Sanchez v. Selective Insurance Company of the Southeast

Filing 28

ORDER Granting 23 Motion for Summary Judgment. Signed by Senior Judge James Lawrence King on 8/12/2015. (jw)

I TH E UNI
N
TED STATES DISTR I T CO UR T
C
FO R TH E SO U TH ERN D I
STR I O F FLO RI
CT
DA
M I M ID I
A
VISI N
O
CASE NO . l CV - 03- NG
4- 239 K1
G LAD Y S SA N CHEZ,

Pl ntf ,
ai i f

SELECTI I SU RANCE COM PAN Y O F
VE N
THE SO UTHEA ST,
Def
endant
.

ORDER GM NTI DEFENDANT' M OTI FOR SUM M ARY JUDGM ENT
NG
S
ON
TH I CA U SE com es bef e t Cour upon Def ndant s M oton f Sum m a y
S
or he
t
e
'
i or
r

J d nt(he i o i n' ( 23 ,sl d J y 9,201 De e a mov s f r s mm a y
u gme t l to ' DE ) e ul
M
)
5. f nd nt e o u r

j gme ton t ba i t a Pli tf tld he Co ant( 1,whih sae a cam f r
ud n
he ss h t an if le r mpli DE ) c tt s li o
br ach of a i ur e contact is
e
n ns anc
r s ued t ough t N atonal Fl
hr
he
i
ood I ur nce Pr am
ns a
ogr

(' FI ',o ti eoft o - e rsaut oflm iai nspr vi e f rb 42 U. C.j407
û P' u sd
N
)
he ne y a t t e i tto o d d o y
S.
2;

4 C. R.j62. 4 a 44 C. R.j 61 App. A) 1,Ar.( 1( . a n ifha f ie
4 F.
22 *; nd
F.
,
( ( ) t V1)R) Pli tf s al d
t rs
o e pond t t M oton,a t tm e t do s haspa e
o he
i nd he i o
o
ss d.
BA CK G RO UN D
Def nda has es abls
e nt
t ihed t f l i 1 Sel tve I ur
he olow ng:
ec i ns ance Com pa of t
ny
he

a a d oo ns r nc lc $
SFl '
)
So t a t (ç lc i ' is e Pli tf a Stnd r Fl d I u a e Po iy (û P'
u he s ç e tve' s u d a n if
se
)
1W her a pary does notr pond t t m ovi pary' a eri ofa pr ry s
e
t
es
o he
ng t s ss ton
ope l uppor e
td

f c,t Co tc nsd r t f c un s ut d. e Fe R.Ci P.56 c ,( ) S. Fl .L.
a t he ur o i e s he a t dip e Se d.
v.
( ) e ; D. a
R. 6.( ) ( )
5 1a , b .

i ur
ns ance polcy t ough t NFI On Oc obe 30,2011,t i ur pr r y suf er
i hr
he
P.
t r
he ns ed ope t
f ed

da a due t toodi The eafer Pl ntf m ade a cl i w ih Sel tve f be is
m ge
o l ng. r t , ai if
am t
ec i or neft

u de t polc ,s e n $1 , 1 47 i c vee d ma e .Afe a j tn Plitf
n r he iy e kig 752 2. n o r d a g s tr dusig anips
cli ,Sel i made a t alpa
am
ectve
ot yment of$43, 80 t Pl ntf,a on J r 24,
555. o ai if nd,
anua y
201 s hera lterdenyi hercl m f t r ni $1 , 67.Pl ntf tld t
2, ent
et
ng
ai or he emai ng 31656.
ai if le he
i t ntl s ton Oct
ns a aw ui
ober21 201
, 4.
LEGA L STAN DA RD

