Summary
In Bankers Insurance, the plaintiff brought claims against his insurance agent after his claim pursuant to a SFIP was denied by the defendant insurance company.
Summary of this case from Richmond v. Chubb Group of Insurance CompaniesOpinion
Civil Action No. 03-2802 Section "C" (3).
May 20, 2005
ORDER AND REASONS
This matter comes before the Court on motion for summary judgment filed by Martin Insurance Agency ("Martin"). Having considered the record, the memoranda of counsel and the law, the Court has determined that summary judgment is appropriate for the following reasons.
The plaintiffs' claim damages resulting from a denied insurance claim on policies issued under the Standard Flood Insurance Program ("SFIP"). Martin had reported the claim on the contents policy to the insurer, an inspection was made and the claim was denied. "After careful examination, it has been determined that your damages were not caused by a general condition of flooding as defined by your National Flood Insurance Policy."
AAR-Inc. was the insured on a contents policy, while Adel H. Abdallah was the insured on a building policy.
According to the complaint, the plaintiffs sue Martin for breach of contract, "negligent performance of the duty to prepare proper proofs of loss" and detrimental reliance regarding Martin's alleged promise to prepare proper proofs of loss with regard to alleged flood losses. (Rec. Doc. 1, ¶¶ 23, 24 25). Martin unsuccessfully sought summary judgment in January 2005. (Rec. Docs. 52 67). The Court recognized that the policy imposes the duty to file proper proofs of loss on the insured, but denied the motion because of the plaintiffs' allegation that one of Martin's agents advised the plaintiff to "hold off" after the claim was rejected but before the SFIP deadline for filing proofs of claims.
This motion is based on the argument that any representation by Martin's agent has no bearing on plaintiffs' affirmative obligation under the SFIP to submit a proper proof of loss. Martin argues that the denial was based on the inspection, not any representation by Martin. It claims that it undisputably acted with reasonable diligence in reporting the claim on the contents policy to the insurer, that neither plaintiff completed the required proof of loss forms, and that no claim on the building policy was never reported to Martin. It also presents proof that it had an agency relationship with the insured at all material times.
The Court recognizes that the Louisiana Supreme Court addressed an insurance agent's obligation to his client in Karam v. St. Paul Fire Marine Insurance Co., 281 So.2d 728, 731 (La. 1973). The Court does not read that case as purporting to set forth the exclusive duties owed by the agent to the insured.
The Court notes that although the insurer was dismissed on summary judgment based on the absence of a properly filed proof of loss, the denial of the claim was based on the results of the inspection, not the substance of any claim.
Martin's argument relies on jurisprudence that any reliance on a material misstatement of an agent with regard to the SFIP is unreasonable as a matter of law. Richmond Printing L.L.C. v. Director, FEMA, 2003 WL 21697457 (5th Cir.); Larmann v. State Farm Insurance Co., 2005 WL 357191 (E.D.La.); Deverant v. Selective Co., Inc., 2004 WL 1171333 (E.D.Pa.). This caselaw provides solid support for summary judgment.
The plaintiffs first argue that Martin "promised" to assist the plaintiffs with their proofs of loss and "instructed the plaintiffs to wait beyond the 60-day proof-of-loss deadline before contesting its claim . . ." (Rec. Doc. 91, p. 5). The record is devoid of such specific evidence. The fact that Martin thought there had been a flood in the building and was "holding off" considering a protest of the denial based did not preclude the plaintiffs from taking any action. There is no proof that the agency undertook to preserve the plaintiffs' legal rights under the policy.
Again, although the previous summary judgment was based on the failure to timely submit a properly supported proof of claim, the original denial of the claim at that time was based on the lack of evidence of flood damage.
The plaintiffs next argue that the existence of an agency agreement between Martin and the insurer is of no import since Martin is not "an integral part of the adjustment of claims under the problem program." (Rec. Doc. 91, p. 7). At the same time, the plaintiffs argue that Martin should have considered the alleged phone call from the plaintiffs' representative as notice of claims under both policies. "Martin Insurance had knowledge that it sold the building policy to Mr. Abdallah, and should not be allowed to escape responsibility for its negligence in failing to report the claims properly." (Rec. Doc. 91, p. 9). There is no record evidence sufficient to raise a genuine issue of material fact that Martin was so obligated to the plaintiffs.
The plaintiffs also argue that summary judgment is premature because additional discovery needs to be taken. The Court notes that more than sufficient time has been allowed for discovery, and that trial is upcoming. In addition, it appears that documentation sufficient to support an untimely claim is still unavailable.
Accordingly,
IT IS ORDERED that the motion for summary judgment filed by the Martin Insurance Agency, Inc. is GRANTED.