Keshish v. Allstate InsuranceKeshish v. Allstate Insurance
ORDER GRANTING DEFENDANT’S MOTION FOR SUMMARY JUDGMENT
On April 2, 2012, Rozik and Vartan Keshish filed this action against Allstate Insurance Company, alleging claims for breach of contract, breach of the covenant of good faith and fair dealing, elder abuse, violation of the Unruh Civil Rights Act, and violation of California’s Unfair Competition Law (“UCL”).
I. BACKGROUND
This case concerns a homeowners’ insurance policy that Allstate issued to plaintiffs.
On November 10, 2009, after evaluating the property, ServiceMaster submitted an independent estimate to Allstate. It placed the damage at $5,322.97, more than $3,000 less than the adjuster’s original estimate.
Two months later, plaintiffs retained an independent industrial hygienist to inspect their property and prepare a report regarding the level of smoke damage to the home.
Between July 2010 and January 2012, plaintiffs and Allstate exchanged several letters in an attempt to select appraisers and conduct the appraisal process.
Allstate retained a hygienist in late January 2012. Plaintiffs, however, refused to allow Allstate’s hygienist to inspect the property. As a consequence, plaintiffs’ was the only hygienist report submitted to the appraisers.
II. DISCUSSION
A. Standard Governing Motions for Summary Judgment
A motion for summary judgment must be granted when “the pleadings, the discovery and disclosure materials on file, and any affidavits show that there is no genuine issue as to any material fact and that the movant is entitled to judgment as a matter of law.” Fed. R.Civ.Proc. 56. A party seeking summary judgment bears the initial burden of informing the court of the basis for its motion and of identifying those portions of the pleadings and discovery responses that demonstrate the absence of a genuine issue of material fact. See Celotex Corp. v. Catrett,
B. Whether Allstate is Entitled to Summary Judgment on Plaintiffs’ Breach of the Covenant of Good Faith and Fair Dealing Claim
California law implies a covenant of good faith and fair dealing in every contract. Carma Developers (Cal), Inc. v. Marathon Development California, Inc.,
“The implied covenant of good faith and fair dealing acts as a ‘supplement to express contractual covenants, to prevent a contracting party from engaging in conduct that frustrates the other party’s rights to the benefits of the agreement.’ ” Moneada v. Allstate Ins. Co.,
Allstate advances three arguments as to why it is entitled to summary judgment: (1) there was a genuine dispute concerning the value of plaintiffs’ insurance claim; (2) plaintiffs concealed the existence of the hygienist’s report; and (3) plaintiffs refused to allow Allstate’s hygienist access to the property.
1. Whether There Was a Genuine Dispute Regarding the Value of Plaintiffs’ Claim
It is well established that “an insurer does not act in bad faith so long as a ‘genuine dispute’ exists over an insured’s coverage.” Maynard v. State Farm Mut. Auto. Ins. Co.,
An insurer may demonstrate the existence of a genuine dispute by showing that “it relied on opinions from experts while evaluating the insured’s claim.” Maynard,
In deciding whether there was a genuine dispute, “the court does not decide which party is ‘right’ as to the disputed matter, but only that a reasonable and legitimate dispute actually existed.” Chateau Chamberay Homeowners Ass’n v. Associated Intern. Ins. Co.,
a. Whether Allstate’s Reliance on ServiceMaster’s Estimate Insulates it From a Bad Faith Claim
The gravamen of plaintiffs’ claim is that Allstate failed to conduct a good faith review of their property damage claim.
It is undisputed that, after plaintiffs objected to Allstate’s original estimate, the insurer retained ServiceMaster to conduct
The facts here, in fact, are strikingly similar to those in Fraley. There, Allstate hired independent contractors to estimate the damage to an insured’s property.
“The record reveals that Allstate handled the Fraleys’ claim reasonably, by retaining experts and investigating, paying the undisputed actual cash value of the loss and proceeding to appraisal on the disputed portion of the claim, replacement cost. Moreover, Allstate promptly paid the replacement cost appraisal award after the Fraleys purchased another home. We agree with the trial court that their bad faith claim fails as a matter of law.” Id.
