Shelter Mutual Insurance Company v. Morrow

2023 IL App (5th) 230249-U
Appellate Court of Illinois·Decided August 24, 2023·No. 5-23-0249·Unpublished·Cited by 2 cases

Opinion

2023 IL App (5th) 230249-U NOTICE

NOTICE

Decision filed 08/24/23. The This order was filed under text of this decision may be NO. 5-23-0249 Supreme Court Rule 23 and is changed or corrected prior to not precedent except in the the filing of a Petition for IN THE limited circumstances allowed Rehearing or the disposition of under Rule 23(e)(1).

the same.

APPELLATE COURT OF ILLINOIS

FIFTH DISTRICT

SHELTER MUTUAL INSURANCE COMPANY, ) Appeal from the ) Circuit Court of

Plaintiff-Appellant, ) Coles County.

)

v. ) No. 22-MR-27 )

TIM MORROW and JODIE MORROW, ) Honorable ) Brien J. O’Brien,

Defendants-Appellees. ) Judge, presiding.

JUSTICE MOORE delivered the judgment of the court.

Justices Barberis and McHaney concurred in the judgment.

ORDER

¶1 Held: The circuit court did not err when it compelled the insurer to participate in the appraisal process as outlined in the applicable insurance policy where the issue to be determined was amount of loss and the appraisal clause specifically listed amount of loss as proper issue to be determined under that process.

¶2 The plaintiff, Shelter Mutual Insurance Company (Shelter), appeals the circuit court of Coles County’s March 28, 2023, oral pronouncement denying its motion for judgment on the pleadings and ordering the parties to proceed forward with the appraisal process as outlined in the at-issue insurance policy, and the circuit court’s written March 30, 2023, order memorializing the same. For the following reasons, we affirm.

¶3 I. BACKGROUND

¶4 Shelter issued a homeowners insurance policy, numbered 12-XX-XXXXXXX-1, to the Morrows (the Policy). The Policy was in effect from April 7, 2021, to April 7, 2022. At all relevant times, the Policy’s relevant provisions provided as follows:

“SECTION I - PROPERTY PROTECTION COVERAGE A – DWELLING INSURING AGREEMENTS 1. We cover accidental direct physical loss to the following property, except for those perils and losses excluded under the heading ‘Exclusions Applicable To Coverages A & B’.

(a) Your dwelling, including building structures attached to it, at the residence premises, but only if that dwelling is used principally as a private residence. If a building structure is connected to the dwelling by only a utility line or fence, it will not be considered attached to the dwelling for purposes of this coverage.

***

COVERAGE B - OTHER STRUCTURES INSURING AGREEMENTS 1. We cover accidental direct physical loss to other structures that are permanently attached to the residence premises but not attached to your dwelling, except for those perils and losses excluded under the heading ‘Exclusions Applicable To Coverages A & B’. ***

***

5. We cover accidental direct physical loss to fences on the residence premises under this coverage only, whether they are attached to your dwelling or not. This

coverage does not extend to a fence used to any extent for business irrespective of the fact that it may also be used for non-business purposes.

***

EXCLUSIONS APPLICABLE TO COVERAGES A & B We do not cover any loss or damage if it would not have occurred in the absence of any event or condition listed below. That loss or damage is excluded from coverage regardless of: (a) The proximate cause of that event or condition; (b) The fact that other events or conditions, which are not excluded, caused the loss or damage; (c) The fact that other events or conditions, which are not excluded, contributed to the loss or damage; (d) The sequence of the events or conditions that caused the loss or damage; (e) Whether the events and conditions that caused the loss or damage occurred suddenly or gradually; (f) Whether the loss or damage is isolated or widespread; or (g) Whether the loss or damage arises from natural forces, external forces, or a combination of such forces.

***

7. The Policy contains the following relevant definitions: 1. Accident means an action or occurrence, or a series of actions or occurrences, that: (a) Started abruptly; (b) During the policy period; and

(c) Directly resulted in bodily injury or property damage.

***

2. Accidental direct physical loss means loss of possession of, or actual physical damage to, a part of the covered property which is caused by an accident. It does not include: (a) Consequential economic damage resulting from such physical damage to that part or to the covered property as a whole; (b) Consequential economic damage resulting from the inability to restore full monetary value to that part or to the covered property as a whole because of the fact that it has sustained physical damage; (c) Consequential economic damage resulting from the loss of use of that part or the covered property as a whole; (d) Consequential economic damage resulting from the inability to match the parts which are repaired or replaced with undamaged adjacent parts; or (e) Any diminution of the pre-loss value of the covered property after the repair or replacement of its parts. 8. The Policy also provides as follows: SPECIAL PROVISIONS AND CONDITIONS RELATING TO SECTION I

***

10. Appraisal If you and we fail to agree on the market value, total restoration cost, actual cash value, or amount of loss, as may be required in the applicable policy provision, either party may make written demand for an appraisal. Each party will select an appraiser and notify the other of the appraiser’s identity within 20 days after the

demand is received. The appraisers will select a competent and impartial umpire. If the appraisers are unable to agree upon an umpire within 15 days, you or we can ask a judge of a court of record in the state where the residence premises is located to select an umpire.

The appraisers shall then appraise the loss, stating separately the market value, total restoration cost, actual cash value, or loss to each item as may be required in the applicable policy provision. If the appraisers submit a written report of an agreement to us, the amount agreed upon shall be the market value, total restoration cost, actual cash value, or amount of loss as may be required in the applicable policy provision. If they cannot agree, they will submit their differences to the umpire. A written award by two will determine the market value, total restoration cost, actual cash value, or amount of loss. Each party will pay the appraiser it chooses, and equally pay expenses for the umpire and all other expenses of the appraisal unless the amount you demanded prior to the appraisal process is awarded by the appraisers pursuant to this provision. In that event, the appraisers and umpire will be fully paid by us.”

¶5 On December 10, 2021, a hail and windstorm occurred affecting the Morrows’ property. The Morrows submitted a claim to Shelter for damage allegedly sustained because of the storm. Shelter inspected the claimed property damage and determined that the damage added up to less than the Morrows’ deductible of $1000. In response, the Morrows obtained their own report and estimate from a public adjuster, the Accuval Group LLC, dated December 21, 2021. That report indicated that a complete tear-off and replacement of the residence roof and garage roof, as well as removal and replacement of the fencing would be necessary at a total cost of $38,198.15, less the $1000 deductible.

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Shelter Mutual Insurance Company v. Morrow, 2023 IL App (5th) 230249-U (Ill. Ct. App. 2023).

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