Sher v. Allstate Insurance

947 F. Supp. 2d 370, 2013 WL 2317140, 2013 U.S. Dist. LEXIS 75362
CourtDistrict Court, S.D. New York
DecidedMay 28, 2013
DocketNo. 10 Civ. 5644 (JGK)
StatusPublished
Cited by9 cases

This text of 947 F. Supp. 2d 370 (Sher v. Allstate Insurance) is published on Counsel Stack Legal Research, covering District Court, S.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Sher v. Allstate Insurance, 947 F. Supp. 2d 370, 2013 WL 2317140, 2013 U.S. Dist. LEXIS 75362 (S.D.N.Y. 2013).

Opinion

OPINION AND ORDER

JOHN G. KOELTL, District Judge:

The plaintiffs, Michael Sher and Paula Sher, bring this purported class action asserting several causes of action against the defendant, Allstate Insurance Company (“Allstate”). The plaintiffs’ claims arise out of Allstate’s alleged practice of requiring that insured property owners replace or complete repairs of damaged property within 180 days of receipt of an actual cash value payment from Allstate. Allstate requires the completion of such repairs or replacement before reimbursing insureds for such costs over-and-above the actual cash value payment. The Shers suffered an insured fire loss in 2008 but, because they could not complete replacement or repairs within 180 days of receipt of the actual cash value payment, they were denied replacemenf/repair cost coverage.

The Second Amended Complaint alleges nine causes of action. Count I alleges breach of the initial insurance contract. Count II alleges that the plaintiffs’ failure to comply with the 180 day condition should be excused on grounds of impossibility. Count III requests a declaratory judgment. Count IV alleges breach of an alleged contract settling the plaintiffs’ claims. Count V alleges fraud. Count VI alleges that Allstate owed the plaintiffs a fiduciary duty, which it allegedly breached. Count VII requests relief under New York General Business Law (“GBL”) section 349, which prohibits deceptive business acts and practices. Count VIII alleges that Allstate provided illusory coverage and seeks the return of a portion of the premiums charged. Count IX alleges that Allstate should be estopped from interpreting the 180-day provision in any manner at variance with the representations Allstate made to. the New York State Insurance Department (“NYSID”) under the doctrine of regulatory estoppel. The defendant now moves to dismiss the plaintiffs’ claims pursuant to Rule 12(b)(6) of the Federal Rules of Civil Procedure. For the reasons explained below, the motion to dismiss is granted.

I.

In deciding a motion to dismiss pursuant to Rule 12(b)(6), the allegations in the complaint are accepted as true, and all reasonable' inferences must be drawn in the plaintiffs favor. McCarthy v. Dun & Bradstreet Corp., 482 F.3d 184, 191 (2d Cir.2007). The Court’s function on a motion to dismiss is “not to weigh the evidence that might be presented at a trial but merely to determine whether the complaint itself is legally sufficient.” Goldman v. Belden, 754 F.2d 1059, 1067 (2d Cir.1985). The Court should not dismiss the complaint if the plaintiff has stated “enough facts to state a claim to relief that is plausible on its face.” Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570, 127 S.Ct. 1955, 167 L.Ed.2d 929 (2007). “A claim [374]*374has facial plausibility when the plaintiff pleads factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged.” Ashcroft v. Iqbal, 556 U.S. 662, 678, 129 S.Ct. 1937, 173 L.Ed.2d 868 (2009). While the Court should construe the factual allegations in the light most favorable to the plaintiff, “the tenet that a court must accept as true all of the allegations contained in the complaint is inapplicable to legal conclusions.” Id. When presented with a motion to dismiss pursuant to Rule 12(b)(6), the Court may consider documents that are referenced in the complaint, documents that the plaintiffs relied on in bringing suit and that are either in the plaintiffs’ possession or that the plaintiffs knew of when bringing suit, or matters of which judicial notice may be taken. See Chambers v. Time Warner, Inc., 282 F.3d 147, 153 (2d Cir.2002).

II.

The following facts are accepted as true for the purposes of this motion to dismiss, unless otherwise indicated.

A.

Allstate sells property insurance policies in New York that cover, among other things, damage due to fire. (Second Amended Complaint (“SAC”) ¶ 1.) In the 1990s, as part of an overhaul of its business model designed to increase profits, Allstate introduced changes to its property damage policies in New York and elsewhere. (SAC ¶¶ 63-71.) Allegedly in furtherance of higher profits, Allstate changed the language in its property damage policies regarding coverage of replacement or repair costs. Prior to the change, the policies provided:

If you decide not to repair or replace the damaged property, settlement will be on an actual cash value basis, not to exceed the limit of liability applicable to the building. You may make claim within 180 days after the date of the loss for any additional payment on a replacement cost basis if you repair the damaged property.

(SAC ¶ 72.) Under this provision, an insured was only required to “make claim” within 180 days of the date of the loss to qualify for additional payment. (SAC ¶ 72.) An insured was not required to complete or even start repairs within 180 days of the loss. (SAC ¶ 72.)

In the 1990s, Allstate drafted new policy terms that restricted replacement and repair cost coverage. (SAC ¶ 73.) The updated policy provision (the “180-day provision”) provides:

If you do not repair or replace the damaged building structure, payment will be on an actual cash value basis ... You may make claim for additional payment ... if you repair or replace the damaged, destroyed, or stolen covered property within 180 days of the actual cash value payment.

(SAC ¶ 74.) Allstate interprets its updated policy language to require that an insured complete repairs and replacement of the insured’s damaged or destroyed home and its contents within 180 days of the date Allstate paid the actual cash value (“ACV”) of the covered property (the “completion requirement”). (SAC ¶ 78.) Thus, under Allstate’s interpretation, Allstate’s policies entitled its insured to the actual cash value of the damaged property and, if repairs or replacements were completed within 180 days of the actual cash value payment, any additional cost of repair or replacement in excess of the actual cash value.

Allstate’s updated policy also contains Building Structure Extended Reimbursement coverage (the “Extended Limits endorsement”) that provides the insured with [375]*375coverage for the amount it costs to repair or replace the damaged insured property up to 125 percent of the stated policy limit. (SAC ¶ 93.) Allstate applies the 180-day provision completion to requirement to the Extended Limits endorsement as well. (SAC ¶ 93.) The Allstate policy further provides that “[w]hen the policy provisions conflict with the statutes of the state in which the residence premises is located, the provisions are amended to conform to such statutes.” (SAC ¶ 94.)

In 1994, NYSID approved the changes to Allstate’s policy, including the 180-day provision. (SAC ¶ 75.) The plaintiffs allege that although NYSID approved the policy changes, it did not “knowingly” approve the 180-day provision.

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947 F. Supp. 2d 370, 2013 WL 2317140, 2013 U.S. Dist. LEXIS 75362, Counsel Stack Legal Research, https://law.counselstack.com/opinion/sher-v-allstate-insurance-nysd-2013.