Here, Allstate and plaintiffs each retained an independent expert to evaluate the damage to plaintiffs’ home; each expert arrived at a different estimate. Allstate promptly paid plaintiffs $7,582.09, the undisputed amount of plaintiffs’ claim. Allstate also honored plaintiffs’ request that it engage in the appraisal process, and paid the appraisal award to plaintiffs soon after it was rendered. The fact that plaintiffs’ expert estimated the loss at approximately ten times the amount Allstate’s adjuster and expert did is insufficient, by itself, to raise triable issues concerning bad faith. See Guebara,
Ultimately, “a single, thorough report by an independent expert is sufficient, all other things being equal, to support application of the ‘genuine dispute’ doctrine.” Adams,
Allstate also argues that the $38,829.45 difference between plaintiffs’ damage estimate and the appraisal award demonstrates, as a matter of law, that there was a genuine dispute concerning the amount of insurance proceeds owed. As authority, it cites Rappaport-Scott,
This rule has been applied in a handful of cases since Rappaport-Scott. In most, as in Rappaport-Scott, the difference between the plaintiffs damage estimate and the amount of loss an arbitrator found was substantial, often in the hundreds of thousands of dollars. See, e.g., Maynard,
“[T]he undisputed facts ... establish that a dispute arose between Behnke (and his Cumis counsel, English & Gloven) on the one hand, and State Farm on the other, over the amount of policy benefits State Farm was obligated to pay for Cumis counsel fees and costs incurred by English & Gloven on Behnke’s behalf; that the dispute was properly submitted to mandatory arbitration under section 2860(c); and that the arbitrator, in an award confirmed by the trial court, ordered State Farm to pay an amount [$16,000] less than the amount billed by English & Gloven. These undisputed facts establish as a matter of law that State Farm’s conduct in disputing the ... amount of fees and costs billed by English & Gloven was objectively reasonable, and thus Behnke’s insurance bad faith claim, which is based on that conduct, fails as a matter of law. Id.
Here, the difference between plaintiffs’ estimate and the amount of loss found by the appraisal panel is greater than the difference in Behnke, but substantially smaller than that in Rappaport-Scott, Maynard, or Holland. The fact that the arbitration award was approximately 47 per cent lower than plaintiffs’ demand is compelling evidence that Allstate had a reasonable basis for believing plaintiffs’ loss estimate was too high. This is particularly true here because, unlike Allstate, the appraisal panel had the benefit of reviewing plaintiffs’ hygienist report when
Plaintiffs cite Brehm v. 21st Century Ins. Co.,
Ultimately, the fact that the appraisers determined plaintiffs’ loss was roughly half of the damages they claimed, viewed in light of Allstate’s reliance on the independent investigation performed by ServiceMaster, strengthens the court’s earlier conclusion that the uncontroverted evidence shows there was a genuine dispute regarding Allstate’s payment obligation. The court is hesitant, however, to conclude that the discrepancy here is sufficiently substantial, by itself, to apply a per se rule mandating the entry of summary judgment in Allstate’s favor. A plaintiff who only moderately overvalues his loss, in good faith, should not be precluded from adducing other evidence that an insurer acted in bad faith simply because an appraisal panel ultimately awards less than he sought. While a significant difference between an insured’s claim and an appraisal might render it unnecessary to evaluate the insurer’s conduct in investigating a claim as a matter of law, an insurer who otherwise acted in bad faith should not be insulated from liability simply because the plaintiffs estimate of loss was slightly higher than the arbitrator’s ultimate award. The court can conceive of scenarios in which an insurer denies a claim in bad faith, but an appraisal panel award plaintiff less than the amount of his demand. In such an instance, a small discrepancy between plaintiffs’ demand and the arbitrator’s award should not defeat plaintiffs claim as a matter of law.
