Souza v. Erie Insurance Company

CourtDistrict Court, N.D. Illinois
DecidedJuly 25, 2023
Docket1:22-cv-03744
StatusUnknown

This text of Souza v. Erie Insurance Company (Souza v. Erie Insurance Company) is published on Counsel Stack Legal Research, covering District Court, N.D. Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Souza v. Erie Insurance Company, (N.D. Ill. 2023).

Opinion

UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ILLINOIS EASTERN DIVISION

JAQUELINE K. SOUZA, ) ) Plaintiff, ) Case No. 22-cv-3744 ) v. ) Hon. Steven C. Seeger ) ERIE INSURANCE COMPANY, ) ) Defendant. ) ____________________________________)

MEMORANDUM OPINION AND ORDER After a bad storm blew through Evanston, Illinois, Plaintiff Jaqueline Souza found herself with a damaged roof. Fortunately, she had taken out a property insurance policy from Defendant Erie Insurance Company to protect her and her property from just that kind of thing. Or so she thought. Souza filed a claim with Erie for the damage. But when Erie assessed the damage to Souza’s home, it concluded that things weren’t as bad as they seemed. In fact, the insurance company concluded that the costs of the damage failed to exceed Souza’s deductible under the policy, so it denied her claim. Souza insists that Erie has undervalued her claim and needs to pay up. She filed a three-count complaint under Illinois law, alleging that the company breached its contract with her, acted unreasonably in handling her claim, and otherwise engaged in unfair business practices. Erie, in turn, moved to dismiss. For the following reasons, Defendant’s motion is granted in part and denied in part. Background At the motion-to-dismiss stage, the Court must accept as true the complaint’s well- pleaded allegations. See Lett v. City of Chicago, 946 F.3d 398, 399 (7th Cir. 2020). The Court “offer[s] no opinion on the ultimate merits because further development of the record may cast the facts in a light different from the complaint.” Savory v. Cannon, 947 F.3d 409, 412 (7th Cir. 2020). Plaintiff Jacqueline Souza is a homeowner in Evanston, Illinois. See Cplt., at ¶ 5 (Dckt. No. 1). Like most homeowners, she sought to protect her investment. So, she purchased an

insurance policy on the property from Defendant Erie Insurance Company. Id. at ¶ 6. According to the complaint, the policy covered the property “against perils including wind/hailstorms.” Id. The coverage included up to $1,399,500 for damage to the home itself; $279,900 for damage to other structures on the property; $1,049,625 for damage to the home’s contents and other personal property; and unlimited loss-of-use benefits for a one-year period. Id. On August 10, 2021, a storm blew through Evanston. Id. at ¶ 7. The storm brought intense winds, which took a toll on Souza’s home. Her property suffered “significant damage to the roof and gutters necessitating costly repairs.” Id. at ¶ 8.

After the storm, Souza took stock of the damage to her property. Id. at ¶ 9. She then “began mitigating the loss as quickly as possible.” Id. And, thinking her insurance policy would cover it, she promptly filed a claim with Erie. Id. In response to her claim, Erie sent a field adjuster to inspect the damaged property for itself. Id. at ¶ 10. After assessing the damage to the property, the insurer determined that the costs of the damage did not exceed the deductible on Souza’s policy. Id. at ¶ 12. So, it denied Souza coverage. Id. Souza would have to foot the bill for the storm herself. Erie’s inspection, and its assessment of the damage to the property, sit at the heart of this dispute. According to the complaint, Erie’s inspection wasn’t thorough, and it wasn’t accurate. “The inspection was brief and failed to document the full scope of damages resulting in an estimate grossly underreporting the extent of damage.” Id. at ¶ 10. To prove it, Souza enlisted independent adjusters to inspect her property and prepare their own damages estimate. Id. at ¶ 13. Those adjusters documented a total of $283,514.38 of damage to the house, apparently a much larger sum than Erie had calculated. Id. Souza

submitted that independent estimate to Erie, along with a bid from a construction company to repair the roof. Id. at ¶ 14. Erie hasn’t put much stock in these third-party assessments and continues to deny coverage under the policy. Id. at ¶ 16. Souza attributes Erie’s obstinance to impropriety. According to the complaint, Erie has “failed and refused to evaluate the information and surrounding facts, choosing instead to rely entirely on the incorrect assumptions and conclusions of its agents, employees, or consultants.” Id. at ¶ 15. Additionally, the complaint alleges that Erie “purposefully and/or negligently” failed to pay out her claim, misrepresented the terms and conditions of her policy, “manipulated its

pricing software to artificially suppress the costs of repairs,” and failed to adequately account for overhead and profit in its damages estimates. Id. at ¶¶ 18–22. As Souza sees it, Erie has “[n]o reasonable basis . . . for [its] delay and/or refusal to provide covered benefits due and owing under the Policy.” Id. at ¶ 16. Souza alleges that she has incurred significant expenses because of Erie’s foot-dragging and chicanery. Id. at ¶ 24. For one thing, her property remains in disrepair. Id. at ¶ 17. Souza also had to pay her own experts to assess the damage, and she predicts that she will continue to incur additional expenses in the future. Id. at ¶¶ 23–25. The parties still do not see eye to eye on the extent of the damage. So, Souza sued Erie based on its handling of her claim, and to enforce the policy. She brings three counts: (1) breach of contract (Count I); (2) a violation of section 155 of the Illinois Insurance Code (Count II); and (3) a violation of the Illinois Consumer Fraud Act (Count III). Id. at ¶¶ 27–37. Erie now moves to dismiss. See Def.’s Mtn. to Dismiss (Dckt. No. 8).

Legal Standard A motion to dismiss under Rule 12(b)(6) challenges the sufficiency of the complaint, not its merits. See Fed. R. Civ. P. 12(b)(6); Gibson v. City of Chicago, 910 F.2d 1510, 1520 (7th Cir. 1990). In considering a Rule 12(b)(6) motion to dismiss, the Court accepts as true all well- pleaded facts in the complaint and draws all reasonable inferences from those facts in the plaintiff’s favor. See AnchorBank, FSB v. Hofer, 649 F.3d 610, 614 (7th Cir. 2011). To survive a Rule 12(b)(6) motion, the complaint must provide the defendant with fair notice of the basis for the claim, and it must be facially plausible. See Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009); Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555 (2007). “A claim has 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.” Iqbal, 556 U.S. at 678. Analysis Souza’s three-count complaint alleges that Erie breached the terms of its contract with her, used deceptive practices to undervalue the damage to her property, and vexatiously and unreasonably delayed covering her claim. See Cplt., at ¶¶ 27–37 (Dckt. No. 1). Erie has moved to dismiss the complaint in its entirety. See Def.’s Mtn. to Dismiss (Dckt. No. 8). The Court takes each count in turn. Before diving in, the Court offers one prefatory observation. Souza’s response to Defendant’s motion to dismiss left the Court a bit puzzled. Calling it a “response” might not be the correct choice of words. Souza did not respond at all to Defendant’s arguments supporting dismissal of Counts I or III. See Pl.’s Resp. (Dckt. No. 12). That’s two of the three claims.

The failure to respond has consequences. Souza’s “silence in response to defendant[’s] motion to dismiss operates as abandonment of any argument against dismissing the claims.” See Sroga v. Rendered Servs. Inc., 2019 WL 6173424, at *1 (N.D. Ill.

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