ûl e Co r s algrn s
i-h u t h l a t ummayj dg nti te mova s wsta t r i no
r u me f h
nt ho h t hee s
g n nedipuea t a y maeilfc a t mo nti e tte t j me ta amatr
e ui s t s o n tra a t nd he va s nild o udg n s te
oflw. Fe R.Ci P.56 a .A pa t a s ri t a a f c c nn tbe o i g n n l
a ' d.
'
v.
()
ry s e tng h t a t a o
r s e ui ey
diput m us s
s ed
t uppor he as eri by k tng t pa tcul pa s of m at ral i t
tt
s ton
i i o ri ar rt
ci
e i s n he

r cor i udi de ii ,docum ent sel r caly s or i or aton,af vis or
e d, ncl ng pos tons
s ectoni l t ed nf m i
fda t

d ca ai ns si ulto (ncud n t s ma e f r pu pos s o t moto onl ,
e lr to , tp ai ns i l i g ho e d o r e f he
i n y)
a i i ,i eroga or a wer or ot m at ral ;or s
dm ssons nt r t y ns s
her
ei s
howi t tm a eral cied do
ng ha
t is t
note t bls t abs
s a ih he ence orpr e ofa genui diput ort an a r epary ca
es nce
ne s e, hat dve s
t nnot

p o uc a s i e e d nc t s p r t f c . 1 a 56 c ( ) $n d tr ni whehe
r d e dmisbl vi e e o u po t he a t' d. t ( ) 1 . k e e mi ng t r
'
1

s mmayj dg nti a o it,t fcsa d i ee e fo t fcsae ve d i
u r u me s pprprae he a t n nfrnc s r m he a t r iwe n
t lghtm os f vor bl t t non- ovi pary,a t bur i pl d on t m ovi
he i
t a a e o he
m ng t nd he den s ace
he
ng
pa t t esabls bot t abs
ry o t i h h he ence of a genui m a e i f ct a t i i entted t
ne t ral a nd hat t s il o

jlg n a a matr oflw. Matu hi El c I du .Co.v Ze t Ra o Cor ,47
td me t s
te
a ' s s t e. n s
'
a
. nih di p. 5
U. 5 ,5 - 7( 9 6)
S. 74 86 8 1 8 .

l o sn amoin frs
n ppo ig
to o ummayj g nt t no movig pat ma n tr l
r ud me ,he n- n ry y o ey
2

s el on t pl ngs, but m us s
ol y
he eadi
t how by af vis, de ii , a wer t
ida t
postons ns s o
i erogat i ,a adm i i t ts fc f sexitdem onsr i a genui is f
nt r ores nd
ssons ha pecii act s
tatng
ne s ue or

til Se Fe R. v. 56 c , e ;s ealo Ceo e Ct p.v Catet 4 U . 31 3 ra . e d. Ci P. ( ) ( ) e s l tx l . r t, 77 S. 7, 23
r
2 ( 98 ) Fu t r t e e se e o a i cntla' o e de e i s ppo tof t no
4 1 6 . rhe , h xitnc f i i il' f vi nc n u r
s
he n-

mov n ' po iin i i ufiint tee mus b e de e o whih t j r c ul
a ts sto s ns fce ; h r
t e vi nc n c he uy o d
r s
ea onabl fnd f t non- ovant Ander en v.Li t Lobb I ,477 U . 242,252
y i or he
m
.
s
bery
y, nc.
S.

(98 . ke s ,ac u tne d n tpemi acaet got aj ywhe t i e e e ta
1 6) Li wie o r e o r t s o o ur
n he nfrnc s h t
ar dr w n fom t evi nce,a upon whi t non- ovantr i ,ar i m pl i e.
e a
r he de
nd
ch he
m
eles e û aus bl '
i
'

Matu ht 475U. a 59 9 Mie v Jfe s n Cf Bd.OfEd . 9 F. 7 ,7
s s ia,
S. t 2-4; z . efro /
y
uc, 3 3d 39 43
( 1h Ci,1 96 .
1t r 9 )

