Spagnola v. Chubb Corp.Spagnola v. Chubb Corp.
On July 13, 2001, Frеd Spagnola and his wife purchased a Chubb Masterpiece homeowner’s policy. 1 The policy provided dwelling coverage of $600,000, contents coverage of $300,000, and liability coverage of $500,000.
The Masterpiece policy allows the insured to select one of three types of coverage: extended replacement cost, verified replacement cost, or conditional replacement cost. Spagnola purchased the extended replacement coverage, which, in the event of an insurable loss, pays the cost of reconstruсtion even if that cost exceeds the stated coverage of the policy. 2 The policy defines “reconstruction cost” as the “amount required at the time of loss to repair or rebuild the house whichever is less, at the same location, with the same quality of materials and workmanship which existed before the loss.”
The amount of coverage was listed in the policy’s Coverage Summary and during each annual policy period, Chubb indicated that the coverage amount:
will be increased daily to reflect the current effect of inflation. At the time of a covered loss, your аmount of house coverage will include any increase in the United States Consumer Price Index from the beginning of the policy period.
The coverage amount could be changed:
With your consent, we may change [the amount of coverage reflected in the coverage summary] when appraisals are conducted and when the policy is renewed, to reflect current costs and values.
The term “costs and values” is not further defined in the policy. Spagnola’s policy originally had a one year policy period. Chubb, however, was obligated to renew the policy for three years and could decline to renew thе policy “only on grounds for which [Chubb] could cancel it.”
3
The policy also contained a conditional renewal provision. Under this provision, if Chubb had grounds to cancel or refuse to renew the policy, it could instead make continued coverage conditional on a change in policy
As far as renewing coverage, the policy stated that at the time of renewal, Chubb “may offer to renew [the policy], at the premiums and under the policy provisions in effect at the date of renewal ... by mailing [the insured] a bill for the premium ... along with any changes in the policy provisions or аmounts of coverage.” If Spagnola did not pay the new premium, the policy would automatically terminate at the end of the current policy period. “Failure to pay the required renewal premium when due shall mean that you have not accepted our offer.”
Over the next five years, Chubb annually increased Spagnola’s coverage and likewise his premiums. The coverage amount for house and contents was increased each year by approximately ten percent, well in excess of the Consumer Price Index (“CPI”). Chubb sent the annual premium summary renewals with the bill for the next year’s coverage describing it as an “annual premium savings.” In 2006, Spagnola discovered that the increases in his premiums had risen faster than the CPI and he filed suit on behalf of a putative class, in state court, later removed to federal court, claiming that Chubb breached the terms of the policy and violated New York Insurance Law by improperly increasing coverage and premiums without his consent and in excess of the CPI. In addition, Spagnola brought an unjust enrichment claim as well as a deceptive business practices claim under New York General Business Law § 349. Chubb responded by filing a motion to dismiss under
The district court granted Chubb’s motion to dismiss all claims. First, the court held that the complaint failed to state a claim under
We review a
Spagnola first argues that the district court erred in dismissing his claim under
Spagnola’s
Chubb and Spagnola agree that
It is well established that we defer to an agency’s construction of a statute
In a July 23, 2003 opinion, the Department unequivocally concluded that the three-year policy period requirement of
As to the notice requirement, the Department considered a policy provision similar to the one here and concluded that no conditional renewal notice was required when a premium increase was due to the application of an inflation guard mechanism provided for in the policy. Conditional Renewal Notices, Office of Gen. Counsel, N.Y. Ins. Dep’t, No. 02-04-10 (April 8, 2002) (informal opinion). The Department reasoned that no notice was required because thе premium increase was attributable to the operation of the inflation guard “required by and set forth in the policy itself.” Spagnola argues that this opinion actually supports his interpretation of
Two other Department opinions help to resolve this issue. In the first, the Department decided that a conditional renewal notice was not required under
In contrast, another Department opinion decided that an increase in the amount of deductible expenses for windstorm coverage did require conditional notice under
Here, the policy provided that Chubb could condition annual renewal on the payment of increased premiums based on current “costs and values,” and thus, the conditional notice requirements of
We therefore affirm the district court’s dismissal of Spagnola’s
II.
Spagnola next argues that the district court erred in dismissing his breach of contract claim. He claims that Chubb violated the insurance contract by: (1) not obtaining his consent to increase the amount of his coverage, and (2) increasing his coverage by an amount that does not reflect current costs and values. 6
A.
Spagnola contends that Chubb breached the insurance policy by failing to obtain his consent to the annual policy renewals. Spagnola states that his payment of the increased premiums did not amount to consent because the payment was not “knowing and voluntary.” He complains that: (1) Chubb never told him that it was increasing his coverage; (2) Chubb never asked for his consent; (3) Chubb did not provide an explanation for the increased coverage; and (4) Chubb never told him the amount of the annual change in premiums and coverаge.
We easily resolve this argument. First, the amount of coverage was shown in the coverage summary that Spagnola received with each reissue of the policy. This summary notified Spagnola that
Spagnola directs us to a New Jersey Supreme Court case from 1961 which held that “[ajbsent notification that there have bеen changes in the restrictions, conditions or limitations of [an insurance policy], the insured is justly entitled to assume that they remain the same and that his coverage has not in anywise been lessened.”