c. Whether Allstate Failed Thoroughly to Investigate Plaintiffs’ Claim
Finally, even if the court concluded as a matter of law that there was not a genuine dispute regarding Allstate’s obligations, undisputed evidence in the record demonstrates that there are no triable issues of fact concerning the thoroughness of Allstate’s investigation. See, e.g., Shade Foods, Inc. v. Innovative Products Sales & Marketing, Inc.,
Masters provides few, if any, details to support his opinion that Allstate failed to negotiate in good faith. Beyond noting that the adjuster declined to have a face to face meeting with plaintiffs and
Absent factual support, Masters’ conclusion that Allstate “fail[ed] to try in good faith to reach an agreed scope of damages” because it did not meet with plaintiffs or their contractor is too conclusory to raise triable issues of fact and defeat summary judgment.
Finally, Masters’ opinion that Allstate acted in bad faith by failing to agree to a scope of damages with plaintiffs is fundamentally inconsistent with case law. The genuine dispute doctrine is built around the notion that an insurer need not agree with plaintiffs on the scope of coverage or damages before it can be found to have acted in good faith. Rather, it will be considered to have acted in good faith as long as it has reasonable grounds for disagreeing with the insured. An insurer need not acquiesce in an insured’s claim for coverage, because “[w]hile an insurer must give as much consideration to the interests of its insured as it does to its own, it is not required to disregard the interests of its shareholders and other policyholders when evaluating claims.” Love v. Fire Ins. Exchange,
This is not a case in which Allstate took no action in the face of its insureds’ dispute with its evaluation of the property damage claim. Rather, Allstate hired ServiceMaster to conduct an independent evaluation so that it could determine whether to revise its initial coverage decision. In Masters’ parlance, Allstate took this step in an effort to determine the proper scope of damages. While Allstate’s ultimate conclusion differed from plaintiffs’, that is not evidence of bad faith.
Plaintiffs also assert that Allstate should be estopped from arguing that it conducted a thorough investigation because it sought to have an industrial hygienist conduct a follow-up evaluation at the property.
“Courts uniformly recognize that the purpose of the judicial estoppel doctrine is to protect the integrity of the judicial process by prohibiting parties from changing positions as circumstances warrant.” Milton H. Greene Archives, Inc. v. CMG Worldwide, Inc.,
The court is also skeptical that Allstate’s positions are wholly inconsistent. The Ninth Circuit has adopted a liberal approach in interpreting this element of judicial estoppel, reflecting its preference that claims be litigated on their merits. See Admiral Ins. Co. v. Rushmore,
Moreover, to the extent plaintiffs contend that Allstate’s failure to retain a hygienist at the outset is evidence of bad faith, the court disagrees. Plaintiffs proffer no evidence that an insurer conducting a reasonable, good faith investigation would necessarily have understood that evaluation by a hygienist was required. They fail, for example, to adduce a hygienist’s or contractor’s opinion that the need for a hygienist was obvious or that such a professional must be hired in every case where a structure has suffered smoke damage. Plaintiffs’ expert, Masters, provides no opinion on this subject; he fails even to mention the fact that Allstate did not retain a hygienist. Plaintiffs’ hygienist, moreover, testified that there is no industry standard or requirement that an insurer must retain an industrial hygienist when remediating smoke damage.
The fact that Allstate subsequently sought to have a hygienist review the property does not demonstrate that Allstate knew its initial review was not thorough. It simply shows that once Allstate learned plaintiffs had retained a hygienist and submitted her report to the appraisal panel, it sought to protect its interests by having a comparable report prepared. As noted, an insurer is entitled to protect its own legitimate interests when investigating claims. Chateau Chamberay,
In short, plaintiffs have failed to adduce evidence that raises triable issues as to whether Allstate investigated their claim in bad faith.
In conclusion, Allstate’s motion for summary judgment is granted.
JUDGMENT FOR DEFENDANT
On April 22, 2013, the court entered an order granting defendant’s motion for summary judgment. Accordingly,
IT IS ORDERED AND ADJUDGED
1. That plaintiffs take nothing by way of their complaint; and
2. That the action be, and it hereby is, dismissed.
Notes
. Removal, Docket No. 1 (May 2, 2012), Exh. A ("Complaint").