Athes mmayj gme sa ,h j g sf ci i n tt t iht e de c
t u r ud nt tge te ud e' un ton s o o û g he vi n e
we
and de e m i t tut oft m a t r butt de e m i w het r t r i a genui i s
t r ne he r h
he te ,
o t r ne
he he e s
ne s ue
f t i .'
or ral'Ande s 477 U . at249.l m a ng t s de er i ton,t Cour m us dec de
r on,
S.
n ki hi t m na i he
t t i
whi h is ar m at i . m at ralf i one t tm i af e t out e oft cas
c s ues e
eral A
e i act s
ha ght f ct he com
he e.
1 1 a 248.lOnl diput over f t t tm i af e t out om e oft s tunder t
6. t
' y s es
ac s ha ght f ct he c
he ui
he

g venig lw wilprpe l p e l et e ty o s
o r n a l o ry r cud he nr f ummayj gme t Fa t ldipue
r ud n . cua s ts
t a e ir eva orunneces a y wilnotbe count '1 The Cour m us alo de e m i
hat r r el nt
sr l
ed.' d.
t t s t r ne
whe he t diput a
t r he s e bouta m at i f cti i
eral a s ndeed ge ne,t i ,ii t e de i
nui hat s çf he vi nce s

s h t ta r a o b ej r c ul r t r ave ditf rt e n movig p ry. 1 ; e ,eg.
uc ha e s na l u y o d eu n r c o h on n a t ' d. s e . ,
'

AfrneCo igso a.l . .UntdSt e , 2F.d 1 ,1 ( 1hCi.1 1.
l f atn fAl , nc v ie ats 93 2 370 375 1 t r 99 )

3

DISCUSSI N
O

The SFI is d t Pl i ife es l sat t a 1lood i ur nc polc esa e
P s ue o a ntf xpr s y t es hat 1 l
ns a e i i r

sb e tt tetr o t Nai a Flo I urn eAc of1 68 4 U. C. 40 , t
u jc o h ems f he ton l o d ns a c t 9 , 2 S. jj 01 e
s q., a t r atons f
e nd he egul i
FR
ound i Til 44 oft Code ofFede alRe atons. 44 C . . .
n te
he
r
gul i l

j61 Ap A( ) A1. . r f r , an ifi b ndno o yby t tr o t poi y
, p. 1 , ' 1 The e o e Pli tf s ou
t
t nl he e ms f he lc ,
bttalo by t t m soft applcabl sat esand r a i .M u olne v M or i 692
l s
he er
he
i e t ut
egul tons ss i .
rs,

F. p 1 6( D. a.1 7 . nd e Sthi polc a alds utsaii fom t
Su p. 30 S. Fl 98 ) I e d,û j s iy nd 1 ip e rsng r he
g
ha i ofa cl m undert polc ar gover d excl vel by t t
ndlng
ny ai
he i y e
ne
usi y
he lood i ur
ns ance

r gu ai nsis e by FEM A, heNai na Fl d I u a eAc of1 68 a a nde ( 2
e l to s u d
t
to l oo ns r nc t 9 , s me d 4

U. C. 40 , ts q. a Fe r l ommo l w. 44C. R.j61 Ap A( ) Ar. X.
S. j 01 e e ) nd de a c
na '
'
F.
, p. l, t I
S cfc ly j407 pr vi e :
pe iial ,
2 o ds
. , .

I t eve t pr a i c red outas pr ded i s cton 4071 of
n he nt he ogr m s ar i
ovi
n e i

t stte t e dr cors l bea h rz d t a j ta ma pa me ofa y
hi il, h ie t ha l ut o ie o d us nd ke y nt n

cl m s f pr
ai
or oved a appr
nd
oved l s c ed by tood i ur e, and
os es over
l
ns anc
upon t dialowanc by t diect ofa s cl m ,orupon t r us
he s l
e
he r or ny uch ai
he ef al
of t cl m a t acce t a ount alow ed upon a s h cl i , t
he ai nt o
pt he m
l
ny uc a m he
cl m a , w ihi one year af er t dat of m aii of notce of
ai nt t n
t
he
e
lng
i
di alow ance or partal di alo ance by t di e or m ay i tt e an
s l
i
s lw
he r ct ,
ns iut
ac i a ns t die oron s h cl m si t U nied St esDi ti tCour
ton gai t he r ct
uc ai n he t
at
sr c
t

frtedsrc i whiht i urdpr pe t o t mao patt rofs l
o h itit n c he ns e o ry r he j r r hee hal
ha be n st td,a o ii le cusv j idito i hee c erd
ve e iuae nd rgna x l ie urs cin s rby onfre
upon s h cour t hea and det r i s h ac i w ihout r r t t
uc
to
r
e m ne uc
ton t
ega d o he
am ounti c r s
n ontover y.

