Urbassik v. American Family Mutual Insurance Co.

CourtDistrict Court, N.D. Ohio
DecidedFebruary 23, 2023
Docket1:21-cv-01974
StatusUnknown

This text of Urbassik v. American Family Mutual Insurance Co. (Urbassik v. American Family Mutual Insurance Co.) is published on Counsel Stack Legal Research, covering District Court, N.D. Ohio primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Urbassik v. American Family Mutual Insurance Co., (N.D. Ohio 2023).

Opinion

UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF OHIO EASTERN DIVISION

JEREMY URBASSIK, ) Case No. 1:21-cv-01974 ) Plaintiff, ) Judge J. Philip Calabrese ) v. ) ) AMERICAN FAMILY MUTUAL ) INSURANCE CO., ) ) Defendant. ) )

OPINION AND ORDER On behalf of himself and a putative class of those similarly situated, Plaintiff Jeremy Urbassik brings this action, alleging that Defendant American Family Mutual Insurance Company failed to pay actual cash value as required under his auto-insurance policy after an accident rendered his vehicle a total loss. In his second amended class action complaint, Plaintiff sues for breach of contract and breach of the covenant of good faith and fair dealing. (ECF No. 36.) Also, he seeks a declaratory judgment that Defendant’s valuation process breaches the policy and violates Ohio law. (Id.) Defendant moves to dismiss the complaint in its entirety. (ECF No. 37.) For the reasons set forth below, the Court GRANTS Defendant’s motion. STATEMENT OF FACTS Taking the facts Plaintiff alleges in the second amended complaint as true and construing them in his favor, as the Court must in the present procedural posture, Plaintiff bases his claims on the following facts. A. Plaintiff’s Total Loss Vehicle Mr. Urbassik’s 2006 Chrysler 300 suffered a total loss around June 26, 2017. (ECF No. 36, ¶ 27, PageID #452.) He had auto insurance through American Family

under an agreement effective April 4, 2017 to October 4, 2017. (ECF No. 36-1, PageID #466.) Mr. Urbassik submitted a claim under the policy for the damage to his vehicle. (ECF No. 36, ¶ 28, PageID #452.) American Family determined that the vehicle was a total loss and offered to pay Mr. Urbassik $6,853.00. (Id., ¶ 30, PageID #453; ECF No. 36-2, PageID #496.) To estimate the value of Mr. Urbassik’s vehicle, and consistent with Ohio law, American Family used a third-party service called AudaExplore, which averages the

prices of comparable vehicles in his area. (ECF No. 36, ¶¶ 14, 29 & 30, PageID #449 & #453.) AudaExplore used a sample of 32 comparable vehicles. (Id., ¶ 30, PageID #453; ECF No. 36-3, PageID #499.) American Family provided Mr. Urbassik with a report from AudaExplore that included a sample of five of these vehicles, their location and condition information, and the “typical negotiation adjustment” AudaExplore imposed on the comparable vehicle’s list price. (ECF No. 36-3,

PageID #500–01.) American Family applied a downward adjustment of $614.17 to the market value of Mr. Urbassik’s car to reflect this average nine percent negotiation or “selling price” adjustment. (ECF No. 36, ¶ 31, PageID #453.) Plaintiff contends that this across-the-board selling-price adjustment bears no relationship to actual prices determined in the market. (Id., ¶¶ 20 & 21, PageID #451.) AudaExplore adjusted the value of Mr. Urbassik’s vehicle based on its odometer reading and the condition of its carpets, headliner, and paint. (ECF No. 36- 3, PageID #499.) AudaExplore made upward adjustments to Mr. Urbassik’s vehicle based on its mileage, carpet wear, and paint wear, and a downward adjustment of $35 for its headliner wear. (Id.) Plaintiff alleges that the $6,853.00 that American

Family paid him undervalued his vehicle by at least $614.17, which is the amount of the selling price adjustment. (ECF No. 36, ¶ 33, PageID #453.) Mr. Urbassik did not dispute the payment of $6,853.00 until he filed suit on October 19, 2021. (Id., ¶ 34, PageID #453.) B. Appraisal under the Policy Under the policy, if the insured disputes American Family’s initial offer to settle a claim, he may demand an appraisal. (ECF No. 36-1, PageID #477.) Also,

