Filed: Jan. 11, 2010
Latest Update: Feb. 21, 2020
Summary: FILED United States Court of Appeals Tenth Circuit January 11, 2010 UNITED STATES COURT OF APPEALS Elisabeth A. Shumaker Clerk of Court FOR THE TENTH CIRCUIT GUS VAKAS; GEORGE VAKAS, Plaintiffs-Appellants, v. No. 09-3141 (D.C. No. 6:08-CV-01127-EFM) HARTFORD CASUALTY (D. Kan.) INSURANCE COMPANY, Defendant-Appellee. ORDER AND JUDGMENT * Before KELLY, PORFILIO, and O’BRIEN, Circuit Judges. The question before us is whether Hartford Casualty Insurance Company must pay the replacement cost value for
Summary: FILED United States Court of Appeals Tenth Circuit January 11, 2010 UNITED STATES COURT OF APPEALS Elisabeth A. Shumaker Clerk of Court FOR THE TENTH CIRCUIT GUS VAKAS; GEORGE VAKAS, Plaintiffs-Appellants, v. No. 09-3141 (D.C. No. 6:08-CV-01127-EFM) HARTFORD CASUALTY (D. Kan.) INSURANCE COMPANY, Defendant-Appellee. ORDER AND JUDGMENT * Before KELLY, PORFILIO, and O’BRIEN, Circuit Judges. The question before us is whether Hartford Casualty Insurance Company must pay the replacement cost value for ..
More
FILED
United States Court of Appeals
Tenth Circuit
January 11, 2010
UNITED STATES COURT OF APPEALS
Elisabeth A. Shumaker
Clerk of Court
FOR THE TENTH CIRCUIT
GUS VAKAS; GEORGE VAKAS,
Plaintiffs-Appellants,
v. No. 09-3141
(D.C. No. 6:08-CV-01127-EFM)
HARTFORD CASUALTY (D. Kan.)
INSURANCE COMPANY,
Defendant-Appellee.
ORDER AND JUDGMENT *
Before KELLY, PORFILIO, and O’BRIEN, Circuit Judges.
The question before us is whether Hartford Casualty Insurance Company
must pay the replacement cost value for business property destroyed in a fire,
even though the appellants did not actually replace the property. We have
jurisdiction under 28 U.S.C. § 1291 to review the district court’s grant of
summary judgment in favor of Hartford. Because the insurance policy at issue
*
After examining the briefs and appellate record, this panel has determined
unanimously to grant the parties’ request for a decision on the briefs without oral
argument. See Fed. R. App. P. 34(f); 10th Cir. R. 34.1(G). The case is therefore
ordered submitted without oral argument. This order and judgment is not binding
precedent, except under the doctrines of law of the case, res judicata, and
collateral estoppel. It may be cited, however, for its persuasive value consistent
with Fed. R. App. P. 32.1 and 10th Cir. R. 32.1.
explicitly provides that Hartford will not pay replacement costs for any property
that is not actually replaced, we affirm.
Background
On August 29, 2007, fire destroyed a medical office building and its
contents in Coffeyville, Kansas. The building and contents were covered by a
Hartford insurance policy issued to John Vakas, M.D., who passed away on
March 13, 2005. The appellants are Dr. Vakas’ heirs, and it is undisputed that
they possess an interest in the policy.
The policy provides for a maximum of $240,800 in replacement costs for
business personal property. The appellants replaced only four items of property.
Hartford asserted they were entitled only to the actual cash value of the remainder
of the destroyed property. Accordingly, Hartford tendered appellants a check for
$129,851.83. The appellants disagreed with Hartford’s reading of the policy and
rejected the check. They brought suit in the district court, arguing that they were
entitled either to the policy limits of $240,800 because all of the building’s
contents were destroyed, or, in the alternative, to the replacement-cost value of
$190,231.13 because the policy provided for replacement-cost value. The district
court granted Hartford’s motion for summary judgment, holding the contract was
not ambiguous and it was Hartford’s prerogative to determine whether to pay
replacement-cost value.
-2-
Analysis
“In diversity cases like this one, the substantive law of the forum state
governs the analysis of the underlying claims, but we are governed by federal law
in determining the propriety of the district court’s grant of summary judgment.”
Stickley v. State Farm Mut. Auto. Ins. Co., 505 F.3d 1070, 1076 (10th Cir. 2007)
(quotation omitted). “Accordingly, we review the grant of summary judgment de
novo, applying the same standard as the district court pursuant to Rule 56(c) of
the Federal Rules of Civil Procedure.”
Id. (quotation omitted).
Under Kansas law:
If the language in an insurance policy is clear and
unambiguous, it must be construed in its plain, ordinary, and popular
sense and according to the sense and meaning of the terms used. An
insurance policy is ambiguous when it contains language of doubtful
or conflicting meaning based on a reasonable construction of the
policy’s language. An ambiguity does not exist merely because the
parties disagree on the interpretation of the language.
To determine whether an insurance contract is ambiguous, the
court must not consider what the insurer intends the language to
mean. Instead, the court must view the language as to what a
reasonably prudent insured would understand the language to mean.
This does not mean that the policy should be construed according to
the insured’s uninformed expectations of the policy’s coverage.
Courts should not strain to find an ambiguity when common
sense shows there is none. The court must consider the terms of an
insurance policy as a whole, without fragmenting the various
provisions and endorsements.
