Kartman v. State Farm Mutual Automobile InsuranceKartman v. State Farm Mutual Automobile Insurance
After a severe hailstorm struck central Indiana in April 2006, thousands of homeowners filed claims with State Farm Fire and Casualty Company
1
for hail damage
The plaintiffs moved to certify a damages class under
State Farm is right. This case is not appropriate for class certification under
More generally, certification of a class under
Finally, certification of an “issues” class under
I. Background
State Farm issues homeowner’s insurance providing coverage for “accidental direct physical loss to property,” including damage resulting from windstorms or hail. In April 2006 a severe hailstorm swept through the Indianapolis metropolitan area causing widespread property damage. Some 49,000 State Farm policyholders filed claims for property damage as a result of the storm. Claims under homeowner’s policies were adjusted based on individualized assessments of the homeowner’s property damage. State Farm has guidelines to aid adjustors in determining a homeowner’s loss but does not use a single, uniform test for assessing hail damage.
Once an adjustor provides a property-damage estimate, the policyholder is permitted to contest that decision in several ways. First, an insured may request that another insurance adjustor provide an independent evaluation. Also, specifically for losses in connection with the April 2006 hailstorm, State Farm permitted dissatisfied policyholders to challenge their damage estimates in arbitration proceedings. 2 Through March 18, 2008, State Farm used these procedures to adjust and pay more than $263 million in property-damage claims resulting from the hailstorm.
In March 2007 several policyholders filed this lawsuit in state court asserting claims for breach of contract, bad-faith denial of insurance benefits, and unjust enrichment arising out of State Farm’s adjustment of their claims for hail damage to the roofs of their homes. The suit was brought as a class action on behalf of approximately 7,000 policyholders and alleged that State Farm engaged in pervasive undercompensation of roof-damage claims stemming from the April 2006 hailstorm. As part of their theory that State Farm breached its contract and tort-based duties to policyholders, the plaintiffs alleged that the insurer failed to implement a uniform “reasonable, objective” standard for assessing hail-damaged roofs.
To highlight the problems associated with State Farm’s ad hoc method for evaluating hail-damage claims, the plaintiffs cited the experiences of class representatives Karen Stergar and Hong Gao. 3 Stergar alleged that when she submitted her claim, State Farm sent several insurance adjustors to assess her roof damage and all provided vastly different opinions. Stergar claims that the first adjustor did not even step out of his car, yet determined the claim was only worth $700. Dissatisfied with this offer, Stergar requested another opinion. State Farm then sent a second adjustor who climbed on the roof and suggested that Stergar needed an “entire new roof,” but stated that he could not provide a compensation figure until a “ropes-and-ladders team” examined the damage. When the ropes-and-ladders team arrived, it disagreed with the second adjustor’s opinion and concluded instead that Stergar’s roof sustained $3,000 worth of damage to shingles, vents, and a downspout.
The State Farm adjustor who examined Gao’s roof determined that there was some
The plaintiffs sought compensatory and punitive damages and also requested injunctive relief in the form of an order requiring State Farm to reinspect all class members’ roofs pursuant to a uniform and objective standard for evaluating hail damage. State Farm removed the suit to federal court pursuant to
The district judge declined to certify a
II. Discussion
We review the district court’s decision to certify a injunction class under
A. Clarifying the Claims
A central problem with the court’s order is that it misconceptualizes the claims in this case. Although the complaint invokes several legal theories, the plaintiffs have only one cognizable injury— underpayment of their insurance claims for hail damage to their roofs — and pro
Nonetheless, in an apparent effort to make their case more amenable to class certification, the plaintiffs included a separate request for injunctive relief in their complaint. For factual support they alleged that State Farm failed to implement a “reasonable, objective” standard to assess the hail damage to their roofs. This allegation, and the accompanying request for injunctive relief, created the illusion that State Farm had two distinct legal obligations arising under the express or implied terms of the insurance contract: an obligation to compensate insured homeowners for the hail damage to their roofs and an independently actionable duty to examine all hail-damaged roofs pursuant to a uniform and objective standard.
In essence, then, the plaintiffs claimed that they suffered two separate injuries— underpayment of their hail-damage claims
and
a violation of a distinct right to have their hail-damaged roofs evaluated under a uniform and objective standard. To the extent that the first injury proved inappropriate for class-wide adjudication (because each policyholder’s claim was unique), the second injury (so the argument goes) was common to the class and could be redressed by an injunction ordering a class-wide reinspection.
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This parsing of remedies gave the plaintiffs a fallback position on the class-certification question. If they failed to win certification of a damages class under
This technique of recasting a straightforward claim for damages as a claim for damages
and
injunctive relief runs into trouble on some basic principles of common law — most fundamentally that a claim of injury is not cognizable unless it results from the breach of a recognized legal duty owed to the plaintiff.
See, e.g., Doe v. Welbom,
The essence of an insurance policy is a promise by the insurer to compensate the insured for the loss of something of value that is covered under the policy, thereby shifting the risk of loss from the insured to the insurer.
See, e.g., Group Life & Health Ins. Co. v. Royal Drug Co.,
The same analysis applies to the plaintiffs’ claim for bad-faith denial of insurance benefits. An insurer has an obligation of “good faith and fair dealing with respect to the discharge of [its] contractual obligation” to the insured.
Erie Ins. Co. v. Hickman,
This argument reflects a fundamental misunderstanding of the tort of bad faith. As relevant here, an insurer breaches its duty of good faith when it offers “no legitimate basis for denying liability.”
