they were designed to support to the extent that stresses in those primary structural members or primary structural systems exceeds one and one-third the nominal strength allowed under the Florida Building Code for new buildings of similar structure, purpose, or location;

3. Damage that results in listing, leaning, or buckling of the exterior load-bearing walls or other vertical primary structural members to such an extent that a plumb line passing through the center of gravity does not fall inside the middle one-third of the base as defined within the Florida Building Code;

4. Damage that results in the building, or any portion of the building containing primary structural members or primary structural systems, being significantly likely to imminently collapse because of the movement or instability of the ground within the influence zone of the supporting ground within the sheer plane necessary for the purpose of supporting such building as defined within the Florida Building Code; or

5. Damage occurring on or after October 15, 2005, that qualifies as “substantial structural damage” as defined in the Florida Building Code.

Fla. Stats. § 627.706(2)(k) (2011).

2. The damage and estimates of repair

The Hegels allege that, on March 1, 2011, they “discovered damage to their home, including, but not limited to, progressive physical damage to the walls and floors of the residence.” They subsequently submitted a claim for their damages to First Liberty under their homeowner’s policy.

First Liberty retained Structural Engineering and Inspections, Inc. (SEI) to investigate the claim in September 2011. SEI concluded in a report that the Hegels’ residence “DOES NOT MEET the criteria for Structural Damage as defined by Florida Statutes § 627.706 [2011].” (Emphases in original.) The SEI report noted some cracking and other issues, but determined that nothing rose to the level of “structural damage” as defined in the 2011 version of the statute. In addition, SEI listed several possible causes for the observed damage that were unrelated to sinkholes, including differential settlements and ordinary concrete shrinkage. *1218 First Liberty accordingly denied the He-gels’ claim in October 2011, stating that their residence “ha[d] not sustained structural damage to the building or foundation” and that the damage was “related to normal concrete shrinkage, differential settlement, and improper embedment of [the] foundation.”

In November 2011, the Hegels requested a neutral evaluation by a public adjuster. Kevin Scott, the neutral evaluator engaged for the claim, issued a report in July 2012. He noted that if the sinkhole claim was made under a policy with an effective date before May 17, 2011, then the 2011 definition of “structural damage” set forth in Florida Statutes § 627.706 would not apply. His report concluded that the damage to the Hegels’ residence was “the result of a combination of factors, including sinkhole activity,” but that “the observed distresses to the house can primarily be attributed to minor differential settlement of the structure and normal shrinkage/drying characteristics of the masonry materials.” Ultimately, Scott recommended subsurface grouting, at an estimated cost of $105,075, to remediate the sinkhole activity.

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Bluebook (online)
778 F.3d 1214, 2015 U.S. App. LEXIS 3024, 2015 WL 821146, Counsel Stack Legal Research, https://law.counselstack.com/opinion/severin-hegel-v-the-first-liberty-insurance-corporation-ca11-2015.