"Moody v. Oregon Community Credit Union: The Oregon Supreme Court Heralds a Significant New Development in First-Party Insurance Litigation"
In the February 2024 issue of Multnomah Lawyer (published by the Multnomah Bar Association), Stephen Leggatt analyzes the Oregon Supreme Court’s recent landmark decision affirming that policyholders harmed by insurance companies’ unfair claims settlement practices may sue their insurers for negligence and may seek award of emotional distress damages. Read the article here; view the opinion here.
Oregon Supreme Court Affirms that Policyholders May Sue Insurance Companies for Emotional Distress
Oregon Supreme Court Affirms that Policyholders May Sue Insurance Companies for Emotional Distress (and Likely Other Extra-Contractual Consequential Damages) Where the Insurer Engages in Unfair Practices Such as Unreasonable Delay, Inadequate Investigation, and Underpayment of Claims
On December 29, 2023, the Oregon Supreme Court issued its long-awaited opinion in Moody v. Oregon Community Credit Union, SC Case No. S069409. View opinion here. The new opinion affirms the Oregon Court of Appeals’ groundbreaking January 26, 2022 opinion, which for the first time recognized a private cause of action to remedy an insurer’s violation of the standard of care every insurer owes to every Oregon policyholder under ORS 746.230.
In his January 26, 2022 Moody opinion, Judge Landau of the Oregon Court of Appeals found that, because ORS 746.230 creates a duty of care that insurers owe to their Oregon policyholders, an insurer’s negligent breach of that duty gives rise to a cause of action for money damages independent and distinct from any cause of action arising out of the insurer’s breach of the insurance policy itself. Moreover, Judge Landau specifically found that where the insurer’s violation of the statutory standard of care deprives the policyholder of the “peace of mind” that is the principal reason insurance consumers purchase insurance policies, the aggrieved policyholder may seek emotional distress damages from the insurer.
The Moody defendant appealed Judge Landau’s decision, and the insurance industry spilled considerable ink on amicus briefs roundly condemning Judge Landau’s legal reasoning. The Oregon Supreme Court heard oral argument on the appeal in November 2022.
More than 14 months later, the Oregon Supreme Court rejected the insurer’s appeal and affirmed Judge Landau’s decision. Although the Oregon Supreme Court agreed entirely with the result reached by the Court of Appeals in recognizing the availability of emotional distress damages in connection with a cause of action arising out of an insurer’s violation of the ORS 746.230 standard of care, its reasoning differed in one significant respect from Judge Landau’s.
Specifically, whereas Judge Landau characterized the newly recognized cause of action as a claim of “negligence per se” distinct from garden variety negligence, expressly rejecting the argument that such a cause may only lie in connection with a separate and independent common-law negligence claim against the insurer, the Oregon Supreme Court found that the newly recognized cause is simply a special case of an ordinary negligence claim and does, in fact, require that a common-law negligence claim “otherwise exist.” However, the Oregon Supreme Court determined that, in light of the nature of the relationship between policyholder and insurer, it is reasonably foreseeable that an insurer’s violation of the statutory standard of care will create a risk of harm to a legally protected interest of the policyholder of sufficient importance to give rise to a claim of negligence. The Oregon Supreme Court further found the policyholder’s legally protected interest in freedom from the unfair practices proscribed by ORS 746.230 to be both of a kind and of sufficient importance to warrant subjecting insurance companies to liability for the policyholder’s consequential emotional distress damages.
As the Oregon Supreme Court observed, its decision brings Oregon in line with the majority of jurisdictions which have recognized for years that where an insurer engages in unfair claims settlement practices, its conduct can cause policyholders significant harm beyond or apart from deprivation of the benefits of the insurance contract itself. To seek damages for such harm, policyholders need not prove that their insurers acted in bad faith in unreasonably delaying payments, failing to perform adequate investigation of claims, or deliberately underpaying valid claims, but rather need only show that the insurer’s conduct was in violation of the statutory standard of care.
In Moody, the only extra-contractual damages at issue were emotional distress damages. However, it is well worth noting that the court expressly left open the question whether other extra-contractual consequential damages could be available in connection with the newly-recognized cause of action. Indeed, given the court’s clear instruction that the claim sounds in negligence and is co-extensive with a common-law negligence claim, the new opinion provides no reason to doubt that the entire range of damages ordinarily available in connection with a negligence claim is likewise available in connection with a so-called Moody claim premised on violation of ORS 746.230.
As a result, the newly issued Moody opinion represents a significant victory for Oregon’s insurance consumers. Prior to Moody, policyholders who suffered financial catastrophe caused by their insurers’ unreasonably delayed payment (or significant underpayment) of insurance benefits had no recourse beyond recovery of the amounts owed under the policy, and no way to repair the damage caused by the delay in paying the full amount owed. Now, under Moody, the Oregon courts have a mechanism for holding insurers accountable for the harms caused by their unfair claims settlement practices.
