Scioneaux et al v. Allstate Insurance Company
Filing
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ORDER AND REASONS denying 22 Motion for Summary Judgment. Signed by Judge Stanwood R. Duval, Jr on 8/27/2014. (swd)
UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF LOUISIANA
ALVIN SCIONEAUX, ET AL.
CIVIL ACTION
VERSUS
NO. 13-6257
ALLSTATE INS. CO.
SECTION “K”(4)
ORDER AND REASONS
Before the Court is a Motion for Summary Judgment (Doc. 22) filed by defendant
Allstate Insurance Company ("Allstate"). Plaintiffs, Alvin J. Scioneaux and Yevette Ann
Scioneaux filed suit against Allstate in its capacity as a Write-Your-Own ("WYO") program
carrier participant in the National Flood Insurance Program ("NFIP"). Under the provisions of
the Standard Flood Insurance Policy ("SFIP"), specifically Article VI(J)(4)(f), plaintiffs were
required as a prerequisite to filing suit to submit a signed, sworn proof of loss with supporting
documentation. Allstate maintains that plaintiffs failed to submit the requisite documentation
and as such is entitled to summary judgment. Having reviewed the memoranda, exhibits and the
relevant law, the Court finds that there are material questions of fact which preclude the granting
of this motion.
Standard for Motion for Summary Judgment
Rule 56(a) of the Federal Rules of Civil Procedure provides that summary judgment
should be granted "if the movant shows that there is no genuine dispute as to any material fact
and the movant is entitled to judgment as a matter of law." The party moving for summary
judgment bears the initial responsibility of informing the district court of the basis for its motion,
and identifying those portions of the record "which it believes demonstrate the absence of a
genuine issue of material fact." Stults v. Conoco, 76 F.3d 651 (5th Cir.1996), citing Skotak v.
Tenneco Resins, Inc., 953 F.2d 909, 912-13 (5th Cir.), quoting Celotex Corp. v. Catrett, 477
U.S. 317, 323, 106 S.Ct. 2548, 2552-53, 91 L.Ed.2d 265 (1986). When the moving party has
carried its burden under Rule 56, its opponent must do more than simply show that there is some
metaphysical doubt as to the material facts. The nonmoving party must come forward with
"specific facts showing that there is a genuine issue for trial." Matsushita Elec. Industrial Co. v.
Zenith Radio Corp., 475 U.S. 574, 588, 106 S.Ct. 1348, 1356, 89 L.Ed.2d 538 (1986); Tubacex,
Inc. v. M/V Risan, 45 F.3d 951, 954 (5th Cir.1995).
“A genuine issue of material fact exists ‘if the evidence is such that a reasonable jury
could return a verdict for the nonmoving party.’ ” Pylant v. Hartford Life and Accident
Insurance Company, 497 F.3d 536, 538 (5th Cir. 2007) quoting Anderson v. Liberty Lobby, Inc.,
477 U.S. 242, 248, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986). Summary judgment evidence must
be “viewed in the light most favorable to the nonmovant, with all factual inferences made in the
nonmovant’s favor.” Bazan ex rel Bazan v. Hildago County, 246 F.3d 481, 489 (5th Cir. 2001),
citing Anderson v. Liberty Lobby, Inc., 477 U.S. at 255, 106 S.Ct. at 2513.
[C]onclusory statements, speculation, and unsubstantiated assertions cannot
defeat a motion for summary judgment. The Court has no duty to search the
record for material fact issues. Rather, the party opposing the summary judgment
is required to identify specific evidence in the record and to articulate precisely
how this evidence supports his claim.
RSR Corporation v. International Insurance Company, 612 F.3rd 851,857 (5th Cir. 2010).
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Analysis
It is uncontested that Allstate issued a SFIP to the plaintiffs for property located at 616
Monticello Court, La Place Louisiana ("property") with effective dates of February 27, 2012 to
February 27, 2013 and with Coverage A (building policy limits of $109,6000 and Coverage B
(personal property policy limits of $14,800.00), each subject to a $1000.00 deductible. On
August 29, 2012, Hurricane Isaac caused damage by or from flood to the insured property.