4 U. C. 40 ( mpha i a e . te , C. R.j6 2 0, tt s
2 S. j 72 e
ss dd d) Furh r 44 F.
2.2( sae :
t cl m a w ihi oneyear af er t dat of m aii by t Federal
he ai nt t n
t he
e
lng
he
I uranc A dm i s raton, t
ns
e
nit i
he par i pat ng W rie-Your w n
tci i
t
-o
Com pany,ort s vi ng agentoft notce ofdialow ance or par i
he er ci
he i
s l
tal
di alow ance of t cl m m a pur uant t 42 U . C .4072,i tt e a
s l
he ai
y, s
o
S.
ns iut n
. . .

2The SFI i codii d a 44 C .F. j61 Ap A( )
P s
fe t
R. , p. 1
4

a i on s h cl i aga ns t i ur onl i t U . D iti t Cour f
cton
uc a m
i t he ns er y n he S. src
t or

t dititi whih tei u e p o ryo t mao po tontee s l
he src n c h ns r d r pe t r he j r ri h rof hal
havebee st t w ihoutr r t t am ounti contove s
n iua ed, t
ega d o he
n
r r y.

( l ha i a e ) An t S P is l pr vi s
enp ss dd d . d, he FI tef o de ;
R.Sui A gai tUs
t
ns
Y ou m a not s t r cover m oney unde t s polcy unl s you ha
y
ue o e
r hi
i
es
ve
com pled w ih al t r r m ent of t polc l you do s you m us
i
t l he equie
s he i y. f
ue,
t
s ar t s t w ihi one year afer t dat oft w rt en deni of aI
t t he ui t n
t he
e
he it
al
I
or par oft cl m ,and you m us fl t s ti t Unied St t Di ti
t he ai
t ie he ui n he t
a es srct
Cour oft diti i w hi t c
t he s rct n
ch he over d pr ry w as l t a t tm e
e ope t
oca ed t he i
ofl s.Thi r r e applest any c ai t you m a have unde t s
os
s equiem nt
i o
l m hat
y
r hi
polc and t any diput t tyou m a ha arsng outoft handlng of
iy
o
s e ha
y ve i i
he
i
any cl m undert polcy.
ai
he i

4 C. R. 6l App. A) 1, t( I( ( mpha i a e .
4 F. j ,
( ( ) Ar. VI)R) e
ss dd d)
Pl ntf cl m was deni on J
ai i ps ai
ed
anua y 24,201 and Pl ntf di notfl
r
2,
ai i f d
ie
t s a i untl O c ober 21 201 The pl n l nguage of t SFI and t
hi cton
i t
,
4.
ai a
he
P,
he
a i abl sat es a r atons r r t t s t be tl w ihi one ye of
pplc e t ut nd egul i , equies ha ui
s ed t n
ar
deni .Accor ngl Pl ntf cl m s a e untm el
al
di y, ai ifs ai r
i y.
CO N CLUSI N
O
Ther or , i i O R DER ED , A DJUD G ED , a D ECR EED t t Def ndants
ef e t s
nd
ha
e
'

M o i n f rSumma y J dg e t( 2 b , ndt e s me i, r by GRANTED .
to o
r u m n DE 3) e a h a s he e
D O NE AN D O R DERED i Cham be s at t J e Lawr nce K i Feder
n
r
he am s
e
ng
al

J tce Buidi and Unied St t s Courhouse,i M i i M i iD ade Count Fl i
us i
l ng
t
ae
t
n am , am y, orda,
t s 1 h day ofA ugus ,2015.
hi 2t
t

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t
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r

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J M ES LA W REN CE KI G
N
I
TED STA TES D I
STRI J i G E
CT

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