The Rights of Oregon Wildfire Victims Will Expire in September 2022
A Bonaparte & Bonaparte client is featured prominently in this Oregonian article regarding the devastation wrought by the 2020 wildfires in the Santiam Canyon area. Many Oregonians lost their homes in those fires, and many have faced serious challenges in connection with rebuilding their homes. As the article relates, thousands of Oregonians lost their homes in the 2020 fires, and only a fraction of the destroyed homes have been rebuilt to date. In many instances, affected homeowners have been unable to rebuild their homes due to the failure of their insurance companies to comply with coverage obligations under their homeowners insurance policies.
Homeowners in that situation should know that a two-year statute of limitations governs their right to bring suit against their insurers. For many victims of the 2020 fires, that time is nearly past.
Federal District of Oregon Restricts an Insurer’s Assertion of a “Vacancy” Coverage Exclusion as a Matter of Oregon Law
On June 1, 2021, Judge Acosta of the District of Oregon issued a Findings and Recommendation in Davison v. Foremost Insurance Company, 20-cv-1387. In Davison, the plaintiffs purchased an all-risk home-insurance policy to cover damage to a residential property they had inherited. The policy contained a coverage exclusion for damage to the property caused while “the dwelling has been vacant for more than 30 consecutive days immediately before the loss.” The policy defined “vacant” to mean “[t]he absence of most of. . . [t]he furniture. . . [and] [o]ther items needed for human occupancy as a dwelling.” The property was subsequently damaged by fire while the plaintiffs were not using the property as a residence but rather were conducting renovations there, exclusively on weekends. The defendant insurer denied coverage on grounds of the vacancy exclusion.
The plaintiffs moved for partial summary judgment as to the issue of the insured’s liability, only. Judge Acosta found that, although the plaintiffs were concededly not using the property as a dwelling during the thirty days preceding the fire, the vacancy exclusion was inapplicable as a matter of Oregon law due to the continuous presence at the property of at least some furniture and household items, including chairs, tables, appliances, and food. On that basis, Judge Acosta recommended that the court grant partial summary judgment in the plaintiffs’ favor as to the insured’s liability for breach of its indemnification obligations under the policy.
On June 23, 2021, Judge Mosman adopted Judge Acosta’s Findings and Recommendation as his own opinion, without modification.
Medford Wildfire Case Ruling Allows Attorney Fees Against Insurer for its Delay in Paying ALE (Additional Living Expense)
A renter in Talent, Oregon lost everything when her rental home burned up in the September 8, 2020, Almeda fire. She engaged Bonaparte & Bonaparte to file suit against her insurer (Lemonade Insurance Company) to recover compensation for her contents and unpaid ALE. In July 2021—11 months after the fire—Lemonade made a supplemental ALE payment, but disputed the insured’s entitlement to attorney fees. On September 30, 2021, Judge Charles Kochlacs of the Jackson County Circuit Court ruled that the insured was entitled to attorney fees based on the insurer’s delayed ALE payment. [See Opinion here.]
INSURANCE COVERAGE FOR CLIMATE CHANGE
First Party Claims for Fire, Wind, Landslide, and Flood
Robert Bonaparte of Shenker & Bonaparte, LLP
Kyle Sturm of Foreman, Sturm & Thede, LLP
I. Introduction
Climate change has profound actuarial implications for the insurance industry. More frequent catastrophic events such as floods, drought, fires, and hurricanes, whether or not attributable to climate change, challenge the insurance industry’s ability to predict and price risk in the first-party context. By extension, increased risk may result in increased premiums or reduced coverage.
Although beyond the subject of this paper, insurers face potential enterprise liability for failure to disclose information regarding the emerging risk of climate change to an unknowing public. By analogy, as solvent asbestos defendants become increasingly rare, plaintiffs began targeting insurers directly, claiming that insurers had a duty to disclose their knowledge of asbestos risk.
This paper narrowly focuses on first-party property claims under personal and commercial policies. All these cases are relevant to climate change because they address issues stemming from shifts in the environment.
II. The Insurance Industry Will Respond to Climate Change
According to a recent survey among actuaries, climate change is the top risk for the insurance industry, beating out cyber damages, financial instability, and terrorism. The survey demonstrates a shift from previous years, when climate change lagged well behind other risks. It has been estimated that natural disasters caused about $340 billion in damages globally in 2017, with insurance companies paying out $138 billion.
When the Camp Fire broke out in California in 2018, it became the most destructive fire on record in the state. At least 88 people died, 150,000 acres burned, and 18,000 structures were destroyed. The Insurance Information Institute estimates that insured losses from the fire will ultimately reach between $8.5 billion and $10.5 billion. In September of 2019, it was announced that PG&E agreed to an $11 billion settlement with insurance companies for the Northern California wildfires in 2017 and 2018. The insurance companies sought to recoup roughly $20 billion from PG&E due to the payouts to the wildfire victims.
