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Ferraro v. Liberty Mutual Fire Insurance
796 F.3d 529
| 5th Cir. | 2015
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Background

  • 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)
Read the full case

Case Details

Case Name: Ferraro v. Liberty Mutual Fire Insurance
Court Name: Court of Appeals for the Fifth Circuit
Date Published: Aug 6, 2015
Citation: 796 F.3d 529
Docket Number: No. 14-30944
Court Abbreviation: 5th Cir.