Case Information
*1 UNITED STATES DISTRICT COURT DISTRICT OF CONNECTICUT
BARRY AGOSTI, and
ROBIN AGOSTI,
Plaintiffs,
No. 3:16-cv-01686 (SRU) v.
MERRIMACK MUT. FIRE INS. CO., and
ALLSTATE INS. CO.,
Defendants.
RULING AND ORDER
In the present insurance dispute, Allstate Insurance Co. (“Allstate”) has moved to dismiss the claims filed against it by Barry and Robin Agosti. The Agostis’ complaint alleges in Counts Four, Five, and Six that (1) Allstate breached its contract with the Agostis by denying coverage under their homeowner’s insurance policy (the “Allstate Policy”) for damage to their basement walls; (2) Allstate breached the implied covenant of good faith and fair dealing by baselessly denying coverage; and (3) Allstate committed unfair and deceptive practices proscribed by the Connecticut Unfair Insurance Practices Act (“CUIPA”), as enforced through the Connecticut Unfair Trade Practices Act (“CUTPA”). Because the Allstate Policy provides coverage only for an “entire collapse,” and the Agostis have alleged no facts to suggest such a collapse occurred here, I grant the motion and dismiss the pertinent counts of the complaint.
I. Standard of Review
A motion to dismiss for failure to state a claim is designed “merely to assess the legal
feasibility of a complaint, not to assay the weight of evidence which might be offered in support
thereof.”
Ryder Energy Distribution Corp. v. Merrill Lynch Commodities
,
Under
Twombly
, “[f]actual allegations must be enough to raise a right to relief above the
speculative level,” and assert a cause of action with enough heft to show entitlement to relief and
“enough facts to state a claim to relief that is plausible on its face.”
II. Background
Plaintiffs Barry and Robin Agosti own and reside at a house in Tolland, Connecticut, which is protected by a homeowner’s insurance policy underwritten by defendant Allstate. Compl., Doc. No. 1, at Count 1, ¶¶ 1, 3. Prior to September 2015, the Agostis gradually “observed visible cracking in the concrete of their home.” at ¶ 5. On September 15, 2015, the Agostis “had their basement inspected by a professional structural engineer” because they were concerned about the “visible cracking patterns in the basement walls” and were “aware[] . . . [of] *3 deteriorating concrete issues [from] recent media reports.” Id. at ¶ 6. The engineer’s inspection “indicated the concrete deterioration and cracking were caused by a chemical reaction in the concrete,” which he concluded “would continue to progressively deteriorate the basement walls, rendering the structure unusable.” Id. at ¶ 7. As a result, the engineer “recommended replacement of the concrete basement walls.” Id.
Following the inspection, on November 10, 2015, the Agostis “made a timely formal claim for coverage under [their] homeowner’s insurance policy” with Allstate. at Count 4, ¶ 8. They asserted that the loss to their basement walls was covered as a “collapse” due to “hidden decay and/or defective materials.” Id. at ¶ 10. Although the Allstate Policy provides that Allstate generally “do[es] not cover loss to the property . . . consisting of or caused by: . . . 12. Collapse . . . [or] 15. . . . (g) settling, cracking, shrinking, bulging or expansion of . . . foundations [or] walls,” Allstate Policy, Ex. C to Allstate’s Mot. Dismiss, Doc. No. 17-4, at 31–33, it does offer coverage pursuant to an “Additional Protection,” which reads as follows:
Collapse
[Allstate] will cover:
a) the entire collapse of a covered building structure; b) the entire collapse of part of a covered building structure; and c) direct physical loss to covered property caused by (a) or (b) above. For coverage to apply, the collapse of a building structure specified in (a) or (b) above must be a sudden and accidental direct physical loss caused by one or more of the following:
a) a loss we cover under Section I, Coverage C—Personal Property Protection;
b) hidden decay of the building structure;
c) hidden damage to the building structure caused by insects or vermin; d) weight of persons, animals, equipment or contents; e) weight of rain or snow which collects on a roof; f) defective methods or materials used in construction, repair, remodeling or renovation.