Six of the 10 most destructive California wildfires have occurred in the last four years. According to the National Oceanic and Atmospheric Administration, a total of 219 weather and climate events cost $1.5 trillion from 1980 to 2017. Reports from the federal government warn these events are becoming more frequent, intense, and widespread. It is no surprise, then, that the industry will respond through a combination of premium and policy adjustments. As of the date of this paper, the authors are unaware of any specific claim change policy endorsements, but we expect that to change in the future.
III. Key First Party Considerations
1. Oregon’s one-way attorney fee statute runs in favor of insureds: ORS 742.061. Attorney fees are treated the same way in Washington pursuant to case law. Olympic Steamship Co., Inc. v. Centennial Ins. Co., 117 Wn.2d 37, 811 P.2d 673 (1991).
2. The insured need not obtain a judgment in Oregon: a mid-litigation payment by the insurer triggers its attorney fee obligation. See Long v. Farmers, 360 Or. 791, 388 P.3d 312 (2017).
3. The efficient proximate cause doctrine is applied in Oregon. The rule provides that when a loss is caused by a combination of covered and specifically excluded risks, the loss is covered if the covered risk was the triggering or “efficient proximate cause” of the loss. See Largent v. State Farm, 116 Or. App. 595, 598, 842 P.2d 445 (1992), rev den 316 Or. 528, 854 P.2d 940 (1993). The rule is also applied in Washington See Vision One, LLC v. Philadelphia Indem. Ins. Co., 174 Wash.2d 501, 276 P.3d 300 (2012).
4. Hoffman Construction Co. v. Fred S. James & Co., 313 Or. 464, 836 P.2d 703 (1992), remains the leading Oregon case holding that insurance contract interpretation is a matter of law, and setting forth the blueprint for policy interpretation. In Washington, insurance policy interpretation is similarly a matter of law, and ambiguities are construed against the insurance company. Queen City Farms, Inc. v. Cent. Nat’l Ins. Co of Omaha, 126 Wash.2d 50, 882 P.2d 123 (1989).
5. The interpretation of certain terms (e.g., “roof”), however, cannot be decided as a matter of law, and may present a factual issue for the jury. See Dewsnup v. Farmers, 349 Or. 33, 47, 239 P.3d 493 (2010).
6. Many lawsuits filed in state courts against insurers will be removed to federal court based on diversity.
7. A federal judge serving as mediator—unlike a private mediator—can suspend mediation and order an insurer’s adjuster to resume mediation with authority to settle at a higher figure.
IV. Wildfire
a. Anatomy of a Case: Nelson v. Liberty; Nelson v. Rough & Ready
1. The Wildfire
On August 8, 2015, a fire started at a sawmill owned by Rough & Ready Lumber Company in Cave Junction, Oregon. Southern Oregon, at this time of year, was hot and windy. The fire began as a grass fire, and then spread to nearby trees, and then leaped across a road to engulf a rural acreage owned by Greg and Ronda Nelson. The fire caused superheated smoke to blast not only vertically, but also horizontally. Ironically, the Nelsons operated a fire-fighting company, and Greg Nelson was in California fighting a wildfire.
2. The Damages
The wildfire directly damaged both business property and personal property (structure and contents) on the Nelsons’ land. Although the wildfire came within 50 feet of the home, the flames did not directly come into contact with the home. However, smoke from the wildfire entered the home through open windows and doors.
3. Litigation Tip #1: Mapping the Wildfire
Plaintiffs’ counsel hired a university trained cartographer who had been employed by Apple Maps. The cartographer walked the property with the Nelsons, tracked the progress of the fire with the guidance of the Nelsons, and corroborated the progress of the fire by reference to evidence of searing, scorching, and burning of the property.
4. Litigation Tip #2: Identifying the Target Defendants
Plaintiffs’ counsel evaluated the Nelsons’ claims against Rough & Ready as well as against the Nelsons’ homeowners insurer (Liberty Insurance Corporation). Although the Nelsons operated a fire-fighting company on their property, the Nelsons did not carry business insurance. The Nelsons’ claims against Liberty were limited to personal property (structure and contents) covered under their homeowners policy.
To avoid statute of limitation issues, plaintiffs’ counsel filed two separate suits against Rough & Ready and Liberty on February 1, 2017.
5. Litigation Tip #3: Dealing with the Oregon Department of Forestry’s Claims
The Oregon Department of Forestry (ODF), through the office of the Oregon Department of Justice (DOJ), pursues cost recovery actions against potentially responsible parties. In this case, the DOJ had interviewed dozens of witnesses, and had ascertained the cause and origin of the wildfire to be negligent operations at the Rough & Ready sawmill. The DOJ’s findings were contained in a report. However, the DOJ refused to release the report based on the assertion of various statutory privileges.
