Viera v. Amica Mutual Insurance Company

CourtDistrict Court, D. Colorado
DecidedFebruary 13, 2023
Docket1:20-cv-00495
StatusUnknown

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

Bluebook
Viera v. Amica Mutual Insurance Company, (D. Colo. 2023).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLORADO Magistrate Judge Maritza Dominguez Braswell

Civil Action No. 1:20–cv–00495–MDB

JOSEPH A. VIERA, an individual, and LYNN DEMCHAK-VIERA, an individual

Plaintiffs,

v.

AMICA MUTUAL INSURANCE COMPANY, a corporation incorporated in the state of Rhode Island,

Defendant.

ORDER

This matter is before the Court on Plaintiffs’ Motion to Set Aside Appraisal Award as to Total Amount of Loss and to Reopen Discovery. ([“Motion”], Doc. No. 74.) Defendant has responded in opposition, and Plaintiffs have replied. ([“Response”], Doc. No. 77; [“Reply”], Doc. No. 78.) The Court also held a hearing on February 7, 2023. Having reviewed the parties’ briefs and supporting documentation, and having heard the parties during oral argument, the Court GRANTS in part and DENIES in part the pending Motion. STATEMENT OF THE CASE The following facts are derived from the Complaint and the parties’ briefing. Defendant Amica Mutual Insurance Company [“Amica” or “Defendant”] issued an insurance policy covering the residential property located at 16389 Forest Light Drive in Colorado Springs, Colorado 80908. [“Property”] (Doc. No. 52-2.) Plaintiffs allege that on or about July 20, 2019, a hailstorm—which Plaintiffs allege brought “golf-ball to baseball sized hail,” struck the Property. (Doc. 6 at ¶¶ 12, 31.) “Plaintiffs suspected, based upon the nature of the storm, that there may be damage to their property, specifically their roof and sought an inspection of the same.” (Id. at ¶ 13.) Plaintiffs also allege that they “observed water intrusion into their home in the way of wet flooring and carpets, as well as water damaged paint on their walls.” (Id. at ¶ 16.) In response to Plaintiffs’ notice, Defendant dispatched Jim Martin—an insurance adjuster employed by Acorn Claims—to inspect the Property. (Id. at ¶20.) Mr. Martin prepared what Plaintiffs call “Estimate 1,” totaling $53,412.75 for the Property and $640.78 for the detached greenhouse. (Id. at ¶ 21.) Defendant eventually sent another insurance adjuster, Tim

Tomlinson—also from Acorn Claims—to conduct another inspection and prepare what Plaintiffs call “Estimate 2,” which totaled $70,600.69 for the Property and $5,078.03 for the detached greenhouse. (Id. at ¶¶ 23-24.) Plaintiffs allege they observed additional damage, beyond what was observed and reported in Estimate 2, but Defendant responded that their independent adjuster could not find any damage to the stucco, manufactured stone, fascia, or any loss-related damage to the interior carpeting, wood floor, cabinet, wood beams. (Id. at ¶¶ 25-27.) According to Plaintiffs, Defendant’s response included citations to coverage exclusions. (Id. at ¶ 28.) Plaintiffs eventually “observed mildew smells within their ground floor rooms…and suspected mold

