MARGARET M. MORROW, District Judge.
On April 2, 2012, Rozik and Vartan Keshish filed this action against Allstate Insurance Company, alleging claims for breach of contract, breach of the covenant of good faith and fair dealing, elder abuse, violation of the Unruh Civil Rights Act, and violation of California's Unfair Competition Law ("UCL").
This case concerns a homeowners' insurance policy that Allstate issued to plaintiffs.
On November 10, 2009, after evaluating the property, ServiceMaster submitted an independent estimate to Allstate. It placed the damage at $5,322.97, more than $3,000 less than the adjuster's original estimate.
Two months later, plaintiffs retained an independent industrial hygienist to inspect their property and prepare a report regarding the level of smoke damage to the home.
Between July 2010 and January 2012, plaintiffs and Allstate exchanged several letters in an attempt to select appraisers and conduct the appraisal process.
Allstate retained a hygienist in late January 2012. Plaintiffs, however, refused to allow Allstate's hygienist to inspect the property. As a consequence, plaintiffs' was the only hygienist report submitted to the appraisers.
A motion for summary judgment must be granted when "the pleadings, the discovery and disclosure materials on file, and any affidavits show that there is no genuine issue as to any material fact and that the movant is entitled to judgment as a matter of law." FED. R.CIV.PROC. 56. A party seeking summary judgment bears the initial burden of informing the court of the basis for its motion and of identifying those portions of the pleadings and discovery responses that demonstrate the absence of a genuine issue of material fact. See Celotex Corp. v. Catrett, 477 U.S. 317, 323, 106 S.Ct. 2548, 91 L.Ed.2d 265 (1986). Where the moving party will have the burden of proof on an issue at trial, the movant must affirmatively demonstrate that no reasonable trier of fact could find other than for the moving party. On an issue as to which the nonmoving party will have the burden of proof, however, the movant can prevail merely by pointing out that there is an absence of evidence to support the nonmoving party's case. See id. If the moving party meets its initial burden, the nonmoving party must set forth, by affidavit or as otherwise provided in Rule 56, "specific facts showing that there is a genuine issue for trial." Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 250, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986); FED.R.CIV.PROC. 56(e)(2). Evidence presented by the parties at the summary judgment stage must be admissible. FED. R.CIV.PROC. 56(e)(1). In reviewing the record, the court does not make credibility determinations or weigh conflicting evidence. Rather, it draws all inferences in the light most favorable to the nonmoving party. See T.W. Electrical Service, Inc. v. Pacific Electrical Contractors Ass'n, 809 F.2d 626, 630-31 (9th Cir.1987).
California law implies a covenant of good faith and fair dealing in every contract. Carma Developers (Cal.), Inc. v. Marathon Development California, Inc., 2 Cal.4th 342, 371, 6 Cal.Rptr.2d 467, 826 P.2d 710 (1992); see also Chodos v. West Publishing Co., 292 F.3d 992, 996 (9th Cir.2002) (noting that "California law, like the law in most states, provides that a covenant of good faith and fair dealing is an implied term in every contract" (citations omitted)). The covenant is implied "to prevent a contracting party from engaging in conduct which (while not technically transgressing the express covenant) frustrates the other party's rights [to] the benefits of the contract." Marsu B.V. v. Walt Disney Co., 185 F.3d 932, 938 (9th Cir.1999) (citing Los Angeles Equestrian Ctr., Inc. v. City of Los Angeles, 17 Cal.App.4th 432, 447, 21 Cal.Rptr.2d 313 (1993)). This principle applies to insurance policies just as it does to other types of contracts. Kransco v. Am. Empire Surplus Lines Ins. Co., 23 Cal.4th 390, 400, 97 Cal.Rptr.2d 151, 2 P.3d 1 (2000). "In order to establish a breach of the implied covenant of good faith and fair dealing under California law, a plaintiff must show: (1) [that] benefits due under the policy were withheld; and (2) [that] the reason for withholding benefits was unreasonable or without proper cause." Guebara v. Allstate Ins. Co., 237 F.3d 987, 992 (9th Cir.2001) (citing Love v. Fire Ins.