Collapse does not include settling, cracking, shrinking, bulging or expansion. at 40 (emphasis removed). *4 Allstate denied the Agostis’ claim on April 19, 2016. Compl., Doc. No. 1, at Count 4, ¶ 11. The Agostis characterize that denial as based on “interpretations of policy provisions [that] are contrary to the [Collapse] provisions of the policy.” Id. ¶ 12.
On October 7, 2016, the Agostis filed a complaint against Allstate in Connecticut Superior Court, Judicial District of Tolland at Rockville. See Notice of Removal, Doc. No. 1, at 1. The Agostis allege that Allstate breached the insurance contract (Count Four), breached the implied covenant of good faith and fair dealing (Count Five), and violated CUTPA/CUIPA (Count Six). Allstate removed the Agostis’ complaint to this court on October 10, 2016. See id. On November 30, 2016, Allstate moved to dismiss the counts of the complaint against it pursuant to Federal Rule of Civil Procedure 12(b)(6). See Doc. No. 17. I heard argument on the motion on January 30, 2017. See Doc. No. 28.
III. Discussion
Allstate moves to dismiss the Agostis’ claim for breach of contract (Count Four) “on the grounds that the alleged damage is not covered under the plain language of the Allstate Policy.” Allstate’s Mot. Dismiss, Doc. No. 17, at 1. Allstate asserts that if I dismiss the claim for breach of contract, I also must dismiss the claims for breach of the implied covenant of good faith and fair dealing (Count Five) and for violation of CUTPA/CUIPA (Count Six), because “neither can be maintained in the absence of a breach of contract.” at 2. Alternatively, even if I decline to dismiss the breach of contract claim, Allstate asks that I dismiss the remaining claims “on the separate and independent grounds that . . . Allstate’s denial of coverage was not in bad faith, and its . . . coverage position here [was] reasonable and fairly debatable.”
The Agostis respond that they have “stated a sufficient cause of action under the [Allstate] Policy” because the policy “fail[s] to exclude losses from a chemical reaction.” Pls.’ *5 Mem. Opp’n Mot. Dismiss, Doc. No. 22, at 4. They argue that the exceptions to the Additional Protection for Collapse cited by Allstate do not preclude coverage, id. at 6–7, and that their allegations of bad faith and violation of CUTPA/CUIPA are likewise sufficient. at 9–13.
A. Count Four: Beach of Contract
Allstate asserts that I must dismiss the Agostis’ claim for breach of contract because “the alleged damage is not covered under the plain language of the Allstate Policy.” Allstate’s Mot. Dismiss, Doc. No. 17, at 1. Accordingly, I first must determine whether coverage exists under the policy for the deterioration of the Agostis’ basement walls.
“[A]s a matter of general insurance law, the insured has the burden of proving that a
benefit is covered.”
Paese v. Hartford Life & Accident Ins. Co.
,
1. Does coverage exist under Coverage A (Dwelling Protection)?
The Agostis argue that their loss is covered under Coverage A (Dwelling Protection) because the Allstate Policy does not specifically “exclu[de] . . . losses due to a chemical *6 reaction.” See Pls.’ Mem. Opp’n Mot. Dismiss, Doc. No. 22, at 4. I disagree, and conclude that the loss to the Agostis’ walls is excluded under Coverage A.
Coverage A of the Allstate Policy appear to provide “all-risk” coverage, meaning that
“losses caused by
any
fortuitous peril not specifically excluded . . . will be covered.”
Parks Real
Estate Purchasing Grp. v. St. Paul Fire & Marine Ins. Co.
,
Although the Agostis’ insurance policy does not exclude by name losses that are caused
by chemical reactions, it does expressly exclude “loss consisting of or caused by . . . settling,
cracking, shrinking, bulging or expansion of . . . foundations [or] walls.” ; Allstate Policy,
Doc. No. 17-4, at 33. That “specific and unambiguous provision . . . expressly exclude[s] the
plaintiffs’ loss” in the present case.
See Costabile
,
2. Does coverage exist under the Additional Protection for Collapse?
The Agostis also contend that their loss may be covered as a “collapse.”
See
Pls.’ Mem.