Bauman v. Royal Indem. Co.,
We reject Spagnola’s argument that the district court erred insofar as it dismissed the breach of contract claim based on lack of consent.
B.
Spagnola also claims that Chubb breached the insurance contract by increasing his coverage amounts and premiums in a way that did not reflect current costs and values. The policy does not define the term “current costs and values.” According to Spagnola, the policy could reasonably be interpreted to base costs and values on either actual reconstruction costs or the CPI. He alleges that Chubb breached this term by increasing the coverage amount without using either as a basis. Spagnola points out that his contents coverage increased at the same percentage rate as his dwelling coverage each year, and this automatic coupling alone supports an inference that Chubb increаsed coverage in a manner that did not accurately reflect current costs and values.
Chubb concedes that the premiums were not increased in an amount determined by the CPI. Chubb argues that this fact is irrelevant, and that it is to be expected that the increases would have exceeded the CPI because the CPI only applies to interim period adjustments, and not the annual increases at issue here. Chubb states: “No fact is pled to permit the inference that the increased coverage amounts were inconsistent with the reconstruction costs of the plaintiffs home in any of the last five years.” Chubb characterizes Spagnola’s home and contents comparison analysis as a “red herring” built on “multiple layers of unreasonable assumptions.” Chubb asserts that under Spagnola’s interpretation of “costs and values,” one as
Spagnola directs us to
Better v. William Penn Life Insurance Co. of N.Y.,
III.
The district court dismissed Spagnola’s breach of contract claim on the alternative ground that the claim was barred by the voluntary payment doctrine. According to the doctrine, a breach of contract claim is barred if a party continues to pay amounts charged under the contract without objection. The district court found that Spagnola had full knowledge of the facts regarding coverage and premiums at the time of his first renewal in 2002 and continued (without objection) to pay the increased premium amounts on each of the five succeeding anniversary dates. The district court reasoned: “It is a little late now, after [Spagnola] has enjoyed the benefits and protections of [Chubb’s] coverage for more than five years,” to challenge the “propriety of [his] coverage.”
Spagnola,
The voluntary payment doctrine precludes a plaintiff from recovering payments “made with full knowledge of the facts” and with a “lack of diligence” in determining his contractual rights and obligations.
See Dillon v. U-A Columbia Cablevision of Westchester, Inc.,
Chubb points out that Spagnola renewed his policy five times, and that “simple math” should have alerted Spagnola to the notion that the increases were not based on the CPI as Spagnola thought. In
Dillon,
a cable customer brought a putative class action seeking to recover five-dollar late fees paid to her cable company over the course of seven years.
Althоugh the voluntary payment doctrine may ultimately bar Spagnola’s breach of contract claim, we decide that it is too early in this case to conclusively answer that question. In some years, Chubb sent Spagnola a renewal letter enclosing the policy and stating that Spagnola was receiving an “annual premium savings,” even while it increased his premiums.
See Samuel v. Time Warner, Inc.,
The cases cited by Chubb do not change our view that the complaint cannot be dismissed based on the voluntary payment doctrine. In
Gimbel,
the appellate court held that the plaintiff could not receive restitution for certain payments made pursuant to a mistake of fact when the record showed that “no mistake of fact had been made.”
IV.
Finally, Spagnola appeals the district court’s dismissal of his deceptive business practices claim under § 349 of the New York General Business Law.
To state a claim under § 349, a plaintiff must allege: (1) the act or practice was consumer-oriented; (2) the act or practice was misleading in a material respect; and (3)' the plaintiff was injured as a result.
Maurizio v. Goldsmith,
The district court dismissed Spagnola’s claim because it failed to plead either a deceptive act or requisite injury. Although a monetary loss is a sufficient injury to satisfy the requirement under § 349, that loss must be independent of the loss caused by the alleged breach of contract. For example, in
Sokoloff v. Town Sports Int’l, Inc.,
Here, as in
Sokoloff,
Spagnola does not claim that he did not receive adequate insurance coverage or that he did not contract for the coverage he received. Cf.
Samuel,
For the foregoing reasons, we reverse the district court’s dismissal of Spagnola’s breach of contract claim and affirm thé district court’s dismissal of all other claims. 7 We remand the case to the district court for further proceedings consistent with this opinion.
Notes
. Spagnola also named as defendants various affiliated entities and persons related to Chubb. For the purpose of this appeal we will refer to the named defendants-appellees collectively as "Chubb.”
. In contrast, a verified replacement cost policy covers the reconstruction cost up to a specified amount of coverage, and a conditional replacement cost policy covers a portion of the reconstruction cost up to a stated amount.
. Grounds for cancellation include such events as nonpayment of premium, conviction of a crime, or misrepresentation increasing the hazard assumed.
. Spagnola does not appeal the district court’s dismissal of his unjust enrichment claim.
. At oral argument we questioned whether this issue should be certified to the New York Court of Appeals. After reviewing New York case law and the opinions of the New York Insurance Department, we conclude that certification is unnecessary. But
see Great N. Ins. Co. v. Mt. Vernon Fire Ins. Co.,
. The complaint also asserted a third breach of contract claim, based on Chubb’s alleged violation of
. We also deny as without merit Spagnola’s claim that the district court’s failure to consider certain authority "warrant[s] reassignment” of his case to a different judge.