Tuesday, November 26, 2019

First Circuit holds insurer did not act in bad faith in relying on property damage estimate that was lower than policyholder's estimate, or in delays that were also caused by the policyholder

River Farm Realty Trust owns property in Sherborn, Massachusetts.  Paul and Linda DeRensis live on the property.  As at so many homes in Massachusetts in the winter of 2015 (blog readers who lived here then will remember this well), in February and March 2015 ice dams caused water infiltration into the house.

The property was insured by Farm Family Casualty Insurance Company ("FFI").  The DeRensises notified FFI of the damage in early March, 2015. Throughout the adjustment of the claim FFI made a number of small errors, such as emailing Linda DeRensis incorrect claim information because the adjuster had mixed up her claim with another claim from a different Linda.  All such errors were quickly corrected.  

 In June, 2015, after inspecting the property, an outside adjuster for FFI provided the DeRensises with an estimate of about $18,000 to repair the damage.

The DeRensises did not make any response until November 2015, when they submitted to FFI  estimates indicating a loss of about $155,000. They retained an attorney who, in February 2016, submitted a new estimate of about $236,000.  FFI had the house reinspected by a new outside adjuster.  The new estimate, less the deductible and depreciation, was for $28,000.  FFI issued payment to the DeRensises in that amount.

On March 28, 2016, River Farm demanded a reference proceeding.  (A reference proceeding is the proceeding required by Massachusetts statute, and incorporated into property insurance policies,  in which a panel of three referees determines a dispute over the amount of loss in a property damage claim.)

The reference proceeding was conducted in June and July, 2016.  The referees found the actual cash value of the loss to be $137,888.  (Although there is a lot of debate about the precise meaning of actual cash value, in shorthand it is the value of the damaged property just before the loss, taking into account that the property is not in new condition.  Under property damage policies, an insurer pays the actual cash value up front.  After repairs are actually made, it pays the difference between actual cash value and replacement cost value.)  FFI paid the actual cash value amount within a month of the decision.

River Farm sued FFI for breach of contract and violations of Mass. Gen. Laws chs. 93A and 176D.  It alleged that FFI violated the statutes because it was first notified of the claim in March, 2015 and did not resolve it until the reference award in July 2016.  River Farm also alleged that a violation was established by the disparity in amounts between FFI's estimates, River Farm's November demand, and the final reference award.

In River Farm Realty Trust v. Farm Family Casualty Insurance Company, __ F.3d __, 2019 WL 6124489 (1st Cir.), the United States Court of  Appeals affirmed summary judgment for FFI. 

The court held that the length of time it took to resolve the claim was not a violation of the statutes. There was no evidence that the time period was unreasonable, and no evidence that delays were a result of a desire to delay or of bad faith.  Although FFI made some internal errors, those errors were not in bad faith.  Other delays were a result of the DeRensises own failure to communicate timely.  The court held that delay caused by a legitimate dispute between the policyholder and the insurer is not a bad faith delay by the insurer.

The court held that the disparity in estimates was not bad faith by FFI.  River Farm offered no evidence or argument that FFI failed to act reasonably in estimating the damage, or that its estimate varied from industry practice.  Moreover, when irrelevant numbers were removed from the estimates, they were not that far apart from each other. 

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