Opp’n Mot. Dismiss, Doc. No. 22, at 8. The Allstate Policy’s Additional Protection for Collapse
applies to “collapse of a building structure” or a part thereof, “caused by . . . hidden decay of the
building structure” or “defective methods or materials used in construction, repair, remodeling or
renovation.” Allstate Policy, Doc. No. 17-4, at 40. For the reasons stated by the Connecticut
Supreme Court in
Beach v. Middlesex Mutual Assurance Co.
, and subsequently followed by
many judges of this court, I conclude that the term “collapse,” standing alone, “is sufficiently
ambiguous to include coverage for any substantial impairment of the structural integrity of a
building.”
Beach v. Middlesex Mut. Assurance Co.
,
The Allstate Policy’s Additional Protection includes a number of qualifiers, however, which operate to reduce the scope of coverage. First, “[c]ollapse does not include settling, cracking, shrinking, bulging or expansion .” Id. (emphasis added) Second, “the collapse . . . must be a sudden and accidental direct physical loss.” (emphasis added) Third, the collapse must be an “ entire collapse of a covered building structure” or a part thereof. (emphasis added) Although the first and second conditions do not necessarily bar coverage for the alleged collapse of the Agostis’ basement walls, the third condition does. Therefore, I grant Allstate’s motion to dismiss the Agostis’ claim for breach of contract.
a. Is the alleged collapse excluded as “cracking, shrinking, bulging, or expansion”? Allstate asserts that the Agostis’ claim for breach of contract must be dismissed because “the Allstate Policy provides that ‘[c]ollapse does not include settling, cracking, shrinking, bulging or expansion.’” Mem. Supp. Allstate’s Mot. Dismiss, Doc. No. 17-1, at 12–13. Relying heavily on my decision from the bench in Alexander v. General Insurance Co. of America , No. 3:16-cv-00059 (SRU), Allstate argues that, under the terms of the policy, “a building could not be considered in a state of collapse even if it showed evidence of cracking, bulging, sagging, bending, leaning, settling, shrinking, or expansion.” Id. at 11. In response, the Agostis contend that the cracking is merely “the manifestation of the chemical reaction” that caused their walls to deteriorate. Pls.’ Mem. Opp’n Mot. Dismiss, Doc. No. 22, at 6. The exception for cracking, they argue, “is in place in order to prevent the homeowner from seeking compensation for every day occurrences,” not to bar coverage for a “catastrophic event” such as “the chemical reaction” in the present case. at 7.
I agree with the Agostis. In
Beach
, the Connecticut Supreme Court held that an
identically worded exclusion could “reasonably be read to exclude loss related to ‘settling,
cracking, shrinkage, bulging or expansion,’ only so long as ‘collapse’ d[id] not ensue.”
Beach
,
My decision in
Alexander
is not to the contrary. In
Alexander
, the policy “define[d]
‘collapse’ to mean an abrupt falling down or caving in of a building or any part of a building
with the result that the building or part of the building cannot be occupied for its intended
purpose.” Mot. Hr’g Tr., Doc. No. 22, at 22,
Alexander
, No. 3:16-cv-0059 (D. Conn. July 7,
2016). The policy also explicitly noted that “[a] building or any part of a building that is standing
is not considered to be in a state of collapse even if it shows evidence of cracking, bulging,
sagging, leaning, settling, shrinkage or expansion.” In other words, the
Alexander
policy
explicitly disavowed any interpretation that it might “includ[e] settling or cracking that result[ed]
in substantial impairment of a home’s structural integrity” when the building was still standing.
Cf. Jones
,
“Language in an insurance contract . . . must be construed in the circumstances of a
particular case, and cannot be found to be ambiguous or unambiguous in the abstract.”
Lexington
Ins. Co.
,
b. Was the alleged collapse “sudden and accidental”?
Allstate also asserts that the policy does not provide coverage because it requires a
collapse to be “sudden and accidental,” which excludes conditions that result from “progressive
deterioration.” Mem. Supp. Allstate’s Mot. Dismiss, Doc. No. 17-1, at 10. It cites to
Buell
Industries v. Greater New York Mutual Insurance Co.