"The implied covenant of good faith and fair dealing acts as a `supplement to express contractual covenants, to prevent a contracting party from engaging in conduct that frustrates the other party's rights to the benefits of the agreement.'" Moncada v. Allstate Ins. Co., 471 F.Supp.2d 987, 996 (N.D.Cal.2006) (quoting Waller v. Truck Ins. Exchange, Inc., 11 Cal.4th 1, 44, 44 Cal.Rptr.2d 370, 900 P.2d 619 (1995)). There can be a breach of the covenant even if the express terms of the contract are not breached. See Schwartz v. State Farm Fire and Cas. Co., 88 Cal.App.4th 1329, 1339, 106 Cal.Rptr.2d 523 (2001) ("It is well-established that a breach of the implied covenant of good faith is a breach of the contract ... and that breach of a specific provision of the contract is not a necessary prerequisite to a claim for breach of the implied covenant of good faith and fair dealing"). Nonetheless, a necessary prerequisite to such a claim is a showing that benefits due under the policy were withheld unreasonably or without proper cause. Moreover, "[i]t is universally recognized [that] the scope of conduct prohibited by the covenant of good faith is circumscribed by the purposes and express terms of the contract." Carma Developers, 2 Cal.4th at 373, 6 Cal.Rptr.2d 467, 826 P.2d 710.
Allstate advances three arguments as to why it is entitled to summary judgment: (1) there was a genuine dispute concerning the value of plaintiffs' insurance claim; (2) plaintiffs concealed the existence of the hygienist's report; and (3) plaintiffs refused to allow Allstate's hygienist access to the property.
It is well established that "an insurer does not act in bad faith so long as a `genuine dispute' exists over an insured's coverage." Maynard v. State Farm Mut. Auto. Ins. Co., 499 F.Supp.2d 1154, 1160 (C.D.Cal.2007) (citing Rappaport-Scott v. Interinsurance Exchange of Auto. Club, 146 Cal.App.4th 831, 837, 53 Cal.Rptr.3d 245 (2007)). A genuine dispute exists only where "the insurer's position is maintained in good faith and on reasonable grounds." Wilson v. 21st Century Ins. Co., 42 Cal.4th 713, 723, 68 Cal.Rptr.3d 746, 171 P.3d 1082 (2007). "The genuine issue rule in the context of bad faith claims allows a district court to grant summary judgment when it is undisputed or indisputable that the basis for the insurer's denial of benefits was reasonable — for example, where even under the plaintiff's version of the facts there is a genuine issue as to the insurer's liability under California law." Amadeo v. Principal Mut. Life Ins. Co., 290 F.3d 1152, 1161 (9th Cir.2002); see also Lunsford v. Am. Guar. & Liab. Ins. Co., 18 F.3d 653, 656 (9th Cir.1994) ("[A] court can conclude as a matter of law that an insurer's denial of a claim is not unreasonable, so long as there existed a genuine issue as to the insurer's liability").
An insurer may demonstrate the existence of a genuine dispute by showing that "it relied on opinions from experts while evaluating the insured's claim." Maynard, 499 F.Supp.2d at 1160 (citing Fraley v. Allstate Ins. Co., 81 Cal.App.4th 1282, 1292, 97 Cal.Rptr.2d 386 (2000) ("The `genuine dispute' doctrine may be applied where the insurer denies a claim based on the opinions of experts")). A genuine dispute can also exist if "an arbitrator awards substantially lower damages than Plaintiff claims." Id. (citing Rappaport-Scott, 146 Cal.App.4th at 839, 53 Cal.Rptr.3d 245 ("[T]he vast difference between the $346,732.34 in losses claimed by Rappaport-Scott and the $63,000 in
In deciding whether there was a genuine dispute, "the court does not decide which party is `right' as to the disputed matter, but only that a reasonable and legitimate dispute actually existed." Chateau Chamberay Homeowners Ass'n v. Associated Intern. Ins. Co., 90 Cal.App.4th 335, 348, 108 Cal.Rptr.2d 776 (2001). "[T]he reasonableness of the insurer's decisions and actions must be evaluated as of the time that they were made; the evaluation cannot fairly be made in the light of subsequent events that may provide evidence of the insurer's errors." Id. at 347, 108 Cal.Rptr.2d 776.