When threatened with a subpoena, and following the settlement of its cost recovery action, the DOJ eventually released the report to plaintiffs’ counsel. The DOJ candidly explained that there was a limited amount of money available from the tortfeasor Rough & Ready, and that any recovery by the Nelsons could negatively impact the ODF’s recovery.
6. Litigation Tip #4: Handling the Separate Claims Against the Insurer and the Tortfeasor
Plaintiffs’ counsel proposed a global mediation to resolve the separate suits against Rough & Ready and Liberty. Rough & Ready agreed to participate. Liberty declined.
As a consequence, plaintiffs’ counsel negotiated to resolve the Nelsons’ claim against Rough & Ready, which of course demanded and obtained a full release. Plaintiffs’ counsel and Rough & Ready’s counsel agreed in the settlement document that the resolution was limited to damaged business property. Plaintiffs’ counsel then continued its claim against Liberty for damaged personal property.
7. Litigation Tip #5: Mid-Litigation Payments
In July 2018, approximately 1 ½ years following suit, Liberty issued an adjustment payment to the Nelsons in the amount of $13,676. Plaintiffs’ counsel immediately asked Liberty to acknowledge its obligation to pay attorney fees under Long v. Farmers Ins. Co., 360 Or. 791, 388 P.3d 312 (2017).
When Liberty’s counsel refused to acknowledge its obligation, plaintiffs’ counsel filed a motion for partial summary judgment. By that stage, Liberty had amended its answer to include a defense of subrogation prejudice (due to plaintiffs’ release of Rough & Ready). Plaintiffs’ motion for partial summary judgment also sought dismissal of Liberty’s subrogation prejudice defense.
Josephine County Circuit Court Judge Robert Bain issued his ruling on April 9, 2019. Judge Bain ruled that: (1) Liberty owed attorney fees to the Nelsons due to its mid-litigation payment; and (2) Liberty was estopped from asserting its subrogation prejudice defense.
8. Litigation Tip #6: Make Repeated Settlement Overtures
Following the summary judgment ruling, plaintiffs’ counsel again requested Liberty to resolve the case and to negotiate or litigate the attorney fees. Liberty refused.
9. Litigation Tip #7: Proceed to Trial
Five days before trial, Liberty issued a second adjustment payment to the Nelsons in the amount of $12,194. Plaintiffs’ counsel again asked Liberty to acknowledge its obligation to pay attorney fees under Long v. Farmers Ins. Co., 360 Or. 791, 388 P.3d 312 (2017). Liberty again refused.
By the time of trial (May 7, 2019) there were only $23,000 of damages in dispute. Plaintiffs’ counsel proposed to compromise the damage claim, and to negotiate or litigate the attorney fees. Liberty refused.
The trial proceeded on the factual issue whether smoke from the wildfire had damaged the home. Liberty argued strenuously that it was not obligated to pay for dry cleaning the clothes of an insured who sits close to the campfire, and likewise was not obligated to pay for smoke damage from a wildfire that did not directly come into contact with the home. There were industrial hygienists on both sides of the case. The jury awarded $10,000 to the Nelsons. The Grants Pass Courier published a front-page article with the headline: Jury’s smoke damage award to Cave Junction couple may be unprecedented.
10. Litigation Tip #8: Pursuing Attorney Fees
Plaintiffs’ counsel then proceeded to file a petition for attorney fees under ORCP 68. The attorney fee trial was held September 25, 2019, and the matter remains under advisement.
b. Anatomy of a Case: Oregon Shakespeare Festival Association v. Great American Insurance Company, D. Or. Case No. 1:15-cv-01932-CL (2016)
1. The Wildfire
In late July and early August, 2013, smoke from several nearby wildfires filled the Allen Elizabethan Theater, causing the Oregon Shakespeare Festival (OSF) to cancel performances and lose business income. The fires caused smoke, soot, and ash to accumulate on the surface of the hard plastic seats and concrete ground of OSF’s open-air theater. The smoke, ashes, and dust permeated the interior of the theater, coating the HVAC, lighting, and electrical systems. OSF canceled four separate evening performances due to health concerns from the poor air quality caused by the wildfire smoke.
2. The Damages
OSF suffered loss of business income due to the cancellations.
3. Litigation Tip #1: Damage to Air in the Theater is “Physical Damage”
The insurer disputed whether the smoke that filled the partially-enclosed, open-air facility constituted “direct physical loss or damage.” OSF claimed that the wildfire smoke caused injury or harm to the interior of the theater, which included the air within the theater. The insurer argued that the air in the theater was not “property,” and that air is not physical. The Court summarily rejected the insurer’s assertion of three exclusions, and cited Oregon cases finding coverage for smoke and vapors from a meth lab in a rental home. See Farmers Ins. Co. v. Trutanich, 123 Or. App. 6, 858 P.2d 1332 (1993); Largent v. State Farm F&C Co., 116 Or. App. 595, 842 P.2d 445 (1992), rev den 316 Or. 528, 854 P.2d 940 (1993).