,
The Agostis’ respond that the cause of the loss—the “chemical reaction”— was “sudden and accidental.” Pls.’ Mem. Opp’n Mot. Dismiss, Doc. No. 22, at 4. They note that, according to both their own expert and Allstate’s, “there is no way to arrest the process and there is no way to repair the existing damage. . . . [T]he only solution is replacement of the concrete.” at 5. Because the eventual collapse is merely “an ostentatious manifestation of th[e] chemical reaction,” the Agostis appear to argue that the chemical reaction itself constitutes the “physical loss” that should be covered under the policy. at 6.
I do not agree with the Agostis’ unorthodox interpretations of causation and loss. Crucially, it is clear from the language of the policy that it is the loss , not the cause of the loss, that must be “sudden and accidental.” In Alexander , I illustrated the distinction using the example of “insect damage”:
There’s termites in the house. No collapse. They’re eating away; every day they’re eating away. No collapse. They keep eating away. Finally, they eat enough that the beam fails. . . . Now there’s coverage. Now you have a collapse or falling in. The fact that it was caused by termites and it was a slow process doesn’t mean you didn’t have an abrupt collapse. You did, when the beam failed and there was literally a falling of the beam, a failure of the beam.
Mot. Hr’g Tr., Doc. No. 22, at 13–14, Alexander , No. 3:16-cv-0059. Thus, in the present case, the Agostis’ loss would only be covered if the collapse itself were “sudden and accidental.”
The “‘sudden and accidental’ language” used in insurance policies “has generated an
enormous amount of litigation,” and “it would be virtually impossible to gauge with precision
whether more courts have found ‘sudden’ . . . to mean ‘abrupt,’” as Allstate urges, or
“unexpected,” as claimed by the Agostis.
See EDO Corp. v. Newark Ins. Co.
,
c. Was the alleged collapse an “entire collapse”? Allstate next contends that the Agostis’ breach of contract claim must be dismissed because the policy only covers an “entire collapse.” Mem. Supp. Allstate’s Mot. Dismiss, Doc. No. 17-1, at 6. The Agostis’ complaint, Allstate notes, “does not allege that the house or part thereof has entirely collapsed.” at 7. Hence, Allstate argues that the Agostis “have failed to allege a plausible breach of contract claim.” The Agostis essentially do not address that portion of Allstate’s argument. See Pls.’ Mem. Opp’n Mot. Dismiss, Doc. No. 22, at 6 (“[I]f the concrete has crumbled resulting in the entire structure imploding, [that] really has nothing to do with the physical loss that is already occurring.”). I agree with Allstate that the gradual deterioration of the basement walls cannot yet be characterized as an “entire collapse,” and so I dismiss the Agostis’ breach of contract claim against Allstate on that ground.
The definition of “collapse” as “substantial impairment of [] structural integrity” in
Beach
is a default rule, not a mandate of public policy.
See Beach
,
Interpreting a policy with identical language from the same insurer, California’s Second
District Court of Appeal deemed it “self-evident that the policy’s use of the term ‘entire’ collapse
necessarily must refer to an actual, not an imminent collapse.”
Jordan v. Allstate Insurance Co.
,
Under the present policy, I agree that “the term ‘entire collapse’ is susceptible of only one
reasonable interpretation,” namely, an “actual collapse.”
[1]
at 1222. The language “‘entire
collapse’ . . . was drafted specifically to limit coverage to actual collapses,” and to exclude
“imminent collapse” or “structural impairment.”
See Ass’n of Unit Owners of Nestani—A
Grecian Villa v. State Farm Fire & Cas. Ins. Co.
,
The plain language of the Allstate Policy limits coverage to “entire collapse[s].” Allstate Policy, Doc. No. 17-4, at 40. The Agostis have not alleged that their house or any portion thereof has “entire[ly] collapse[d].” See Compl., Doc. No. 1. “[I]f and when the walls fall in” and an “entire collapse” occurs, the Agostis may have a viable claim against Allstate (should the insurer fail to honor the policy). See Mot. Hr’g Tr., Doc. No. 22, at 6, Alexander , No. 3:16-cv-0059. At present, however, the Agostis fail to state a plausible claim against Allstate for breach of contract, and I dismiss Count Four pursuant to Rule 12(b)(6).