The gravamen of plaintiffs' claim is that Allstate failed to conduct a good faith review of their property damage claim.
It is undisputed that, after plaintiffs objected to Allstate's original estimate, the insurer retained ServiceMaster to conduct
The facts here, in fact, are strikingly similar to those in Fraley. There, Allstate hired independent contractors to estimate the damage to an insured's property. 81 Cal.App.4th at 1292, 97 Cal.Rptr.2d 386. The contractors submitted estimates of approximately $110,000. Id. Plaintiffs' contractor, by contrast, estimated that repairs would cost approximately $230,000. Id. After evaluating the estimates, Allstate determined that the minimum repair cost was $199,000, and promptly paid plaintiffs that amount. Id. at 1293, 97 Cal.Rptr.2d 386. Plaintiffs sued Allstate for bad faith, seeking to recover the difference between their estimate and the amount paid. The court granted Allstate's motion for summary judgment, finding that a genuine dispute existed at the time plaintiffs submitted their claim; this genuine dispute, the court held, precluded a finding that Allstate had acted in bad faith. It noted:
Here, Allstate and plaintiffs each retained an independent expert to evaluate the damage to plaintiffs' home; each expert arrived at a different estimate. Allstate promptly paid plaintiffs $7,582.09, the undisputed amount of plaintiffs' claim. Allstate also honored plaintiffs' request that it engage in the appraisal process, and paid the appraisal award to plaintiffs soon after it was rendered. The fact that plaintiffs' expert estimated the loss at approximately ten times the amount Allstate's adjuster and expert did is insufficient, by itself, to raise triable issues concerning bad faith. See Guebara, 237 F.3d at 993 ("Where the parties rely on expert opinions, even a substantial disparity in estimates for the scope and cost of repairs does not, by itself, suggest the insurer acted in bad faith," citing Fraley, 81 Cal.App.4th at 1292, 97 Cal.Rptr.2d 386).
Ultimately, "a single, thorough report by an independent expert is sufficient, all other things being equal, to support application of the `genuine dispute' doctrine." Adams, 187 F.Supp.2d at 1215. It is undisputed that ServiceMaster independently examined plaintiffs' property, and provided an estimate significantly below that of plaintiffs' contractors. Plaintiffs have not raised triable issues of fact regarding the reasonableness of Allstate's reliance on the ServiceMaster estimate in denying their request for additional compensation. Accordingly, the undisputed evidence shows that there was a legitimate, genuine dispute regarding the amount Allstate owed under the policy. This precludes a finding of bad faith.
Allstate also argues that the $38,829.45 difference between plaintiffs' damage estimate and the appraisal award demonstrates, as a matter of law, that there was a genuine dispute concerning the amount of insurance proceeds owed. As authority, it cites Rappaport-Scott, 146 Cal.App.4th at 833-35, 53 Cal.Rptr.3d 245. In Rappaport-Scott, the court determined that a substantial difference between the amount of loss a plaintiff claims and the amount of loss ultimately found by an arbitrator can conclusively determine that a genuine dispute existed. Id. at 839, 53 Cal.Rptr.3d 245 ("[T]he vast difference between the $346,732.34 in losses claimed by Rappaport-Scott and the $63,000 in actual losses as determined by the arbitrator demonstrates, as a matter of law, that a genuine dispute existed as to the amount payable on the claim" (emphasis original)).