. Stipulation to Dismiss Fifth Claim for Relief, Docket No. 9 (May 22, 2012).
. Order Granting in Part and Denying in Part Motion for Judgment on the Pleadings, Docket No. 18 (July 30, 2012).
. Id. at 21.
. Id. at 8 ("[T]he breach of contract claim is duplicative of the breach of implied covenant claim, since the plaintiff can recover contract damages in addition to tort damages on the latter”).
. Stipulation to Dismiss Third Claim for Relief for Elder Abuse, Docket No. 26 (Nov. 7, 2012).
. Motion for Summary Judgment (“Motion”), Docket No. 38 (Feb. 23, 2013); Reply in Support of Motion for Summary Judgment ("Reply”), Docket No. 43 (March 25, 2013).
. Opposition to Motion for Summary Judgment (“Opp.”), Docket No. 41 (March 18, 2013).
. Statement of Uncontroverted Facts ("SUF”), Docket no. 39 (Feb. 23, 2013), ¶ 1; Statement of Genuine Issues (“SGI”), Docket No. 41 (March 18, 2013), ¶ 1.
. SUF, ¶2; SGI, ¶2.
. SUF, ¶3; SGI, ¶3.
. SUF, ¶3; SGI, ¶3.
. SUF, ¶ 4; SGI, ¶ 4.
. SUF, ¶5; SGI, ¶5.
. SUF, ¶¶ 6-7; SGI, ¶¶ 6-7.
. SUF, ¶8; SGI, ¶ 8.
. SUF, ¶ 9; SGI, ¶ 9.
. SUF, ¶ 10; SGI, ¶ 10.
. SUF, ¶ 12; SGI, ¶ 12.
. SUF, ¶ 13; SGI, ¶ 13.
. SUF, ¶ 14; SGI, ¶ 14.
. SUF, ¶ 16; SGI, V 16.
. SUF, ¶ 17; SGI, ¶ 17.
. SUF, ¶ 18; SGI, ¶ 18.
. SUF, ¶ 20; SGI, ¶ 20.
. SUF, ¶ 21; SGI, ¶ 21. The appraisal provision in the policy gives the insured a right to request an independent appraisal in the event the insured and Allstate disagree regarding the amount of loss. Under the policy, each party is to select a disinterested umpire; together, the umpires must then conduct an informal evaluation of the insured's claim. Each umpire is to be paid by the party who selected him or her. (Exhibits to Motion for Summary Judgment ("Exhibits”), Docket No. 40 (Feb. 23, 2013), Exh. 1 ("Policy”) at 28.
. SUF, ¶ 22; SGI, ¶ 22.
. SUF. ¶ 23: SGI. ¶ 23.
. SUF, ¶ 24; SGI, ¶ 24.
. SUF, ¶ 26; SGI, ¶ 26.
. SUF, ¶¶ 29-51; SGI, ¶¶ 29-51.
. SUF, ¶ 36; SGI, ¶ 36.
. SUF, ¶ 50; SGI, ¶ 50.
. SUF, ¶ 51; SGI, ¶ 51.
. SUF, ¶ 51; SGI, ¶ 51.
. SUF, ¶ 52; SGI, ¶ 52.
. SUF, ¶ 57; SGI, ¶ 57.
. SUF, ¶ 60; SGI, ¶ 60.
. SUF. ¶ 61: SGI. ¶ 61.
. Opp. at 19. Plaintiffs devote a substantial portion of their opposition to a discussion of California's arbitration rules and the level of deference courts must give arbitration awards. (See Opp. at 11-16). Plaintiffs argue that Allstate’s motion is a collateral attack on the arbitration award and should not be permitted. The court fails to see, however, how Allstate’s motion is in any manner an attack on the appraisal award. Allstate has paid the money it owed under the award, and is not seeking restitution or reimbursement. Rather, it is trying to avoid additional liability, beyond that it has already incurred as a result of the appraisal. The court therefore finds plaintiffs’ discussion of the arbitration rules inapposite.
. Motion at 17.
