44 F. Supp. 3d 813
S.D. Ind.2014Background
- PIIC issued a first-party property insurance policy to Pebble Point, covering 3030 Pebble Point Dr., Indianapolis, for 11/22/2011–11/22/2012.
- Pebble Point submitted a December 2, 2012 claim for roof damage after Hurricane Sandy (Oct. 29, 2012).
- Rimkus found no high-wind event on Oct. 29, 2012; damage largely due to non-wind causes; PIIC paid $16,288.56, less a $10,000 deductible.
- Pebble Point demanded appraisal on May 21, 2013; PIIC hired PT & C in July 2013; PT & C attributed some Oct. 29, 2012 damage to storm but majority to long-term deterioration and installation/maintenance issues.
- PIIC filed suit on Sept. 12, 2013 seeking a declaratory judgment that its payment discharged its obligations; PIIC argued appraisal was unwarranted.
- Court grants Pebble Point’s motion to dismiss without prejudice and directs the parties to proceed to appraisal, with PIIC allowed to re-file within 30 days after appraisal concludes.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether appraisal applies to causation/coverage disputes | Pebble Point entitled to appraisal under policy | PIIC argues appraisal only resolves amount, not coverage | Appraisal applies to causation disputes; proceed to appraisal |
| Appraisal as a condition precedent to suit | PIIC contends no appraisal prerequisite | Appraisal required before declaratory relief | Appraisal is a prerequisite; suit dismissed without prejudice to allow appraisal |
| Effect of dismissal and re-filing deadline | N/A | N/A | Dismissal without prejudice; PIIC may re-file within 30 days after appraisal conclusion |
Key Cases Cited
- Hayes v. Allstate Ins. Co., 722 F.2d 1332 (7th Cir. 1983) (arbitration/appraisal and coverage distinctions depend on contract terms)
- Atlas Constr. Co. v. Ind. Ins. Co., 309 N.E.2d 810 (Ind. Ct. App. 1974) (arbitration/appraisal as a condition precedent analogy to arbitration clauses)
- Vernon Ins. & Trust Co. v. Maitlen, 63 N.E. 755 (Ind. 1902) (arbitration-like appraisal provisions can be implicit conditions precedent to suit)
- 188 LLC v. Trinity Indus., Inc., 300 F.3d 730 (7th Cir. 2002) (court may consider attached policy documents in ruling on motion; relevance to contract interpretation)