This rule has been applied in a handful of cases since Rappaport-Scott. In most, as in Rappaport-Scott, the difference between the plaintiff's damage estimate and the amount of loss an arbitrator found was substantial, often in the hundreds of thousands of dollars. See, e.g., Maynard, 499 F.Supp.2d at 1162 ("Plaintiff's recovery in the arbitration was an astonishing $414,000 less than what he requested, the difference between $500,000 in claimed damages and $86,000 in damages as determined by the arbitrator"); Holland, 2007 WL 1456045 at *4 (finding that a genuine dispute existed as a matter of law because "[t]he $19,000 liability the arbitrator attributed to Westport was significantly less than the $1 million Holland demanded"). At least one court, however, has held that even a small difference between plaintiffs' estimate and an appraisal award suffices to show the existence of a genuine dispute. In Behnke v. State Farm General Ins. Co., 196 Cal.App.4th 1443, 1470, 127 Cal.Rptr.3d 372 (2011), the court concluded that an arbitrator's award that was $16,000 less than plaintiff's demand was sufficient to defeat a claim that the insurer had acted in bad faith. The court concluded:
Here, the difference between plaintiffs' estimate and the amount of loss found by the appraisal panel is greater than the difference in Behnke, but substantially smaller than that in Rappaport-Scott, Maynard, or Holland. The fact that the arbitration award was approximately 47 per cent lower than plaintiffs' demand is compelling evidence that Allstate had a reasonable basis for believing plaintiffs' loss estimate was too high. This is particularly true here because, unlike Allstate, the appraisal panel had the benefit of reviewing plaintiffs' hygienist report when
Plaintiffs cite Brehm v. 21st Century Ins. Co., 166 Cal.App.4th 1225, 83 Cal.Rptr.3d 410 (2008), as authority for the proposition that the discrepancy between their estimate and the appraisal panel's finding is insufficient to demonstrate a lack of bad faith as a matter of law.
Ultimately, the fact that the appraisers determined plaintiffs' loss was roughly half of the damages they claimed, viewed in light of Allstate's reliance on the independent investigation performed by ServiceMaster, strengthens the court's earlier conclusion that the uncontroverted evidence shows there was a genuine dispute regarding Allstate's payment obligation. The court is hesitant, however, to conclude that the discrepancy here is sufficiently substantial, by itself, to apply a per se rule mandating the entry of summary judgment in Allstate's favor. A plaintiff who only moderately overvalues his loss, in good faith, should not be precluded from adducing other evidence that an insurer acted in bad faith simply because an appraisal panel ultimately awards less than he sought. While a significant difference between an insured's claim and an appraisal might render it unnecessary to evaluate the insurer's conduct in investigating a claim as a matter of law, an insurer who otherwise acted in bad faith should not be insulated from liability simply because the plaintiff's estimate of loss was slightly higher than the arbitrator's ultimate award. The court can conceive of scenarios in which an insurer denies a claim in bad faith, but an appraisal panel award plaintiff less than the amount of his demand. In such an instance, a small discrepancy between plaintiffs' demand and the arbitrator's award should not defeat plaintiff's claim as a matter of law.
Finally, even if the court concluded as a matter of law that there was not a genuine dispute regarding Allstate's obligations, undisputed evidence in the record demonstrates that there are no triable issues of fact concerning the thoroughness of Allstate's investigation. See, e.g., Shade Foods, Inc. v. Innovative Products Sales & Marketing, Inc., 78 Cal.App.4th 847, 879-80, 93 Cal.Rptr.2d 364 (2000) ("Among the most critical factors bearing on the insurer's good faith is the adequacy of its investigation of the claim. `[T]he covenant of good faith and fair dealing implied in all insurance agreements entails a duty to investigate properly submitted claims'").
Masters provides few, if any, details to support his opinion that Allstate failed to negotiate in good faith. Beyond noting that the adjuster declined to have a face to face meeting with plaintiffs and
Absent factual support, Masters' conclusion that Allstate "fail[ed] to try in good faith to reach an agreed scope of damages" because it did not meet with plaintiffs or their contractor is too conclusory to raise triable issues of fact and defeat summary judgment.
Finally, Masters' opinion that Allstate acted in bad faith by failing to agree to a scope of damages with plaintiffs is fundamentally inconsistent with case law. The genuine dispute doctrine is built around the notion that an insurer need not agree with plaintiffs on the scope of coverage or damages before it can be found to have acted in good faith. Rather, it will be considered to have acted in good faith as long as it has reasonable grounds for disagreeing with the insured. An insurer need not acquiesce in an insured's claim for coverage, because "[w]hile an insurer must give as much consideration to the interests of its insured as it does to its own, it is not required to disregard the interests of its shareholders and other policyholders when evaluating claims." Love v. Fire Ins. Exchange, 221 Cal.App.3d 1136, 1148-49, 271 Cal.Rptr. 246 (1990); see also Chateau Chamberay, 90 Cal. App.4th at 347, 108 Cal.Rptr.2d 776 ("[A]n insurer is entitled to give its own interests consideration when evaluating the merits of an insured's claim").