V. Wind
a. Anatomy of a Case: MacDonald v. American Family Insurance Company
1. The Wind Event
In November 2012, the barn of plaintiffs Tom and Karen MacDonald suffered heavy damage during a severe wind storm. Plaintiffs lived in a valley in Lake County, Oregon with vertical bluffs rising 7,200 feet in elevation. Plaintiffs promptly reported the damage to the insurer, which assigned a new adjuster, whose only prior work experience was as a physical therapist, to inspect the loss and to adjust the claim.
2. The Damages
The untrained adjuster dramatically underestimated the damages, and plaintiffs hired counsel to bring an action against the insurer.
3. Litigation Tip #1: Consider the Association of Co-Counsel
Plaintiffs engaged experienced counsel (Carl Burnham of the Yturri Rose firm in Ontario) who filed an action. Subsequently, Carl Burnham associated as co-counsel Robert Bonaparte of Shenker & Bonaparte based on the firm’s insurance coverage expertise. The case proceeded to successful mediation.
VI. Landslide
a. Anatomy of a Case: Hendrickson v. Farmers Insurance
1. The Landslide Event
At 5:00 a.m. on October 8, 2008, the home of plaintiffs Kathei and David Hendrickson, perched on the top of a hill, slid down the hill without warning. The descent of the home was arrested mid-slope for a few minutes by a stump, allowing a neighbor to extend a ladder over the cliff-side and haul Kathei Hendrickson to safety. Plaintiffs’ home continued its descent, and crashed into two neighboring homes at the foot of the hill.
2. Litigation Tip #1: Use Experts Creatively to Challenge the “Earth Movement” Exclusion
Like most homeowners policies, plaintiffs’ policy devoted a full page or more to its “earth movement” exclusion. Virtually no domestic homeowners policies cover landslide.
Plaintiffs’ counsel engaged Portland expert Scot Mills, whose firm GeoDesign, Inc. had done work on the OHSU tram, to analyze the claim. Just 10 days before the loss, plaintiffs had hired an arborist to cut down an 80-year-old cedar tree. There was evidence that a water line had been severed in the process, causing water equivalent to that of a 30,000 gallon swimming pool to be trapped at the top of the hill, walled in by plaintiffs’ west retaining wall. Plaintiffs’ expert argued that the home was destroyed when its west retaining wall failed as a result of “earth pressure.” See, e.g., Simon v. Encompass Insurance Company, 2005 Ohio App. LEXIS 5164 (2005), discretionary appeal not allowed, 108 Ohio St.3d 1489, 843 N.E.2d 795 (2006) (“hydrostatic pressure and earth pressure are not the same as earth movement, as defined in Encompass’ policy. Therefore, the earth movement exclusion is inapplicable”).
3. Litigation Tip #2: Separate Claims for Structure and Contents
Plaintiffs’ policy provided coverage for water damage to personal property caused by broken pipes. The court allowed both the earth pressure claim for damaged structure and the water damage claim for damaged personal property to proceed to a jury.
The jury found in favor of the insurer on the structure claim, and in favor of plaintiffs on the water damage claim to personal property, and awarded damages. The court entered a JNOV. The Oregon Court of Appeals affirmed without opinion.
4. Litigation Tip #3: Pursue Tortfeasors
Plaintiffs filed a third party action against the arborist, and obtained a settlement.
VII. Flood
The typical homeowners policy does not cover flood damage. Flood insurance may be purchased through the National Flood Insurance Program (NFIP), and a few private insurers, subject to a 30-day waiting period. The NFIP provides coverage up to $250,000 for structure, and up to $100,000 for contents.
a. Anatomy of a Case: Hatley v. Truck Insurance Exchange, 261 Or. 606, 494 P.2d 426 (1972)
1. The “Flood” Event
A vandal left a hose on all night, causing damage to the insured’s home.
2. Litigation Tip #1: Parse the Asserted Exclusion Carefully
The insurer asserted that the damage was excluded from coverage under a surface and flood water exclusion:
“This policy does not insure against…Loss caused by, resulting from, contributed to or aggravated by any of the following…flood, surface water, waves, tidal water or tidal wave, overflow of streams or other bodies of water, or spray from any of the foregoing, all whether driven by wind or not.”