Plaintiffs submitted a claim to Allstate for these damages on August 29, 2012. On or about
October 23, 2012, plaintiffs submitted by way of a their public adjuster Michael Michio, a signed
proof of loss form in the amount of $127,400.33. (Rec. Doc. 22-1, Uncontested Facts, ¶¶ 1-4
and Rec. Doc. 24-8, Plaintiff's (sic) Statement of Disputed Material Facts, ¶¶ 1-4 noted as
"uncontested.")
Allstate contends that this signed proof of loss submitted did not contain supporting
documentation. It maintains that it sent a letter on November 8, 2012 to Mr. Michio verifying
receipt of the proof of loss, and rejecting the October 23, 2012 proof of loss for lack of
supporting documentation.
A review of the letter provides the following language:
We are in receipt of the Proof of Loss sent to us by you dated October 23,
2012, and we thank you for same. We must reject the Proof of Loss submitted
due to failure to produce supporting documentation, i.e., the estimate does not
support the amount of the Proof of Loss you submitted.
The letter then makes reference to Article VII, Section J, paragraph 4f which requires
"specifications of damaged buildings and detailed raper estimates." (Rec. Doc. 22-5). This letter
was issued by the Claims Department, Allstate Insurance Company, Gulf Coast Flood MCO and
was not signed by any individual.
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To support its motion, Allstate filed the affidavit of Jason Raske who is the Flood Field
Manager for Allstate Insurance. (Rec. Doc. 22-3) In this affidavit, Mr. Raske claims that
"Allstate did not receive any supporting documentation for Plaintiff's October 23, 2012 building
damages proof of loss form, despite requesting such documentation, prior to Plaintiffs filed (sic)
their lawsuit on or around October 25, 2013." (Rec. Doc. 22-3, ¶14).
Plaintiffs vehemently dispute this contention. They filed the affidavit of Mr. Michio, the
aforementioned public adjuster. He avers unequivocally:
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"On or about October 6, 2012, [his company] finalized a detailed and
itemized estimate of the flood-related damage to Mr. and Mrs. Scioneaux's home,
which it then submitted to Allstate. The estimate provides (1) the materials
required to fully repair the home; (2) the specific work required for such repairs;
(3) the cost of the materials and work; (4) the quantity of the materials; (5) the
total calculation of loss, including service charges, overhead costs, and profit; and
(6) photographs of the property. A true and correct copy of the estimate is
attached hereto as Exhibit B.
5.
Based on this estimate, ProClaim prepared a proof of loss form claiming
$127,400.33, which Mr. Scioneaux signed on October 23, 2012, and which
ProClaim submitted to Allstate. This proof of loss form provided the full amount
of damages that Mr. and Mrs. Scioneaux incurred. . . .
6.
In a letter dated November 8, 2012, Allstate acknowledged receipt of both
the proof of loss form dated October 23, 2012, and the estimate prepared by
ProClaim. The letter states: "We are in receipt of the Proof of Loss sent to us by
you dated October 23, 2012, and we thank you for same. We must reject the
Proof of Loss submitted due to failure to produce supporting documentation, i.e.,
the estimate does not support the amount of the Proof of Loss you
submitted." Because Allstate acknowledged receipt of the estimate, I did not resubmit the estimate. . . .
(Rec. Doc. 24-1 at 2 of 3, Affidavit of Michio) (emphasis added). Indeed, a review of Exhibit B
to Mr. Michio's affidavit appears to be an extremely detailed estimate as is required.
Allstate's sole basis for this motion is that plaintiffs failed to file the necessary supporting
documentation as required under the SFIP language Article VII(J)(4). Clearly, plaintiffs have
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presented documentary and testamentary evidence to the contrary. Thus, there are material
questions of fact which preclude summary judgment. Accordingly,
IT IS ORDERED that a Motion for Summary Judgment (Doc. 22) filed by defendant
Allstate Insurance Company ("Allstate") is DENIED.
New Orleans, Louisiana, this 27th day of August, 2014.
STANWOOD R. DUVAL, JR.
UNITED STATES DISTRICT COURT JUDGE
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