. (Declaration of Ari Moss ("Moss Decl.”), Docket No. 42 (March 18, 2013), Exh. 3 (ServiceMaster Estimate). The estimate is comprised of several pages of specific, detailed cost breakdowns for cleaning and repairing both the structural components of the home and the furniture in each room.
. Declaration of Sonyia Rouel ("Rouel Decl."), Docket No. 38 (Feb. 23, 2013).
. The only argument plaintiffs offer regarding the substance of the ServiceMaster report is that it failed to determine how far plaintiffs' property was from the “fire-line.” (Opp. at 8). Plaintiffs do not explain the relevance of this fact; presumably, however, they argue that this piece of information was a necessary component of a reasonable insurance evaluation, and that the closer the distance, the greater the damage that was likely. Even if this is correct, the evidence cited by plaintiffs in support of their argument does not demonstrate that ServiceMaster failed to determine the distance between the property and the fire-line. At his deposition, ServiceMaster’s CEO testified that while the distance was not "precisely known,” his company determined that the fire-line was approximately “half a mile away from the residence.” (Moss Deck, Exh. 10 at 133:2-4). The CEO also stated that ServiceMaster took this fact into account in valuing plaintiffs’ loss. (Id. at 134:7-14 (“Knowing that it was a half mile from the fire, based on our experience, there was a stronger likelihood that that household had fire particulates in there than a household on the coast.... These are the things that I’m looking at during the fire — wildfire assessment period”). Thus, plaintiffs argument that ServiceMaster failed to consider the distance between the house and the fire-line is unavailing. As a consequence, they cannot raise triable issues of fact concerning the reasonableness of ServiceMaster’s investigation on this basis.
. Opp. at 22-23.
. Declaration of Anahid Barsegian ("Barsegian Decl.”), Docket No. 41 (March 18, 2013), 11 11.
. Declaration of Richard Masters ("Masters Decl.”), Docket No. 41 (March 18, 2013), ¶ 8.
. Id., ¶ 9.
. Id., ¶ 8.
. Id., ¶ 9.
. As Allstate notes, allowing a bad faith claim to proceed beyond summary judgment based only on evidence that an insurer failed to reach agreement with its insured regarding the value of a claim would allow insureds to raise triable issues of fact in every case in which an insurer disagrees with the insured’s estimate of the loss, whether or not the insurer's valuation was reasonable. (Reply at 5). This is inconsistent with the well-established genuine dispute doctrine.
. Opp. at 20
. Id. at 22.
. Supplemental Declaration of Theona Zhordania, Docket No. 43 (Mar. 25, 2013), Exh. 1 at 123:5-12 ("Q. Are you aware of any standard or guidelines that requires an insurance company to use an industrial hygienist in every fire or smoke damage claim? A. I'm not aware of any. That would probably be their own policy. I would assume that. Q. Not anything that the industry imposes on them; correct? A. No, not that I’m aware of”).
. Rouel Decl., ¶ 6.
. Id.
. Plaintiffs’ assertion that Allstate failed to investigate their claim thoroughly because it did not retain a hygienist is also disingenuous. It is undisputed that when Allstate advised plaintiffs it was closing their claim, it invited them to submit additional evidence if they felt the evidence warranted a reevaluation of the loss. It is also undisputed that plaintiffs failed to inform Allstate that they had had a hygienist inspect the property and prepare a report. Plaintiffs, in fact, never told Allstate they had had a hygienist report prepared; it was only through the appraisers that Allstate discovered this fact, more than a year after plaintiffs' hygienist had inspected the property. It is further undisputed that, once Allstate learned of the hygienist report, plaintiffs denied Allstate’s hygienist access to their property to, conduct an additional inspection. Plaintiffs’, claim that Allstate acted in bad faith by failing to retain a hygienist when they did not communicate to Allstate their view that the services of a hygienist were required, and prevented Allstate from obtaining a hygienist’s opinion when it asked to do so, is thus, at a minimum, suspect.
. As the court has determined that a genuine dispute existed regarding the amount of insurance proceeds Allstate was required to pay,