Westfield Insurance v. Appleton

132 F. App'x 567
CourtCourt of Appeals for the Sixth Circuit
DecidedMay 9, 2005
Docket03-2016
StatusUnpublished
Cited by11 cases

This text of 132 F. App'x 567 (Westfield Insurance v. Appleton) is published on Counsel Stack Legal Research, covering Court of Appeals for the Sixth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Westfield Insurance v. Appleton, 132 F. App'x 567 (6th Cir. 2005).

Opinion

O’MALLEY, District Judge.

Westfield Insurance Company (“West-field”) filed this lawsuit against its insureds, Randy and Tammy Appleton (“Appletons”), seeking a declaration that it is not hable under the Appletons’ homeowners insurance policy. In response, the Appletons filed counterclaims against Westfield. In due course, Westfield filed a motion for summary judgment, which the district court granted. The court also dis- . missed with prejudice the Appletons’ counterclaims. The court later denied the Appletons’ motion to reconsider its grant of summary judgment to Westfield. The Appletons, thereafter, timely filed this appeal. For the reasons outlined more fully below, we AFFIRM the district court’s grant of summary judgment in favor of Westfield and the district court’s dismissal “with prejudice” of the Appletons’ counterclaims.

I. FACTUAL AND PROCEDURAL BACKGROUND

The undisputed facts are as follows. Westfield issued a homeowners insurance policy to Randy Appleton for the property located at 33273 East Palmer Lake Road in Colon, Michigan. 1 Generally, the policy insured against loss of the Appletons’ real property, as well as the personal items within their home. The policy contained a “Duty After Loss” provision requiring the Appletons to submit a proof of loss statement within sixty days after any claimed loss. The policy further provided that, if the insureds failed timely to submit a proof of loss statement, the subject claim would be invalidated unless they proved it was “not reasonably possible” to timely submit the proof of loss statement.

On the morning of December 13, 2001, a fire destroyed the Appletons’ home. The next day, with the Appletons’ permission, Westfield’s fire investigator, Ken Shelley, together with a Michigan State Police Fire Marshal, examined the fire-damaged premises. After completing their investigation that evening, Shelley and the Fire Marshal informed the Appletons that they could do as they wished with the premises. Thereafter, the Appletons demolished the dwelling with the intent to rebuild.

On January 11, 2002, Westfield’s insurance adjuster, Scott Whaley, requested by letter a proof of loss statement and supporting documentation from the Appletons. The letter included three blank proof of *569 loss statement forms (along with instructions on how to complete the forms) and established a March 12, 2002 deadline for completing and returning the forms (i.e., sixty days later per the policy's terms). The letter went on to state that failure to meet the March 12, 2002 deadline would mean that Westfield would not honor the Appletons’ claim. Whaley then made two appointments to help the Appletons complete the forms, but never conditioned the Appletons’ obligation to complete the forms on his assistance. Due to scheduling conflicts, Whaley had to cancel both appointments and ultimately never met with the Appletons.

In early February, the Appletons sought legal representation. On February 12, 2002, Mike Grenon, a special fire investigator for Westfield, met the Appletons at their attorney’s office and took recorded statements regarding the fire. The statements, however, were not “under oath.” At that meeting, Grenon told the Apple-tons that they also needed to submit personal property inventories. Upon learning that the Appletons were represented, on February 13, 2002, Whaley informed the Appletons’ attorney by letter that he would no longer contact the Appletons directly. In his letter, Whaley specifically referenced his January 11, 2002 letter and reiterated the Appletons’ obligation to submit a sworn proof of loss statement.

On March 6, 2002, the Appletons submitted the personal property inventories that Grenon had requested at the February 12, 2002 meeting, and asked when Westfield would make its final decision on their claim. At that time, however, they did not provide the required proof of loss statement. By letter dated March 7, 2002, Grenon followed up with the Appletons regarding their property inventories and requested that they submit additional information including: 1) tax returns and financial statements; 2) cell phone records; 3) airline ticket records; 4) their parents’ contact information; and 5) “mortgage loan” information. On April 3, 2002, the Appletons submitted the additional items that Grenon requested, and, through their attorney, again inquired as to when West-field would make its decision on their claim.

In an April 24, 2002 letter, Grenon acknowledged that he had received the Appletons’ supplemental documentation relative to their property inventories, but never acknowledged their inquiry regarding Westfield’s consideration of their claim. The Appletons never provided Westfield with an executed sworn proof of loss statement prior to the March 12, 2002 deadline as 1) required by their policy, and 2) requested in Whaley’s January 11 and 13, 2002 letters to the Appletons and their attorney. Accordingly, West-field denied the Appletons’ claim.

Rather than simply telling the Appletons of its intent to deny their claim, on April 30, 2002, Westfield filed this action. In its complaint, Westfield sought a declaratory judgment that it had no coverage obligation to the Appletons because they had failed to timely file a proof of loss statement, as required by their insurance policy and the notices provided to them by West-field.

The Appletons responded in two ways. First, they submitted a sworn proof of loss statement to Westfield on May 15, 2002. By letter dated June 14, 2002, however, Westfield rejected the Appletons’ proof of loss statement because it: 1) was untimely; 2) was not signed by Tammy Appleton; and 3) “merely estimate[d] the cash value, whole loss and damage and amount claimed, [without support] by adequate documentation or information.” Second, the Appletons answered Westfield’s complaint, and asserted that Westfield had *570 waived, or was otherwise estopped from enforcing, strict compliance of the policy’s sixty-day “proof of loss” requirement. The Appletons also filed counterclaims against Westfield for breach of contract and unfair trade practices in violation of Michigan law.

Westfield ultimately moved for summary judgment on all of its claims. Finding no genuine issues of material fact, the district court granted Westfield’s motion and, thereafter, dismissed the Appletons’ counterclaims with prejudice as having no legal basis in light of the court’s grant of summary judgment to Westfield. The Apple-tons filed a motion for reconsideration, which the district court considered and denied. 2 The Appletons timely filed this appeal.

II. DISCUSSION

Michigan law, which the parties agree applies in this case, strongly favors insurance companies in connection with insurance policies that contain the somewhat standard “proof of loss” requirement— usually sixty days after a claimed loss. See Dellar v. Frankenmuth Mut. Ins. Co., 173 Mich.App. 138, 433 N.W.2d 380, 383 (1988) (“Clearly, the failure to file a signed and sworn proof of loss within sixty days of the loss bars recovery on a claim without regard to whether the insurer is prejudiced by such failure.”).

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132 F. App'x 567, Counsel Stack Legal Research, https://law.counselstack.com/opinion/westfield-insurance-v-appleton-ca6-2005.