Sonya Fuller v. Mercury Insurance Company of Georgia
708 F. App'x 637
| 11th Cir. | 2018Background
- Fuller’s Smyrna, GA house was damaged by fire; she submitted an insurance claim to Mercury Insurance Company of Georgia.
- Mercury investigated, concluded Fuller (or someone acting for her) started the fire, and denied the claim under policy exclusions for "Intentional Loss" and for "concealment or fraud."
- Fuller sued Mercury in Georgia state court; Mercury removed to federal district court and counterclaimed to recover amounts it had advanced.
- A Georgia grand jury indicted Fuller for arson and insurance fraud; Fuller entered an Alford (plea of convenience) plea to insurance fraud and received probation. The state court found a satisfactory factual basis for the plea.
- The district court granted summary judgment for Mercury on liability, concluding Fuller’s plea constituted unrebutted evidence of fraudulent conduct that voided coverage; the parties later stipulated to the restitution amount, which the court awarded to Mercury.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Fuller’s Alford plea is sufficient to defeat coverage | Alford plea is only prima facie evidence; does not conclusively establish fraud for insurance forfeiture | Plea constitutes an admission/confession equivalent to a guilty plea and, absent rebuttal, is conclusive evidence of insurance fraud | Court: Plea, with factual basis and voluntary entry, is conclusive here; Mercury may deny/cancel policy |
| Whether Mercury properly denied claim under "Intentional Loss" exclusion | Fuller disputed that she intentionally caused the loss (implied by plea’s limited nature) | Intentional-loss exclusion applies where insured committed act with intent to cause loss; plea establishes intent-related fraudulent conduct | Court: Exclusion applies because plea established fraudulent conduct sufficient to void coverage |
| Whether Mercury properly denied claim under "concealment or fraud" clause | Fuller argued plea is not dispositive and that she rebutted or created a genuine dispute | Mercury argued plea shows materially false statements/fraud before/after loss, triggering cancellation/denial clause | Court: Clause triggered; plea unrebutted, so cancellation and denial appropriate |
| Whether genuine issue of material fact precluded summary judgment | Fuller contended plea is only prima facie and she raised factual dispute | Mercury argued no evidence rebutting plea; summary judgment appropriate | Court: No genuine dispute; de novo review supports summary judgment for Mercury |
Key Cases Cited
- Cynergy, LLC v. First Am. Title Ins. Co., 706 F.3d 1321 (11th Cir.) (summary judgment standard)
- Blohm v. Comm’r of Internal Revenue, 994 F.2d 1542 (11th Cir.) (effect of a guilty plea as equivalent to admission)
- Alford v. North Carolina, 400 U.S. 25 (U.S. 1970) (Alford plea and its legal significance)
- Trustgard Ins. Co. v. Herndon, 790 S.E.2d 115 (Ga. Ct. App.) (conviction/plea establishes prima facie insurance fraud)
- Harden v. State Farm Fire & Cas. Co., 605 S.E.2d 37 (Ga. Ct. App.) (guilty plea supports denial of coverage)
- State Farm Fire & Cas. Co. v. Moss, 441 S.E.2d 809 (Ga. Ct. App.) (same principle regarding plea/coverage)