The court found that the hose water was not “surface water” because “[t]he term ‘surface water,’ particularly when used in conjunction with flood, waves, and tidal water, was intended to mean water ‘diffused over the surface of the ground, derived from falling rains or melting snows.’ We have been cited to no cases either in the field of property insurance or that of water law in which water from any but a natural source is held to be surface water.”
b. Anatomy of a Case: Veloz v. Foremost Insurance Co. Grand Rapids, 306 F. Supp.3d 1271 (D. Or. 2018)
In Veloz, Sabino Veloz’s rental property was damaged after a water main burst and water flowed downhill to Veloz’s house. Foremost Insurance Company denied Veloz’s claim based partly on a flood and surface water exclusion in Veloz’s insurance policy that provided:
“Loss caused by…Flood Water, surface water, waves, tidal water, tidal waves, storm surge, tsunami or overflow of a body of water or spray from any of these whether or not driven by wind…This exclusion applies whether or not there was widespread damage and whether or not it was caused by a human activity or an act of nature.”
Foremost claimed that the damage was caused by “surface water” or “flood water” from the water main. Foremost argued that it did not matter if the cause of the released water was man-made because the insurance policy provides that the exclusion applies to “human activity,” citing Citi Gas Convenience v. Utica Mut. Ins. Co., No. 15-6691, 2016 U.S. Dist. LEXIS 15503 (E.D. Pa. Feb. 9, 2016), which involved similar policy language.
The Veloz court was not convinced by Foremost’s arguments and reliance on Citi Gas. Instead, it held “that the terms ‘surface water’ and ‘flood water’ unambiguously refer to natural water sources and that no reasonable insured would interpret those terms to refer to water that escapes from a man-made source such as a water main.” In coming to its decision, the court relied on the finding in Hatley that flood and surface water is water arising from a natural source. The court distinguished Citi Gas based on subtle differences in the policy wording. The court held that the “it” in Foremost’s policy “refers to structural damage,” not to the source of the water. In other words, if the Veloz policy had excluded “flood and surface water caused by a man-made source” rather than excluding “damage… caused by a human activity,” the court may have found that the water damage was excluded from coverage.
c. Anatomy of a Case: Barnard v. State Farm
1. The “Flood” Event
On August 14, 2015, the failure of an under-sink water heater resulted in flooding of the home, causing structural damage to the insureds’ home and damage to the insureds’ personal property.
2. Litigation Tip #1: Consider Tort Claims
The insureds alleged both misfeasance and malfeasance by State Farm’s adjuster, including the unauthorized removal of the water heater. The removal of the water heater may have compromised the potential claim against the manufacturer.
The insureds brought the following claims: (i) for breach of contract and for breach of the implied covenant of fair dealing, in two separate counts, (ii) for tortious interference with business relationships, (iii) for negligence, (iv) for negligent misrepresentation, (v) for intentional misrepresentation, (vi) for bad faith and unfair dealing, (vii) for intentional infliction of emotional distress, and (viii) for conversion.
State Farm filed a Rule 12 motion to dismiss the sixth claim for bad faith and unfair dealing. The court declined to dismiss the insureds’ bad faith claim based on the following:
Further support for that conclusion may be found in the Barnards’ allegations that State Farm’s claims representative, in an act of expressly conceded impropriety, removed from the insured premises the water heater the failure of which caused the water intrusion at issue, thereby compromising the key evidence which would otherwise have supported a claim against the manufacturer of the heater…A finder of fact assuming the truth of that allegation and drawing all reasonable inferences therefrom in the Barnards’ favor could reasonably conclude that State Farm, by and through its conduct in compromising or eliminating the Barnards’ alternative avenue of recourse for seeking compensation for their loss in the event resolution of their claim on the policy proves insufficient to compensate them completely, created a special relationship with the Barnards that carried with it an extra-contractual duty of care to ensure that the insured premises were restored to their pre-loss condition without exceeding the limits of coverage under the policy. Again, the Barnards have alleged that State Farm breached that extra-contractual duty of care…For this reason, also, State Farm has not established that it is entitled to dismissal of the Barnards’ bad faith claim at this pleading stage of these proceedings.
See Barnard v. State Farm, D. Or. Case No. 3:17-cv-01340-PK (2017) (Findings and Recommendation) (Judge Paul Papak).
"Jury’s Smoke Damage Award to CJ Couple may be Unprecedented"
Attorney Robert E.L. Bonaparte recently received a jury verdict in Southern Oregon and The Grants Pass Daily Courier wrote a story about it.
Jury’s Smoke Damage Award to CJ Couple may be Unprecedented
By Jeff Duewel of the Daily Courier
A Cave Junction couple who challenged their insurance company over damage claims from a brush fire in 2015 won a possible precedent-setting $10,000 verdict last week in Josephine County Circuit Court after a three-day jury trial.
Bob Bonaparte, attorney for Greg and Ronda Nelson, said his clients were originally given a check for $2,743 from Liberty Mutual, then eventually given $28,000 more by the company two years after filing suit in 2017.
The jury award was on top of that.
The Nelsons also settled out of court in 2018 for an undisclosed amount with Rough & Ready Lumber, the sawmill where the Krauss Lane Fire was sparked by discarded hot ash from electricity generating boilers.