B. Count Five: Breach of the Implied Covenant of Good Faith and Fair Dealing
In Count Five of the complaint, the Agostis assert that Allstate violated the implied duty
of good faith and fair dealing. “Every contract imposes upon each party a duty of good faith and
fair dealing in its performance and its enforcement.”
Warner v. Konover
,
Allstate asserts that if I dismiss the Agostis’ breach of contract claim against Allstate, then I “should also dismiss Count Five . . . alleging a breach of the implied covenant of good faith and fair dealing.” Mem. Supp. Allstate’s Mot. Dismiss, Doc. No. 17-1, at 15. The Agostis likewise imply in their memorandum (and agreed at oral argument) that Count Five succeeds or fails along with Count Four. See Pls.’ Mem. Opp’n Mot. Dismiss, Doc. No. 22, at 10.
Because I conclude that I must dismiss the Agostis’ claim for breach of contract—and thereby hold that Allstate did not wrongfully “den[y] . . . a contractually mandated benefit” under the policy—I also dismiss the Agostis’ claim for breach of the implied covenant of good faith and fair dealing pursuant to Rule 12(b)(6). See id. at 796.
C. Count Six: Violation of CUTPA/CUIPA
In Count Six, the Agostis allege that Allstate engaged in unfair trade practices in violation of CUTPA and CUIPA by “deny[ing] coverage for claims such as the [Agostis’] based on other purported exclusions despite a provision[] within the policy that provide[d] coverage for the chemical reaction that occurred and collapse.” See Compl., Doc. No. 1, at Count 6, ¶ 21. Allstate argues that, like the Agostis’ claim for breach of the implied covenant of good faith and fair dealing, the Agostis’ CUTPA/CUIPA claim must fail in the absence of a viable breach of contract claim. See Mem. Supp. Allstate’s Mot. Dismiss, Doc. No. 17-1, at 15.
To succeed on a CUTPA/CUIPA claim, “a plaintiff must show that the defendant
engaged in an act prohibited by CUIPA’s substantive provisions, and that the act proximately
caused the harm alleged.”
Belz
,
“The requirement that the insurer settle when the insured’s liability is ‘reasonably clear’
means that the existence of liability has to be substantially certain.”
Tucker v. AIG
, 2015 WL
403195, at *27 n.48 (D. Conn. Jan. 28, 2015) (quoting 2
Insurance Claims and Disputes
§ 9:35
(6th ed. updated March 2014)). “Logically speaking, liability cannot be substantially certain
where it plainly does not exist on the explicit . . . terms of the contract.” Hence, if “the
defendant’s interpretation of the policy’s coverage limitation was correct,” then the “application
of that interpretation” cannot have constituted “oppressive, unethical or unscrupulous conduct in
violation of the statutes.”
Zulick v. Patrons Mut. Ins. Co.
,
The Agostis’ CUTPA/CUIPA claim challenges Allstate’s denial of coverage under the
insurance policy. “Having no obligation to pay under the policy,” however, Allstate “could not
have violated CUIPA or CUTPA.”
Wright v. State Farm Mut. Auto. Ins. Co.
,
IV. Conclusion
For the reasons set forth above, I grant Allstate’s motion and dismiss Counts Four, Five, and Six of the Agostis’ Complaint. The Clerk shall terminate Allstate as a party to this case.
So ordered.
Dated at Bridgeport, Connecticut, this 28th day of August 2017.
/s/ STEFAN R. UNDERHILL Stefan R. Underhill United States District Judge
Notes
[1] On their own, the words “entire collapse” could perhaps be read to mean that the
entire
structure
must be substantially impaired. In the present case, however, the Allstate Policy
contains additional language providing that Allstate “will cover . . . the entire collapse of
part
of
a covered building structure,” Allstate Policy, Ex. C to Allstate’s Mot. Dismiss, Doc. No. 17-4,
at 40 (emphasis added), which confirms that an “actual collapse” was meant.
See Jordan v.
Allstate Insurance Co.
,
