BROWN et al v. STATE FARM INSURANCE COMPANY et al
Filing
57
OPINION. Signed by Chief Judge Jerome B. Simandle on 3/12/2015. (drw)
IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF NEW JERSEY
CHRISTOPHER BROWN, et al.,
HONORABLE JEROME B. SIMANDLE
Plaintiffs,
Civil Action
No. 14-2064 (JBS/JS)
v.
STATE FARM INSURANCE COMPANY,
et al.,
OPINION
Defendants.
APPEARANCES:
Rachel B. Drake, Esq.
80 Main Street, Suite 450
West Orange, NJ 07052
Attorney for Plaintiffs Christopher Brown and Felicia Brown
Charles M. Fisher, Esq.
WINDELS, MARX, LANE & MITTENDORF, LLP
104 Carnegie Center, Suite 201
Princeton, NJ 08540
Attorney for Defendant State Farm Insurance Company
Erin Elizabeth Nulty, Esq.
CLARK & FOX
923 Haddonfield Road, Suite 300
Cherry Hill, NJ 08002
Attorney for Defendant Colonial Claims Corporation
SIMANDLE, Chief Judge:
INTRODUCTION
This matter comes before the Court on motions to dismiss by
Defendant State Farm Insurance Company (“State Farm”) [Docket
Item 23] and Defendant Colonial Claims Corporation (“Colonial”)
[Docket Item 24]. Plaintiffs’ claims in this action, arising
from damage to their home in Monmouth County, New Jersey caused
by Hurricane Sandy, formed the basis of two nearly identical
lawsuits by Plaintiffs against State Farm in the District of New
Jersey. The other, earlier case, originally filed in the
Superior Court of New Jersey, was removed by State Farm and
docketed in the District of New Jersey as Christopher Brown, et
al. v. State Farm Fire and Casualty Company, Civil No. 14-3375,
and assigned to the Honorable William H. Walls in Newark. Having
purportedly been dismissed with prejudice by stipulation between
the parties, the Newark action is now closed.
In the instant motions, State Farm and Colonial each raise
distinct arguments. State Farm contends that Plaintiffs’ claims
must be dismissed based on res judicata, failure to comply with
the contractual limitations period, lack of privity of contract,
and failure to comply with Rule 4(m), Fed. R. Civ. P. regarding
timely service. Colonial seeks dismissal because Plaintiffs’
claims are preempted by federal law.
The motions are decided without oral argument pursuant to
Rule 78, Fed. R. Civ. P. 1
For the reasons discussed below, the Court will grant both
motions to dismiss.
1
Scheduled dates for oral argument were cancelled on multiple
occasions due to the unavailability or illness of Plaintiffs’
counsel for an indefinite period.
2
BACKGROUND
A. Factual background
The Court accepts as true the following facts from
Plaintiffs’ Complaint. [Docket Item 1.] Plaintiffs Christopher
and Felicia Brown own real property located at 227 2nd Street,
Keyport, New Jersey, which was their primary residence at all
relevant times. (Compl. ¶ 20.) Defendant State Farm sold
Plaintiffs a homeowners insurance policy and a flood insurance
policy as part of a comprehensive package of insurance. (Id. ¶
9.) Plaintiffs believe they purchased a flood insurance policy
from State Farm as a third-party “Write Your Own” (“WYO”)
carrier for the Federal Emergency Management Agency (“FEMA”)
under the National Flood Insurance Program (“NFIP”). (Id. ¶¶ 911.) As such, Plaintiffs were the named insureds of a homeowners
insurance policy (No. 30-CV-0372-1) commencing June 29, 2012 and
expiring June 29, 2013 which provided coverage for wind damage.
(Id. ¶ 15.) Plaintiffs also held a flood insurance policy (No.
SF00475324) commencing June 17, 2012 and expiring June 17, 2013.
(Id. ¶ 16.) Defendant Colonial is an insurance adjusting company
that contracted with FEMA and State Farm to assist in processing
insurance claims for damages resulting from Hurricane Sandy.
(Id. ¶ 12.) Defendant CJ Hester Inc. allegedly subcontracted
with Colonial to provide claim adjusting services. (Id. ¶ 24.)
