Ferraro v. Liberty Mutual Fire Insurance
796 F.3d 529
| 5th Cir. | 2015Background
- Ron and Patricia Ferraro owned a home insured under a Standard Flood Insurance Policy (SFIP) issued through the NFIP/WYO program; Hurricane Isaac damaged the house.
- An insurer adjuster prepared a proof-of-loss for $103,826.83; the Ferraros signed and swore to that form and handwrote: “Will send supplement later.” Liberty Mutual paid that amount.
- The Ferraros later retained a public adjuster who estimated total damages of $320,436.55 and submitted that report to Liberty Mutual, but the Ferraros did not sign and swear to a second proof-of-loss asserting the higher amount.
- Liberty Mutual declined further payment; the Ferraros sued for additional flood-insurance proceeds. Liberty Mutual moved for summary judgment arguing the SFIP requires a signed, sworn proof of loss as a condition precedent to suit.
- The district court granted summary judgment for Liberty Mutual; the Ferraros appealed, raising (1) whether a supplemental unsigned report can suffice as proof of loss and (2) whether they reasonably relied on an insurer adjuster’s email saying no special supplemental form was required.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether a second signed, sworn proof of loss is required to recover supplemental flood damages beyond an earlier sworn amount | Ferraro: original sworn proof plus notice (“Will send supplement later”) and submission of adjuster’s report suffice; no new proof-of-loss form required for additional payment on same claim | Liberty Mutual: SFIP’s proof-of-loss requirement must be strictly complied with; supplemental amount requires a new signed, sworn proof of loss | Held: A second signed, sworn proof of loss was required; merely submitting an unsigned adjuster’s estimate or notice does not satisfy SFIP |
| Whether Ferraros can rely on insurer adjuster’s email stating no special forms required (detrimental reliance/new evidence for reconsideration) | Ferraro: they justifiably relied on adjuster Lee Holcomb’s email telling them no special forms were needed for the supplement | Liberty Mutual: Ferraros had the email and could have used it earlier; they failed to show it was newly discovered or would change the outcome | Held: District court did not abuse discretion denying reconsideration — email was not shown to be newly discovered nor likely to change the result |
Key Cases Cited
- DeCosta v. Allstate Ins. Co., 730 F.3d 76 (1st Cir.) (insured must sign and swear to the exact supplemental amount; adjuster estimates alone insufficient)
- Gunter v. Farmers Ins. Co., 736 F.3d 768 (8th Cir.) (proof of loss is the insured’s signed, sworn final statement; adjuster statements are only courtesy)
- Gowland v. Aetna, 143 F.3d 951 (5th Cir.) (SFIP requirements strictly construed; failure to provide complete sworn proof of loss relieves insurer’s payment obligation)
- Marseilles Homeowners Condo. Ass’n v. Fidelity Nat’l Ins. Co., 542 F.3d 1053 (5th Cir.) (SFIP strict compliance; sworn proof of loss required to pursue supplemental recovery)
- Mancini v. Redland Ins. Co., 248 F.3d 729 (8th Cir.) (SFIP is a FEMA regulation setting conditions for federal disbursement; its requirements must be enforced)
- Campo v. Allstate Ins. Co., 562 F.3d 751 (5th Cir.) (explaining WYO carriers’ administrative role and FEMA’s ultimate payment responsibility)
