181 So. 3d 1033
Ala.2014Background
- Baldwin Mutual Insurance Company (BMIC) sued ~130 insureds after insureds’ counsel sent a November 12, 2010 letter invoking appraisal for previously settled losses and requesting policy files; BMIC sought to enjoin appraisal demands as premature.
- BMIC argued appraisal is triggered only when there is a true disagreement about the amount of loss and only after insureds have complied with post‑loss policy duties (proofs of loss, examinations under oath, documentation).
- Baldwin Circuit Court (Dec. 2010) stayed appraisal deadlines pending insureds’ provision of a basis for rejecting prior settlements; the case later transferred to Calhoun Circuit Court.
- Calhoun Circuit Court (Apr. 2011, clarified Apr. 29) ordered BMIC to name an appraiser within 10 days as to 14 insureds, finding those 14 had shown sufficient disagreement; BMIC appealed.
- Alabama Supreme Court reviewed de novo (no ore tenus evidence) and reversed the April 2011 order, holding appraisal cannot be compelled until insureds satisfy post‑loss obligations and there is a genuine disagreement on amount.
Issues
| Issue | Plaintiff's Argument (BMIC) | Defendant's Argument (insureds) | Held |
|---|---|---|---|
| Whether insureds must satisfy policy post‑loss obligations before invoking appraisal | Insureds must comply with post‑loss duties (proofs of loss, EXUs, documentation) because insurer has no obligation to evaluate or pay until those conditions are met | Policy language permits either party to demand appraisal upon disagreement; post‑loss provisions are separate and do not condition the appraisal clause | Held for BMIC: insureds must satisfy post‑loss obligations and allow investigation before appraisal can be compelled |
| Whether insureds had established the prerequisite "disagreement" to trigger appraisal | No genuine disagreement exists where insureds only assert dissatisfaction without providing required documentation; unilateral demand is insufficient | A notice to insurer that the settlement was inadequate suffices to create a disagreement and appraisal may be demanded; policies do not require contractors’ estimates | Held for BMIC: absent sufficient information from insureds (which BMIC is entitled to under the policies), there is no meaningful disagreement to trigger appraisal; circuit court erred in ordering appraisal for the 14 insureds |
Key Cases Cited
- Twin City Fire Ins. Co. v. Alfa Mut. Ins. Co., 817 So.2d 687 (Ala. 2001) (insurer policy construction principles)
- State Farm Mut. Auto. Ins. Co. v. Brown, 26 So.3d 1167 (Ala. 2009) (policy interpretation rules; give words ordinary meaning)
- Nationwide Ins. Co. v. Nilsen, 745 So.2d 264 (Ala. 1998) (insurer need not investigate or pay until insured complies with claim submission terms)
- United States Fid. & Guar. Co. v. Romay, 744 So.2d 467 (Fla. Dist. Ct. App. 1999) (appraisal not triggered until insured complies with post‑loss duties so insurer can investigate)
- Galindo v. ARI Mut. Ins. Co., 203 F.3d 771 (11th Cir. 2000) (following Romay; insurer entitled to investigate supplemental claims before appraisal)