3
On or around October 29, 2012, Hurricane Sandy made
landfall in New Jersey and caused severe damage to Plaintiffs’
property. (Id. ¶ 21.) The damage was caused by multiple
concurrent conditions, including rising flood waters, driving
rain, high force winds, wave action, power failures, and
collisions with unsecured debris. (Id.) On November 19, 2012,
the Borough of Keyport inspected Plaintiffs’ property and
declared it uninhabitable due to health and safety conditions.
(Id. ¶ 23.) On or around January 4, 2013, Plaintiffs submitted a
claim for damages exceeding $200,000. (Id. ¶ 26.) Paul Neier, an
employee of CJ Hester, was assigned to Plaintiffs’ claim. (Id. ¶
25.) However, the claims filed by Neier with the other
defendants only reported damages of $12,034.64. (Id. ¶ 26.) On
or around January 15, 2013, Plaintiffs submitted claims directly
to State Farm for damages caused by rain, wind, tides, and other
concurrent causes, which State Farm denied with the exception of
a $2,900 payment for roof damages. (Id. ¶¶ 27-28.) On or around
April 5, 2013, Plaintiffs received a letter from FEMA denying
that the damages claimed were caused by a covered peril. (Id. ¶
29.) Plaintiffs filed a formal appeal of FEMA’s findings on
April 29, 2013. (Id. ¶ 30.)
Plaintiffs filed supplemental claims with FEMA through Mr.
Neier of CJ Hester. (Id. ¶ 31.) While some of these claims were
denied, others remain unresolved. (Id.) In addition, Plaintiffs
4
have tried to contact Neier regarding outstanding claims, but he
has not responded. (Id. ¶ 32.)
Plaintiffs assert that Defendants have breached their
contractual duties by failing to reimburse Plaintiffs for damage
covered by their insurance policies and demand payment which
they are due under the policies. (Id. ¶ 34.)
The Court also accepts as true the following facts
supported by documents integral to or specifically referred to
in the Complaint. See In re Rockefeller Ctr. Properties, Inc.
Sec. Litig., 184 F.3d 280, 287 (3d Cir. 1999); In re Burlington
Coat Factory Sec. Litig., 114 F.3d 1410, 1426 (3d Cir. 1997).
Plaintiffs’ homeowners policy provides that any suit against
State Farm must commence within one year after the date of loss
or damage:
Suit Against Us. No action shall be brought unless there has
been compliance with the policy provisions. The action must
be started within one year after the date of loss or damage.
(Reid Decl., Ex. A [Docket Item 23-7] at 14.) Regarding the
flood policy, the declarations page of Plaintiffs’ flood
insurance policy makes clear that the policy was issued by FEMA,
not State Farm. (Fisher Decl., Ex. S [Docket Item 23-5.])
B.
Procedural background
On April 1, 2014, Plaintiffs initiated this action by
filing a Complaint in the District of New Jersey against State
Farm, FEMA Administrator William Craig Fugate, FEMA, Colonial,
5
and CJ Hester. 2 [Docket Item 1.] Plaintiffs assert claims for
breach of contract against all defendants under federal common
law. Plaintiffs also assert state law claims against State Farm
for breach of contract and breach of a duty of good faith and
fair dealing, and against Colonial and CJ Hester for breach of
fiduciary duty. On May 22, 2014, this case became subject to the
Hurricane Sandy Case Management Order (“HSCMO”). [Docket Item
5.] Pursuant to the HSCMO, FEMA and William Craig Fugate were
automatically terminated because Plaintiffs alleged that the
flood insurance policy was a Write-Your-Own (“WYO”) policy
issued by State Farm, and the HSCMO provided that FEMA and its
officers or directors are automatically dismissed from any WYO
action, subject to plaintiff’s right to seek to reinstate such
claims within thirty (30) days of the entry of the HSCMO. See
HSCMO ¶ 3(b) [Docket Item 5].