Freidline v. Shelby Ins. Co.,
Instead, the bad-faith claim asserted here is a garden-variety one: Bad faith arises when an insurance claim is wrongfully denied
and
the insurer knows there is “no rational, principled basis” for denying the claim.
Id.; see also Mahan v. Am. Standard Ins. Co.,
Stated differently, the plaintiffs cannot prove that their hail-damage claims were denied in bad faith without first showing that they received inadequate coverage for their loss.
See id.; see also
1 Couch § 1:6. This requires proof that a compensable loss occurred and was underpaid or not paid at all — a claim-specific inquiry that turns on the nature of the damage to each plaintiffs roof and the amount State Farm paid to repair it. And as the district court properly held in declining to certify a
Finally, we need not spend much time on the claim for unjust enrichment. In Indiana, as elsewhere, “the existence of an express contract precludes recovery under the theory of unjust enrichment.”
T-3 Martinsville, LLC v. U.S. Holding, LLC,
At bottom, the actionable claims in this case are for State Farms’s alleged underpayment of the plaintiffs’ hail-damage claims — nothing more, nothing less. The insurer’s use of an ad hoc loss-assessment standard may be evidence that it underpaid in some cases but is not an independently actionable wrong. With this con
B. Certification of an Injunction Class Under
A case may be certified as a class action under
The proposed injunction would not be an appropriate remedy for any single plaintiff, let alone for the class as a whole. To begin with, the plaintiffs cannot satisfy the test for a remedy in equity. An injunction requires a showing that: (1) the plaintiffs have suffered irreparable harm; (2) monetary damages are inadequate to remedy the injury; (3) an equitable remedy is warranted based on the balance of hardships between the plaintiffs and defendant; and (4) the public interest would be well served by the injunction.
eBay Inc. v. MercExchange, L.L.C.,
This case cannot satisfy the basic requirements for an injunction. First, the plaintiffs have not suffered irreparable harm. Their injury — the underpayment of their insurance claims — is easily remedied by an award of money damages, a fully adequate remedy. It follows that class certification under
Injunctive relief is also not “appropriate” because the hardships of the contemplated injunction would fall disproportionately on State Farm. (This point also demonstrates the “finality” problem.) As proposed, the injunction would require State Farm to carry out a class-wide roof reinspection. The district court defined the class to include all State Farm policyholders who filed insurance claims for damage resulting from the April 2006 hailstorm and did not receive “an entirely new roof.” It is quite possible that some— perhaps many — of the policyholders who did not receive an “entirely new roof’ were nonetheless fully compensated for their hail-damage losses. Yet these policyholders would be entitled to a reinspection at State Farm’s expense. Because the April 2006 hailstorm generated some 7,000 roof-damage claims, the cost of complying with such an injunction would be immense.
Finally, as a practical matter, it’s hard to see what purpose would be served by a class-wide roof reinspection. For example, at least four of the named class plaintiffs, including Gao, have replaced their roofs. A reinspection would serve absolutely no purpose for this subclass of plaintiffs. 8 It is very likely that many others have already had their roofs repaired using the proceeds of their insurance payments. In short, the proposed injunction is not merely inappropriate, it is broadly impractical.
There is a second fundamental reason why this case is unsuitable for class certification: An injunction would not provide “final” relief as required by
Seen in this light, the contemplated injunction would essentially have the effect of shifting the burden to State Farm to prove elements of the plaintiffs’ claims. It goes without saying that no plaintiff is entitled to recover except on proof of breach and damage.
See, e.g., Berkel & Co. Contractors, Inc. v. Palm & Assocs., Inc.,
The plaintiffs argue that disallowing an injunction class under
The plaintiffs also contend that their claim for injunctive relief is analogous to “medical monitoring” injunctions in class actions brought by smokers against tobacco companies. In this context, other circuits have indicated that
This argument misses the mark. A medical-monitoring injunction is designed to relieve class plaintiffs of the prospective costs associated with medical supervision.
Barnes,
Before concluding, we offer an observation about an anomaly in the district court’s class-certification order. The judge said he would use the
For the foregoing reasons, we Reverse and Remand with instructions to decertify the
Notes
. The defendants include the insurer State Farm Fire and Casualty Company, as well as
. Initially, the arbitration results were binding on all parties. However, in January 2007 State Farm revised this policy so that the arbitration results were only binding on State Farm.
. Throughout the course of this litigation, the number of named plaintiffs has not remained constant. At the time this appeal was filed, 17 named plaintiffs remained, including plaintiff Cynthia Kartman, the first listed plaintiff in the caption of this case.
. With extremely limited exceptions, putative class members in suits for monetary damages are entitled to notice of the pending action and an opportunity to opt out.
Jefferson v. Ingersoll Int’l Inc.,
. Even if State Farm had a cognizable legal obligation to use a uniform and objective standard for evaluating hail-damage claims, an equitable remedy would not necessarily follow. A remedy in equity is awarded in exceptional circumstances, and as we explain, infra, the claims in this case do not satisfy the traditional test for injunctive relief.
. Review of the class-certification decision in this case requires a preliminary look at the merits.
See Szabo v. Bridgeport Machs., Inc.,
. Moreover, even if plaintiffs are able to prove their bad-faith claims, the remedy for State Farm’s violation of the Hickman duty of good faith would be damages, not equitable relief. See Hickman, 622 N.E.2d at 519-20.
. This may constitute another barrier to class certification. Where a class is not cohesive such that a uniform remedy will not redress the injuries of
all
plaintiffs, class certification is typically not appropriate.
See Shook v. Bd. of County Comm’rs,
. Not all forms of medical monitoring are equitable in nature, and courts have warned that certification under