Court hands down decision in State Farm in homeowner’s fire insurance claim case

Court hands down decision in State Farm in homeowner’s fire insurance claim case | Insurance Business America

Property

Court hands down decision in State Farm in homeowner’s fire insurance claim case

Does a carrier need to explain the severity of deductibles, or subrogate when possible? New court decision explains

Property

By
Matthew Sellars

When Praveen and Jyoti Patel bought their near-6000 square foot house in Delaware’s largest city, they insured the property with State Farm, just like their neighbours did. They paid just under a million dollars for the Malvern Heritage built home in the prestigious Brandywine suburb, close to the border with Pennsylvania.

In late August four years ago disaster struck when a fire at their neighbours’ home spread to their property. When they claimed against State Farm, they expected the carrier to claim against the neighbors to cover their costs, but as State Farm was also insuring the neighbor, the company didn’t. That’s when they called in the lawyers.

Background: The case of Praveen Patel and Jyoti Patel v. State Farm Fire and Casualty Company revolves around a fire incident on August 2, 2020. The Plaintiffs’ house, located at 403 Derby Way, Wilmington, Delaware, sustained significant damage due to a fire originating from a neighboring property at 401 Derby Way. Both properties were insured by State Farm.

At the time of the incident, the Plaintiffs’ property was covered under a State Farm insurance policy that provided dwelling coverage of $1,450,900.00, subject to a 5% deductible amounting to $72,545.00. Following the fire, the Plaintiffs expected State Farm to cover their losses, and also sought subrogation from the insurance policy of the neighbor where the fire originated.

On August 1, 2023, the Plaintiffs filed a complaint against State Farm, alleging breach of the implied covenant of good faith and fair dealing. The Plaintiffs’ claims centered on two main issues: the failure of State Farm to explain the severity of the deductible and the failure to seek subrogation from the neighbor’s insurance policy.

Failure to Explain Deductible Severity: The Plaintiffs argued that State Farm breached the implied covenant of good faith and fair dealing by not adequately explaining the severity of the deductible in the insurance policy. They contended that this omission affected their understanding and expectations of the policy.
Failure to Seek Subrogation: The Plaintiffs also claimed that State Farm acted in bad faith by not pursuing subrogation against the neighboring property owner. Subrogation would have allowed State Farm to recover the costs from the party responsible for the fire. The Plaintiffs believed State Farm’s decision was influenced by its interest in insuring both properties, leading to a conflict of interest and a self-serving decision.

Court’s Analysis and Decision:

Duty to Explain the Deductible:

The court noted that insurance policyholders have a duty to read and understand their policies. The deductible amount of $72,545.00 was clearly stated in the policy.
The court referenced precedent, emphasizing that failing to read a contract does not exempt a party from their obligations under that contract. Given that the deductible was explicitly outlined in the policy, the court ruled that State Farm was not required to provide additional explanations regarding its severity.

2. Subrogation Clause Interpretation:

The insurance policy included a subrogation clause, which allowed State Farm to seek recovery of payments made under the policy from responsible third parties. However, this clause did not obligate State Farm to exercise this right.
The court examined the implied covenant of good faith and fair dealing, which ensures that parties to a contract act in good faith and do not frustrate the purpose of the contract. It concluded that since the contract did not mandate subrogation, State Farm’s decision not to pursue subrogation was not a breach of this covenant.
The court emphasized that the implied covenant cannot be used to impose duties that are not present in the contract. The subrogation terms were clear, and there was no requirement for State Farm to seek subrogation on behalf of the Plaintiffs.

Conclusion: The court granted summary judgment in favor of State Farm, determining that:

State Farm did not breach the implied covenant of good faith and fair dealing by not explaining the deductible, as policyholders are responsible for reading and understanding their insurance contracts.
State Farm’s decision not to pursue subrogation did not constitute a breach of the implied covenant, as the insurance policy did not obligate it to seek subrogation.

This case underscores the importance for brokers to make sure policyholders thoroughly review and understand their insurance policies and it also highlights the limitations of the implied covenant of good faith and fair dealing in imposing duties beyond the explicit terms of a contract.

Related Stories

Keep up with the latest news and events

Join our mailing list, it’s free!