This is not a case in which Allstate took no action in the face of its insureds' dispute with its evaluation of the property damage claim. Rather, Allstate hired ServiceMaster to conduct an independent evaluation so that it could determine whether to revise its initial coverage decision. In Masters' parlance, Allstate took this step in an effort to determine the proper scope of damages. While Allstate's ultimate conclusion differed from plaintiffs', that is not evidence of bad faith.
Plaintiffs also assert that Allstate should be estopped from arguing that it conducted a thorough investigation because it sought to have an industrial hygienist conduct a follow-up evaluation at the property.
"Courts uniformly recognize that the purpose of the judicial estoppel doctrine is to protect the integrity of the judicial process by prohibiting parties from changing positions as circumstances warrant." Milton H. Greene Archives, Inc. v. CMG Worldwide, Inc., 568 F.Supp.2d 1152, 1160 (C.D.Cal.2008). The doctrine applies when "(1) the same party has taken two positions; (2) the positions were taken in judicial or quasi-judicial administrative proceedings; (3) the party was successful in asserting the first position (i.e., the tribunal adopted the position or accepted it as true); (4) the two positions
The court is also skeptical that Allstate's positions are wholly inconsistent. The Ninth Circuit has adopted a liberal approach in interpreting this element of judicial estoppel, reflecting its preference that claims be litigated on their merits. See Admiral Ins. Co. v. Rushmore, 70 F.3d 1277, 1995 WL 693335, *3 (9th Cir.1995) (Unpub. Disp.) (Noting that "in most cases, [the Ninth Circuit] has declined to preclude the litigants' allegedly inconsistent claims," citing United States v. Garcia, 37 F.3d 1359, 1366-67 (9th Cir.1994)). Allstate's argument that it was prejudiced by the fact that plaintiffs unilaterally submitted a hygienist's report to the appraisal panel and denied Allstate's hygienist access to their property is not inconsistent with an argument that it conducted a thorough investigation. Allstate merely asserts that plaintiffs' retention of a hygienist, whose report they did not share with Allstate, and their refusal to permit Allstate's hygienist to visit the property, gave plaintiffs an advantage in the appraisal. Arguing that it was prejudiced by such conduct is not inconsistent with an assertion that Allstate thoroughly investigated plaintiffs' claim.
Moreover, to the extent plaintiffs contend that Allstate's failure to retain a hygienist at the outset is evidence of bad faith, the court disagrees. Plaintiffs proffer no evidence that an insurer conducting a reasonable, good faith investigation would necessarily have understood that evaluation by a hygienist was required. They fail, for example, to adduce a hygienist's or contractor's opinion that the need for a hygienist was obvious or that such a professional must be hired in every case where a structure has suffered smoke damage. Plaintiffs' expert, Masters, provides no opinion on this subject; he fails even to mention the fact that Allstate did not retain a hygienist. Plaintiffs' hygienist, moreover, testified that there is no industry standard or requirement that an insurer must retain an industrial hygienist when remediating smoke damage.
The fact that Allstate subsequently sought to have a hygienist review the property does not demonstrate that Allstate knew its initial review was not thorough. It simply shows that once Allstate learned plaintiffs had retained a hygienist and submitted her report to the appraisal panel, it sought to protect its interests by having a comparable report prepared. As noted, an insurer is entitled to protect its own legitimate interests when investigating claims. Chateau Chamberay, 90 Cal. App.4th at 347, 108 Cal.Rptr.2d 776 ("[A]n insurer is entitled to give its own interests consideration when evaluating the merits of an insured's claim"). Absent evidence that a hygienist should have been retained before Allstate closed its filed, the fact that it felt it advisable to obtain a hygienist's report for purposes of the appraisal does not raise triable issues of fact as to whether its investigation prior to that time was inadequate and undertaken in bad faith.
In short, plaintiffs have failed to adduce evidence that raises triable issues as to whether Allstate investigated their claim in bad faith.
In conclusion, Allstate's motion for summary judgment is granted.
On April 22, 2013, the court entered an order granting defendant's motion for summary judgment. Accordingly,
IT IS ORDERED AND ADJUDGED
1. That plaintiffs take nothing by way of their complaint; and
2. That the action be, and it hereby is, dismissed.