GEORGE CARAM STEEH, District Judge.
This insurance coverage dispute arises out of plaintiffs', husband and wife, Frank and Sheri Monteleone, claim under their homeowner's policy, for significant water damage in their basement which they allege amounts to a loss of more than $115,000. (Complaint, ¶ 48). Jurisdiction in this putative class action is based on the Class Action Fairness Act ("CAFA"), pursuant to 28 U.S.C. § 1332(d), because the amount in controversy allegedly exceeds $5 million and at least one member is a citizen of a different state than defendant. Defendants are The AutoClub Group ("AutoClub") and MemberSelect Insurance Company ("MemberSelect") (collectively "defendants"). The homeowner's policy was issued by MemberSelect. Defendants have filed a joint motion to deny class certification and to dismiss certain claims.
On January, 17, 2013, plaintiffs suffered water damage in their finished basement of their Clinton Township home which caused significant harm, including loss of personal property, and structural damage to their home. (Complaint, ¶ 16). Plaintiffs claim the water damage has been traced to a faulty back flow preventer in the plumbing waste line that extends under the slab in plaintiffs' basement.
Plaintiffs claim coverage for the loss existed under the policy's provision providing that insured perils include, "[a]ccidental discharge or overflow of water or steam from within a plumbing, heating, air conditioning or automatic fire protection sprinkler system or domestic appliance." (Doc. 49, Ex. A at 8, ¶ 13). Defendants denied coverage under the policies' exclusion paragraph 3(b) which provides no coverage exists for:
In addition to their individual claims for loss under the policy, plaintiffs seek to certify two categories of policyholders as class plaintiffs: (1) "property damage" plaintiffs, and (2) the "premium" plaintiffs.
Plaintiffs seek to certify as a subclass the following individuals:
The "premium plaintiffs" are described as all individuals who purchased homeowners' insurance from the defendants since March, 2009, regardless of whether these individuals filed any loss claims.
(Doc. 49, Ex. E, emphasis in original). Plaintiffs claim that defendants' above policy interpretation reduced water related claim pay outs. Defendants dispute this, asserting that the average amount paid for water damage claims increased from 2009, when the policy was allegedly adopted, to 2010.
Concerning the "premium" subclass, plaintiffs argue damages will be determined based on the percentage of premiums paid which their expert will conclude covered the risk of "overflow" damages. (Doc. 49 at 35-36).
Federal Rule of Civil Procedure 23 governs class certification. "While [a] district court has broad discretion in certifying class actions, it must exercise that discretion within the framework of Rule 23."
Fed. R. Civ. P. 23(b)(3).
Defendants do not dispute that the requirements of Rule 23(a) have been met, but focus their analysis on the prerequisites of Rule 23(b)(3). Defendants argue that (1) plaintiffs have failed to show that common questions of law or fact predominate over questions affecting only individual members, and (2) plaintiffs have failed to show that a class action is a superior method of adjudicating individual disputes. Plaintiffs respond that defendants' motion is premature as discovery is ongoing and the deadline for filing a motion for class certification, pursuant to the court's scheduling order, is set for August, 2014. The court finds, however, that the record is sufficiently developed that the court can decide the matter at this time. No additional discovery will alter the fact that adjudication of the "property damage" claims would require individual coverage determinations as to every member of the class. Such an unwieldy undertaking is clearly not appropriate in a class action.
Plaintiffs also argue that the subclass of "property damage" plaintiffs should be certified because each putative class member shares the factual question of whether defendants' misapplied the 3(b) exclusion. While admitting that the damages will vary for each putative class member, plaintiffs argue they flow from the same liability theory. Plaintiffs' reliance on
In order to satisfy the predominance requirement, "plaintiff[s] must establish that issues subject to generalized proof and applicable to the class as a whole predominate over those issues that are subject to only individualized proof."
Plaintiffs allege that discovery may lead to a class description that is not dependent upon a review of an insured's claim file. Such a hypothetical is both speculative and unlikely. The Complaint describes the subclass as "all persons who made water-related damage claims." (Complaint, ¶ 53). That such claims could be resolved without factual inquiry into the underlying claim is specious. Plaintiffs also argue that liability could be separated from damages. Such bifurcation would fail to make the case appropriate for class certification as both the issue of liability and the issue of damages are fact-specific inquiries depending on the particular circumstances of each individual case.
Finally, plaintiffs argue that their damages claims may be resolved through an appraisal process as envisioned in the policy and provided for by Michigan law; thus, the individual issue of damages does not defeat a finding that common issues predominate. At oral argument, plaintiffs' counsel submitted a slide stating that "[i]ndividual issues as to basis for denial; scope of coverage; and values will be resolved by appraiser." This argument is belied by the clear language of the policy which provides that "[i]f you and we fail to agree on the Actual Cash Value or amount of loss, either party may make written demand for an appraisal." (Doc. 49, Ex. A at 10). "Scope of coverage" is not a matter for appraisal, and the law is well settled that "the issue of an insurance policy's coverage is for the court to decide, not the appraisers."