American Family has the right to demand an appraisal. (Id.) The policy provides that, if either party demands an appraisal, each will hire an appraiser at their own expense, and split the other costs of the appraisal equally. (Id.) Plaintiff alleges that Defendant intentionally applies the selling price adjustment to total loss vehicles and requires the insured to pay for their own appraiser to deter insureds from demanding an appraisal. (ECF No. 36, ¶ 26, PageID #452.) Then, American Family recovers the

difference between the actual cash value before the adjustment and the adjusted value. (Id.) Plaintiff alleges this process “systematically undervalues total-loss vehicles” to reduce the amount Defendant ultimately pays out to insured individuals. (Id., ¶ 1, PageID #446.) C. Relevant Policy Language American Family’s automotive policy provides collision and comprehensive coverage for physical damage resulting in the total loss of an insured’s vehicle. The

following policy language is relevant to Plaintiff’s allegations: DEFINITIONS 2. Loss means direct and accidental damage to or theft of your covered car. Loss does not mean any difference in the market value of your covered car immediately prior to the loss; and the market value of your covered car after repairs from the loss are completed.

(ECF No. 36-1, PageID #475.)

INSURING AGREEMENT Collision Coverage 2. We will pay for loss due to the collision of your covered car with another object, or upset of your covered car.

(Id., PageID #476.)

Limits of Liability 1. . . . our limit of liability for loss will not exceed the lesser of: a. the actual cash value of the stolen or damaged covered property; or

b. the amount necessary to repair or replace the stolen or damaged covered property. . . . 5. An adjustment for depreciation and physical condition will be made in determining actual cash value.

(Id., PageID #477.) Payment of Loss 2. You or we may demand appraisal of the loss. Each will appoint and pay a competent and impartial appraiser and will equally share other appraisal expenses. Each appraiser will state separately the actual cash value and the amount of loss. An award in writing by any two appraisers will determine the amount payable. The appraisers, or a judge of a court having jurisdiction, will select an umpire to decide any differences.

(Id.) D. Procedural History and Appraisal On December 16, 2021, Defendant moved to dismiss Plaintiff’s claims or, alternatively, to compel appraisal under the policy. (ECF No. 14.) After Plaintiff amended (ECF No. 22), Defendant renewed the motion on February 7, 2022 (ECF No. 30). In March 2022, Plaintiff agreed to participate in the appraisal process. (ECF No. 36, ¶ 35, PageID #454.) Plaintiff paid his appraiser $349. (Id., ¶ 37, PageID #454.) Plaintiff’s appraiser and Defendant’s appraiser found different actual cash values for Plaintiff’s vehicle. (Id., ¶ 43, PageID #455.) Defendant’s appraiser determined an actual cash value of $5,974.22, and Plaintiff’s set it at $7,500. (Id., ¶¶ 41 & 42, PageID #455.) The parties submitted the appraisal to a third-party umpire to resolve the dispute as contemplated under the policy. (Id., ¶ 44, PageID # 455.) Plaintiff’s portion of the umpire’s fee was $200. (Id., ¶ 44, PageID #455.) The umpire determined that the actual cash value of Plaintiff’s vehicle was $8,793.91. (Id., ¶ 45, PageID #455; ECF No. 36-6, PageID #532.) Plaintiff does not allege that Defendant failed to pay him the difference between that amount and the original 2017 payment. These allegations show that Plaintiff paid $549 in costs for the appraisal, which resulted in a determination that his vehicle had an actual cash value of $8,793.91—which is $1,940.91 greater than the $6,853.00 American Family initially

offered, and $1,326.74 greater than the $7,467.17 value before application of the discount (nine percent in the case of Mr. Urbassik) about which Plaintiff complains. Further, the umpire determined an actual cash value $1,293.91 higher than Plaintiff’s appraiser. On August 30, 2023, Plaintiff amended to include allegations concerning the appraisal process. (ECF No. 36.) Then, Defendant moved to dismiss. (ECF No. 37.)

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Urbassik v. American Family Mutual Insurance Co., Counsel Stack Legal Research, https://law.counselstack.com/opinion/urbassik-v-american-family-mutual-insurance-co-ohnd-2023.