Rough & Ready, which shut down the mill in 2016, eventually paid $364,000 to the Oregon Department of Forestry for suppression of the fire, which threatened 125 homes.
Bonaparte said his clients' case against Liberty Mutual is unique because while the Nelsons lost heavy equipment, classic cars, fencing, firewood and landscaping outside their home, the flames didn't hit the house.
"I think this case may be the first in Oregon to litigate the issue of smoke damage from a wildfire, where the wildfire does not physically come into contact with the home," Bonaparte said. "The insurance company fought this case tooth and nail because it was worried about the case spawning copycat claims. During closing argument it warned that an award in our case could open the floodgates to thousands of claims by Southern Oregon homeowners who experienced any degree of wafting smoke from the many wildfires in the area.
"I've done dozens and dozens of fire cases, and I've never had a case involving drifting smoke," he said.
Attorneys for Liberty Mutual did not respond to a request for comment.
The Nelsons own a logging company and Greg Nelson is a firefighter. He was in California fighting a wildfire there when the Krauss Lane Fire hit.
Ronda Nelson said she drove to their property and saw flames approaching the house and shop before the fire made a last-second turn with the wind. She grabbed a hose and also saved dogs and horses.
"A helicopter stopped the flames 20 feet from the house," she said.
She said while most of the heavy equipment was covered by another policy, the money offered by Liberty Mutual wouldn't have covered the wood pile.
"They didn't want to pay. I spent three days in Grants Pass with a jury trial," she said. "You would have thought they were trying a murder. It was ridiculous they spent so much money. The top dollar we asked was $23,000."
Nelson and Bonaparte said the home was filled with soot, and carpets and other fabric had to be cleaned, and the smell lingered. The smoke damage was estimated at $25,000.
Lawsuits like this could become more common, said Amy Bach, executive director of San Francisco-based United Policyholders, a national organization that helps consumers with insurance matters.
Bach said smoke damage claims have been a sensitive point between homeowners in wildfire areas and insurance companies for several years.
It seems to be ramping up, following the recent heavy fire seasons. Smoke blanketed large areas in California after devastating wildfires in Santa Rosa and Napa in 2017 and Redding and Paradise in 2018. Thousands of homes were lost.
Grants Pass had its worst-ever smoke year in 2018, with 22 days of an air quality index that reached unhealthy for sensitive groups or worse.
"In the last couple of years we've seen insurance companies issue new language that tries to distinguish wildfire smoke from fire damage," Bach said. "As soon as we saw that we brought it to the (California) Department of Insurance and said, 'You can't do this.' The department hasn't taken an official position."
"In our opinion an insurance company should not be allowed a different standard of coverage for wildfire smoke or any other kind of smoke damage," Bach said.
"The insurance companies got away with cutting flood and earthquake out of basic home insurance, but they can't be allowed to cut out fire. What do you have left?"
Federal Jury Awards Million Dollar Verdict to Business Owners Falsely Accused of Arson by Insurance Company
Portland, OR—A federal jury awarded Steve and Rena Muller damages in the amount of $1,082,500 after their insurance company refused to pay them following the loss of their auto shop business. The Mullers’ insurance company refused to pay their insurance claim, instead accusing the Mullers of arson. Attorneys Andrew C. Lauersdorf, Francis J. Maloney, and Scott A. MacLaren, from the Maloney Lauersdorf Reiner law firm, along with Robert Bonaparte from the Shenker & Bonaparte law firm, represented the Mullers in an eight-day jury trial against the insurance company in federal court in Portland, Oregon. The million-dollar verdict came after a nearly five-year struggle and involved fire investigators and other experts from around the state. The Mullers’ struggle began on November 18, 2012. The Mullers, with their two young children, locked up their home and their auto shop next door, and hit the road from La Grande to Klamath Falls to spend the Thanksgiving holiday with friends. Their holiday ended abruptly when they received a phone call from a neighbor reporting that their auto shop was on fire. The Mullers, who were almost four hours away outside of Madras when they received the call, immediately turned around and headed back home. They found their auto shop destroyed when they arrived.
When the Mullers turned to their insurance company for help, the insurance company denied the claim. The insurance company refused to pay the Mullers for their loss, and instead accused the Mullers of committing arson, despite digital photographs, video surveillance records, and cell phone records that corroborated the Mullers’ version of events on the day of the fire and proved that the Mullers were almost four hours away from the auto shop when the fire started.
“The Mullers have been fighting this battle for four and a half years. They were falsely accused of arson, and they have been dragged through the mud, in addition to losing their shop. We are very happy for the Mullers and thrilled that the jury made this right,” said trial attorney Andrew C. Lauersdorf.
Hairstylist 'Mr. Thom' Wins Insurance Case Seven Years After Mansion Fire
Dec. 27, 2015 at 12:01 AM
By Nick Morgan Mail Tribune
Hairstylist "Mr. Thom" Martin is finally able to start rebuilding his mansion on South Stage Road, seven years after it burned to the ground.