growth within the walls which were damaged from the water intrusion.” (Id. at ¶ 35.) On or about January 3, 2020, Plaintiffs hired Ampro Inspections, Inc. to inspect for mold, and they “identified at least three (3) types of harmful fungi intrusion and growth.” (Id. at ¶¶ 37-38.) Plaintiffs allege Mr. Viera has respiratory issues that require daily oxygen use, so they decided to engage in remediation efforts. (/d. at {§ 39-43.) Less than a month later, Plaintiffs filed this lawsuit. (See Doc. No. 1-2.) Defendant filed an Answer shortly after the case was removed to federal district court. (Doc. No. 10.) The original scheduling order set the discovery deadline for November 25, 2020, and the dispositive motion deadline for December 25, 2020. (Doc. No. 24.) However, after some extensions, discovery closed on February 26, 2021. (Doc. No. 31.) The matter was set for a jury trial on August 9, 2021, with a readiness conference set for July 15, 2021. (Doc. No. 39.) Thereafter, the parties were active in filing proposed jury instructions, exhibit lists, witness lists, and proposed voir dire. (Doc. Nos. 39, 42-51.) In other words, the docket reflects a case that was gearing up for trial. However, just before the readiness conference, Defendant invoked the appraisal clause and filed a motion to dismiss or stay the litigation and compel an appraisal. (Doc. No. 52.) The appraisal provision provides as follows: rote ty were wer ais: wie PUSS, F. Appraisal If you and we fail to agree on the amount of loss, either may demand an appraisal of the loss. In this event, each party will choose a competent and impartial appraiser within 20 days after receiving a written request from the other. The two appraisers will choose an umpire. If they cannot agree upon an umpire within 15 days, you or we may request that the choice be made by a judge of a court of record in the state where the residence premises js located. The appraisers will separately set the amount of loss. If the appraisers submit a written report of an agreement to us, the amount agreed upon will be the amount of loss. If they fail to agree, they will submit their differences to the umpire. A decision agreed to by any two will set the amount of loss. Each party will: 1. Pay its own appraiser; and 2. Bear the other expenses of the appraisal and umpire equally.

(Doc. No. 52-2 at 27.) Upon receiving Defendant’s motion to compel appraisal, the court rescheduled the readiness conference to July 20, 2021, at which time the court denied Defendants’ motion to compel appraisal, finding that by “waiting until less than a month before trial to invoke the appraisal provision, Defendant has waived the right to insist on the appraisal option in the insurance contract and clearly has elected to go forward with trial instead.” (Doc. No. 55.) The final pretrial order was entered, and the matter was near ready for trial. (Doc. No. 56.) However, two days later, on July 22, 2021, the parties appeared for a status conference, during which Plaintiffs represented that they reconsidered their position and decided to move forward with an appraisal. (Doc. No. 59.) Defendant agreed. The jury trial was vacated, the case

was stayed, and the parties commenced with the appraisal process set forth in the policy. (Id.) On September 20, 2021, the parties filed a Joint Status Update in which they represented that “the Appraisal process began more slowly than expected but is now moving appropriately and [the parties] would request that this Court grant another extension to resolve these matters for an additional sixty (60) to ninety (90) days to allow the Appraisers to finish their review, inspections, interviews, and reports.” (Doc. No. 60 at 2.) The update further stated that “Plaintiffs have elected to use David Hann of American Claims LLC as their Appraiser.” (Id. at 1.) It also stated that “Defendant has elected to use Aaron Sullenberger as their Appraiser.” (Id.) At that point in time, the Appraisers had not yet selected an umpire. (Id.)

Approximately three months after the Joint Status Update was filed, Plaintiffs filed a motion asking the court to halt the appraisal process due to a lack of good faith participation by Defendant. (Doc. No. 61.) Specifically, Plaintiffs argued that Appraiser Sullenberger was not engaging in good faith because he was “ignoring the claimed damages in an effort to limit the amount of loss,” and had stated in an email accompanying his report “that he would not be evaluating any of the interior damages because that was related to a separate date or incident of loss.” (Id. at 7-8.) Plaintiffs also raised Appraiser Sullenberger’s potential bias stating that “Plaintiffs notified Defendant’s counsel that they objected to the selection of Mr. Sullenberger as not being impartial because of his prior work with ACORN claims, an adjustment agency that was directly involved with the underlying litigation.” (Id. at 3.) Plaintiffs further argued that they “participated [in the appraisal] reluctantly in hopes of avoid [sic] a trial.

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Viera v. Amica Mutual Insurance Company, Counsel Stack Legal Research, https://law.counselstack.com/opinion/viera-v-amica-mutual-insurance-company-cod-2023.