Plaintiffs rely upon
Here plaintiffs allege that defendants have "improperly interpreted and misapplied its 3(b) exclusion to the water damage claims." (Doc. 49 at 34). While plaintiffs' theory of recovery involves interpretation of the policy, that does not end the inquiry. Each "property damage" class plaintiff would need to prove that coverage for that particular loss is provided by the policy. Even if this court were to determine that defendant-insurers had a policy of improperly denying all claims where water backed up in a basement, regardless of the origination of the water, such a declaratory judgment by this court would not answer the question of whether particular plaintiffs were entitled to relief for their water damage losses. The court's interpretation of the policy language is only the first step in determining coverage. The court would then have to consider the facts of each individual's claims. A decision from this court that defendant-insurers adopted an improper method of determining water damage losses and failed to investigate meritorious claims, still would not require a finding of class-wide liability because in some individual cases, defendants still might prove the damage was caused by "water or water-borne material which back[ed] up through sewers or drains" (Doc. 35, Ex. 1 at ¶ 3(b)) or that some other exclusion applied. Contrary to plaintiffs' argument, once this court decides the legal issue of whether defendant-insurers allegedly adopted a uniform method of wrongfully denying legitimate water loss claims, the "property damage" class claims would not be ripe for an appraisal at that time. The court still would face the formidable task of considering whether coverage exists in each individual case.
There are no common issues which predominate. The individual questions of liability are fact-specific and will vary in each instance. Plaintiffs' argument that questions as to whether the statute of limitations applies, or whether defendants conducted a proper investigation of loss claims, are common questions, does not ring true. Each of these inquiries depends, in part, on the sufficiency of the particular claims of individual homeowners.
The "property damage" subclass also must be denied class certification under Rule 23(b)(3) because plaintiffs have failed to show that a class action is the superior method of adjudicating the claims. In
The court turns now to the question of whether the "premium" subclass should be certified and finds that the motion shall be denied. Defendants argue that the "premium" subclass should not be certified and should be dismissed because (1) they have submitted proof that they paid many claims for water damage claims characterized as "overflows," by way of an affidavit of their homeowners claim director, Sally Shiminski, and (2) plaintiffs' claim that they were charged excessive premiums must be resolved by the administrative remedies provided in the Michigan Insurance Code, MCL § 500.2113, and by Iowa Code § 515F.6(3). Plaintiffs respond that Shiminski's affidavit only establishes that it pays some overflow claims, and does not answer the question of whether defendants had a policy of broadly applying the paragraph 3(b) exclusion to wrongfully deny coverage whenever water entered a policyholder's basement, regardless of the cause of the water event. Because Shiminski's affidavit merely raises a factual dispute as to whether or not defendant-insurers had a policy of wrongfully denying meritorious water damage claims, class certification should not be denied on the basis of her affidavit.
The court turns now to defendants' argument that plaintiffs must exhaust their administrative remedies by seeking a review and hearing by the insurance commissioner. MCL § 500.2113 provides that where an insurer "has charged an incorrect premium" on a policy for home insurance, she is entitled to "a private informal managerial-level conference with the insurer, and, if that fails, to a review before the commissioner." MCL § 500.2113(1). In
The court turns now to the question of whether the "premium" class claims should be limited to those claims arising no more than one year prior to the filing of this lawsuit on June 19, 2013, or as to the Minnesota policies, no more than two years prior to the filing of this lawsuit, based on contractual limitations periods set forth in the homeowners' policies. Defendants have moved to dismiss all claims occurring outside the contractual limitations period and seek a ruling from this court that discovery be prohibited as to any policyholder claims barred by the contractual limitations period. The proposed class includes those members who paid premiums "from approximately March 2009 to present." (Complaint, ¶ 53).
(Doc. 49, Ex. A at 11, ¶ 10). There is no dispute that the Iowa, Kentucky, and Wisconsin policies contain a one-year contractual limitations period, stating, "Suit must be brought within one year after the loss or damage occurs." The Minnesota policy contains the same language except that the suit must be brought "within two years." Plaintiffs argue that the contractual limitations period set forth in the policies should not apply but the general statute of limitations periods provided by state law should govern because, among other things, the "premium" class members do not assert any property losses owing under the policies. This argument bears on the viability of their claims, since it is unclear how policyholders, who have not suffered any insured loss, can pursue claims for breach of the policy at all. But this determination is not, as yet, before the court. Plaintiffs also argue that the statute of limitations issue is not ripe for decision now as "questions involving temporal limitations often intrude into the merits of the case and require development of a complete factual record," and the factual record is not sufficiently developed at this time to make such a determination. (Doc. 49 at 43). Because it is unclear at this time whether an alleged breach of contract occurred, and whether an alleged overpayment of premiums is considered a "loss" under the policy or is recoverable under some other theory, the court shall deny without prejudice defendants' motion to exclude certain claims as time-barred.
The court next considers defendants' request that this court order that any discovery concerning claims outside the contractual limitations period set forth in the policies be barred. Federal Rule of Civil Procedure 26 allows for broad discovery of all relevant nonprivileged matter. Because plaintiffs' theory of the case is that defendantinsurers adopted a company-wide policy of denying meritorious water damage claims beginning in March, 2009, company records, and information dating back until 2009 and possibly before, would be relevant to the Monteleone's individual coverage issue and to the "premium" class members' claims as well. Accordingly, defendant's motion shall be denied.
For the reasons stated above, defendants' motion to deny class certification (Doc. 35) as to the "property damage" subclass is GRANTED. Defendants' motion to deny class certification as to the "premium" subclass (Doc. 35) is DENIED WITHOUT PREJUDICE; defendants' motion to dismiss the "premium" class claims (Doc. 35) is DENIED; and defendant's motion to dismiss the "premium" class claims allegedly falling outside the contractual limitations period set forth in the policies (Doc. 35), is DENIED WITHOUT PREJUDICE. Defendants' request that discovery of matters outside the alleged contractual limitations period be prohibited is DENIED.