In 2008, two days prior to his 63rd birthday, "Mr. Thom" Martin's Medford mansion burned down. This month, after a seven-year fight with his insurance company, the hairdresser can finally get on with his life.
Earlier this year, Martin and his mortgage holder were awarded about $1.6 million by Jackson County Circuit Court Judge Tim Gerking in a judgment against Martin's insurance company, Oregon Mutual Insurance Company. The company paid up Dec. 4.
Martin said he had 921 guests confirmed for a "surprise" birthday party for himself on Saturday, July 19, 2008, at his mansion at 59 S. Stage Road, which had been assembled from four historic properties that were moved to the location. His birthday plans were dashed two days before the party when the mansion — which served as his home, salon and a bed and breakfast — caught fire.
"I had nine people here with foil on their heads," Martin recalled of the day the fire broke out. He said those salon clients had no choice but to rinse their hair in a neighbor's well.
A self-described "stylist to the stars," Martin said he was "literally" sick to his stomach at the loss of items in the home he could never replace, including a Rolodex filled with celebrity phone numbers, 17 Alberto Vargas pin-up paintings and a Rolls Royce Silver Cloud from actress Connie Stevens.
It was dealing with the items that could be replaced, however, that stretched Martin's nightmare to seven years.
Martin said insurance investigators first withheld coverage on his mansion because they suspected arson, in part because a building that was to be connected to the home burned to the ground on the property in 1999. Martin said vagrants had been occupying that structure while he was away in Texas to attend to his ailing wife.
Although the source of the mansion fire was believed to be electrical, investigators reached an "undetermined" conclusion two months after the fire because outlets at the ignition point had been destroyed. Because of that, investigators couldn't say with certainty which object on the back deck started the blaze. Martin believes the fire stemmed from a new electrical outlet used for portable refrigeration units storing deviled eggs and other hors d'oeuvres for parties on the property.
"They wanted it to be arson," Martin said.
He said the insurance company's allegations and media reports harmed his reputation, and he still remembers malicious comments made about his loss. Oregon Mutual Insurance Company later alleged that Martin's insurance policy had been cancelled at the time of the fire. Martin said he had mortgage insurance on the home, but confusion arose because the bank that held the mortgage had sold it to another bank. The case continued back and forth, with motions and counter-motions for years without any relief from the insurance company.
His home and his livelihood were wiped out in the fire, and he said other salons were apprehensive about giving him space to work until a salon in Phoenix reached out. The change was an adjustment for a man who once styled hair for television shows such as "The Love Boat" and "The Partridge Family," and who ran a 100-station Las Vegas salon and styled the hair of hundreds of stars, from Ginger Rogers to Cher.
"I just thought, 'Oh, my gosh, this is so embarrassing,' " Martin said of the little Phoenix salon. He later redecorated the salon at his own expense.
For the first six months after the fire, he lived with a friend from high school and then in a fifth-wheel trailer on his property that was loaned to him.
"I just lived there for the longest time," Martin said.
Years later, he purchased a manufactured home for the property with the $7,200 insurance payment for his totaled Rolls Royce. As his income grew again, he was able to rebuild a portion of the salon, but without insurance money he had to rebuild in fits and starts. The concrete foundation of the previous house was never removed because he couldn't afford the excavation expense.
The turning point for Martin came a little over two years ago when local lawyer Sandra Sawyer, a client of Martin's, suggested he contact Bob Bonaparte, a lawyer with Shenker & Bonaparte, a Portland firm specializing in insurance matters. Bonaparte reorganized the case while working with a local lawyer.
"He gave me another shot in the arm," Martin said. Bonaparte said Oregon Mutual litigated the case for seven years using four Portland law firms and a variety of defenses. The argument at the end of Martin's case, according to Bonaparte, was that Martin had been late on an insurance payment and that they'd sent him notice of cancellation. Bonaparte said the insurance company violated Oregon law because business owners are entitled to a hearing before a policy is cancelled.
"I have seen countless cases where insurance companies deny coverage on a technicality," Bonaparte said.
Bonaparte and Martin declined to discuss the specific figure awarded, but Martin said the building was insured for $1.8 million, and its contents were insured for $1.5 million. Bonaparte said that in Oregon, insurance companies accrue interest if a policyholder is later awarded a judgment.
According to court records, Gerking on June 30 awarded a judgment of $1,050,000, most of which went to Martin's mortgage company. Martin got about $260,000, plus a share of an additional $600,000 in interest awarded by the court.The judge also ordered Oregon Mutual to pay attorney fees for Martin and his mortgage company. "It's wonderful," Martin said this week. "It wasn't fair, but I'm done." Reach reporter Nick Morgan at 541-776-4471 or nmorgan@mailtribune.com. Follow him on Twitter at @MTCrimeBeat.