As a general rule, exceptions, limitations, and exclusions to
insurance policies are narrowly construed. The insurer assumes the
duty to define limitations to an insured’s coverage in clear and
-3-
explicit terms. To restrict or limit coverage, an insurer must use
clear and unambiguous language. Otherwise, the insurance policy
will be construed in favor of the insured.
Marshall v. Kan. Med. Mut. Ins. Co., 73 P.3d 120, 130 (Kan. 2003) (citations
omitted).
The appellants assert they are entitled to either the policy limits or the
stipulated replacement-cost value. But there does not appear to be any basis for
the appellants to collect additional monies just because the property was entirely
destroyed and the policy limits happen to exceed the replacement-cost value.
Accordingly, we focus on whether the policy entitles the appellants to receive
replacement-cost value for the unreplaced items.
The applicable policy provisions are as follows:
E. PROPERTY LOSS CONDITIONS
...
5. Loss Payment
In the event of physical loss or physical damage covered
by this policy:
a. At our option we will either:
(1) Pay the value of physically lost or physically
damaged property, as described in paragraph d.
below.
(2) Pay the cost of repairing and replacing the
physically lost or physically damaged property,
plus any reduction in value of repaired items;
-4-
(3) Take all or any part of the property at an agreed or
appraised value;
(4) Repair, rebuild or replace the property with other
property of like kind and quality.
b. We will give notice of our intentions within 30 days
after we receive the sworn statement of loss.
c. We will not pay you more than your financial interest
in the Covered Property.
d. We will determine the value of Covered Property as
follows:
(1) At replacement cost (without deduction for
depreciation), except as provided in (2) through
(7) below.
(a) You may make a claim for physical loss or
physical damage covered by this insurance on
an actual cash value basis instead of on a
replacement cost basis. In the event you
elect to have physical loss or physical
damage settled on an actual cash value basis,
you may still make a claim on a replacement
cost basis if you notify us of your intent to do
so within 180 days after the physical loss or
physical damage.
(b) We will not pay on a replacement cost basis
for any physical loss or physical damage:
(i) Until the physically lost or physically
damaged property is actually repaired or
replaced; and
(ii) Unless the repairs or replacement are
made as soon as reasonably possible
after the physical loss or physical
damage.
-5-
...
(c) We will not pay more for physical loss or
physical damage on a replacement cost basis
than the least of:
(i) The cost to replace, on the same
premises, the physically lost or
physically damaged property with other
property of comparable material and
quality and which is used for the same
purpose; or
(ii) The amount you actually spend that is
necessary to repair or replace the
physically lost or physically damaged
property.
Aplt. App. at A-87 to A-89.
It is not clear from the record which § E.5.a. payment option Hartford
selected. The district court assumed that the tender was made under § E.5.a.(3),
the option to “[t]ake all or any part of the property at an agreed or appraised
value.” We disagree. The parties have stipulated to certain amounts for actual
cash value and replacement-cost value, but they have not agreed on the value of
the property. If they had, they would not now be before this court, each
advocating the adoption of a different value standard. Moreover, the record does
not reflect any appraisal other than Hartford’s own valuation of the actual cash
value of the destroyed property (the appellants did not demand an appraisal).
Thus, we cannot conclude that Hartford acted pursuant to § E.5.a.(3).
-6-
But “we may affirm a district court decision on any grounds for which there
is a record sufficient to permit conclusions of law, even grounds not relied on by
the district court.” Stickley, 505 F.3d at 1076 (quotation omitted). And in
contrast to § E.5.a.(3), § E.5.a.(1) does not require the parties to agree on a value,
but instead allows Hartford to “[p]ay the value of physically lost or physically
damaged property,” under the value-determination provisions set forth in § E.5.d.
Section E.5.a.(1) more accurately reflects Hartford’s conduct in this case.
As the appellants assert, under § E.5.d.(1), the presumptive method of
valuing the destroyed property is replacement cost. But as the district court
recognized, paragraph d.(1) also carries limitations in subparagraphs (1)(b) and
(1)(c), which clearly provide that Hartford is not liable to pay replacement-cost
value unless and until property actually is replaced. Reading § d.(1) without
taking account of subparagraphs (1)(b) and (1)(c) would impermissibly fragment
the policy.
The policy is not ambiguous or internally inconsistent. In light of the clear
language of §§ E.5.d.(1)(b) and (c), a reasonably prudent insured would
understand that Hartford would not pay replacement-cost value unless and until
the property actually was replaced. Cf. Burchett v. Kan. Mut. Ins. Co., 48 P.3d
1290, 1291-92 (Kan. App. 2002) (“The unambiguous terms of the contract require
the insured to actually repair or replace the damaged property before he or she
may collect the full replacement cost. If the insured does not repair or replace the
-7-
damaged property, he or she is only entitled to actual cash value.”). It is
undisputed that the appellants did not replace the bulk of the property for which
they seek reimbursement. Having failed to satisfy the policy’s explicit
requirements for payment of replacement costs, and therefore having made
themselves ineligible to receive payment on that basis for all but four items, the
appellants implicitly elected the “actual cash value” payment option in
§ E.5.d.(1)(a) for the bulk of the property. Hartford is not liable to pay
replacement-cost value for the property the appellants never replaced.
Conclusion
The judgment of the district court is AFFIRMED.
Entered for the Court
Terrence L. O’Brien
Circuit Judge
-8-
