Are carriers’ "statute of limitations" clauses enforceable?
Are carriers’ “statute of limitations” clauses enforceable? | Insurance Business America
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Are carriers’ “statute of limitations” clauses enforceable?
Renter sues over two-year claim limit after fire, claims term limit clause was ‘inconspicuous’
Insurance News
By
Matthew Sellers
Carriers often will limit the time available under which a policyholder can make a claim. That time period, however, can conflict with the national or state-mandated time period.
In this case, an insured had their claim refused for a number of reasons (not least of which was the fact they did not appear to be living in the relevant property at the time) but the legal issue arose – was the American Bankers Insurance two-year limitation clause enforceable?
Background
The case of Arelis Gutierrez v. American Bankers Insurance Company of Florida centers on a dispute over coverage under a renter’s insurance policy. Arelis Gutierrez filed a complaint against the insurance company, alleging breach of contract after her claim for property loss was denied. The denial was based on the insurer’s assertion that the claim was not filed within the policy’s specified two-year statute of limitations period. The key issues revolved around the enforceability of this limitations period and whether it was adequately communicated to the policyholder.
Facts of the Case
In 2019, Arelis Gutierrez purchased a renter’s insurance policy from American Bankers Insurance Company of Florida, effective from Oct. 30, 2019. The policy provided coverage for personal property and loss of use of the property for one year. Under the policy, a mandatory amendatory endorsement for New Jersey extended the time to bring an action to two years from the date the loss was discovered.
On Jan. 17, 2020, a fire destroyed the insured property. Gutierrez promptly filed a claim on Jan. 21, 2020. However, the insurance company denied her claim on May 8, 2020, citing several reasons, including allegations that she was not a resident of the property at the time of the fire and that the individuals occupying the property were not listed as insureds under the policy. The denial was also based on the policy’s concealment or fraud provision.
Gutierrez filed a lawsuit on Feb. 7, 2023, alleging breach of contract and other claims, arguing that she had not waived the six-year statute of limitations, and that there was no mutual assent to shorten the limitations period. She also claimed she did not timely receive her insurance policy, and that even if she had, the shortened limitations period was not conspicuous enough to be enforceable.
Legal Issues
Exclusive Remedy Provision: The primary legal issue was whether the two-year statute of limitations specified in the insurance policy was enforceable and whether Gutierrez was adequately informed of this provision.
Mutual Assent and Conspicuousness: Gutierrez argued that there was no mutual assent to the shortened statute of limitations and that the clause was inconspicuous within the policy document, thus should not be enforceable.
Equitable Estoppel: Gutierrez also claimed that American Bankers Insurance Company should be estopped from enforcing the shortened statute of limitations due to alleged breaches of the insurance policy by the company.
Court’s Analysis and Decision
Duty to Read and Understand the Policy:
The court emphasized that policyholders are expected to read and understand their insurance policies. The two-year statute of limitations was explicitly stated in the policy issued in October 2019 saying that the language was “abundantly clear and unmistakable, and is under no misleading headings.”
The court referred to established precedent that failure to read a contract does not relieve a party from the obligations imposed by the contract. Since the limitations period was clearly stated, Gutierrez was deemed to have had notice of the provision.
Statutory and Contractual Limitations:
The court cited previous rulings, noting that under New Jersey law, while there is a six-year statute of limitations for insurance contract claims, this period can be shortened by the terms of the insurance contract itself.
The court found the limitations clause to be valid and enforceable, as it was clearly outlined in the policy. The court rejected Gutierrez’s argument that the clause was buried in the policy, stating that the language was clear and unmistakable.
Equitable Estoppel:
The court determined that Gutierrez did not present sufficient evidence to support claims of promissory or equitable estoppel. There was no evidence she requested the policy and was denied access to it by the insurer.
The court concluded that the allegations of fraud and concealment did not negate the enforceability of the contractual limitations period.
Conclusion
The court backed up the trial court’s decision to grant summary judgment in favor of American Bankers Insurance Company, holding that Gutierrez’s lawsuit was barred by the two-year statute of limitations stipulated in the insurance policy. The ruling reinforces the principle that policyholders are responsible for reading and understanding their insurance contracts, and that clearly stated contractual limitations are enforceable. For the insurance industry, this case highlights the importance of clear policy language and the need for insurers to ensure that policyholders are adequately informed of significant provisions, such as limitations periods.
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