By letter dated August 28, 2014, counsel for State Farm
noted that Plaintiffs maintained two pending lawsuits in the
District of New Jersey asserting the same exact claim against
State Farm. [Docket Item 13.] The other, Civil No. 14-3375,
arose from a complaint filed in the Superior Court of New Jersey
on April 17, 2014, which State Farm timely removed to federal
court. On September 4, 2014, Magistrate Judge Schneider directed
2
Plaintiffs also assert claims against fictitious individual and
corporate defendants.
6
Plaintiffs’ counsel in the instant action, Rachel B. Drake,
Esq., to respond to State Farm’s letter. However, the next day,
September 5, 2014, before the Court received any response from
Ms. Drake, counsel for State Farm filed a stipulation of
dismissal with prejudice in Civ. No. 14-3375 signed by counsel
for State Farm, Charles M. Fisher, Esq. and Antonio J. Smith,
Esq. of Speights & Worrich, LLP. 3 (Civ. No. 14-3375, Docket Item
11.)
On September 15, 2014, Judge Schneider entered a letter
order notifying the parties that all current scheduling
deadlines in Civ. No. 14-2064 remained in place, “even if State
Farm[] files a Motion to Dismiss.” [Docket Item 15.] Ultimately,
Judge Schneider directed Defendants to respond to Plaintiffs’
Complaint by October 21, 2014, if they had not done so already. 4
[Docket Item 22.] On October 21, 2014, State Farm and Colonial
filed their respective motions to dismiss which are currently
before the Court. [Docket Items 23 & 24.] Plaintiffs filed
3
Soon thereafter, on September 9, 2014, Judge Walls entered an
order dismissing Civ. No. 14-3375 without prejudice to re-open
the action within 60 days if the settlement has not been
consummated. (Civ. No. 14-3375, Docket Item 12.)
4 Defendant CJ Hester filed an Answer to Plaintiffs’ Complaint on
May 22, 2014. [Docket Item 4.] By stipulation entered November
18, 2014, Plaintiffs dismissed without prejudice their claims
against CJ Hester. [Docket Item 32.] By stipulation entered
November 21, 2014, all cross-claims asserted by CJ Hester
against State Farm were dismissed without prejudice. [Docket
Item 37.]
7
opposition to each [Docket Items 28 & 29], and Defendants filed
a reply [Docket Items 35 & 36].
Ms. Drake responded to Mr. Fisher’s letter regarding the
two pending cases by letter dated September 11, 2014. Ms. Drake
explained that she only learned about the other action upon
receipt of Mr. Fisher’s August 28, 2014 letter and that
Plaintiffs “neither retained Speights and Worrich nor authorized
them to file a Complaint on their behalf.” Ms. Drake stated that
Shawn Wallach, Esq. at Speights & Worrich failed to return her
calls, but Plaintiffs successfully contacted a paralegal at
Speights & Worrich and directed the firm to cease work on their
file. Ms. Drake clarified that Plaintiffs “intend to pursue all
claims set forth under Civil Action No. 14-2064 (JBS-JS) and are
represented in this action by Rachel B. Drake, Esq. Civil Action
No. 14-3375 (WHW-CLW) was filed by Speights & Worrich, LLP
without the knowledge or authorization of Plaintiffs.” 5
5
On November 17, 2014, Plaintiffs submitted an affidavit signed
by Christopher Brown stating that he “met with agents of
Christopher Fife, Public Adjuster, and signed a retainer on
February 24, 2014.” [Docket Item 31.] However, Mr. Brown
understood Fife to be “a public insurance adjuster” and Fife
never told Mr. Brown that he was working for Speights & Worrich.
Mr. Brown first learned of Speights & Worrich after Ms. Drake
received State Farm’s August 28, 2014 letter. Mr. Brown asserts
that he never spoke or met with Antonio J. Smith, Esq. or Shawn
J. Wallach, Esq., nor did he consent to dismissing claims
against State Farm.
8
Shawn Wallach, Esq. of Speights & Worrich, LLP addressed
their representation of Plaintiffs by letter dated September 12,
2014. Mr. Wallach represented that on or about February 24,
2014, Plaintiffs retained Speights & Worrich, LLP “with regard
to Sandy damage,” and the firm filed suit in state court on or
about April 22, 2014. According to Mr. Wallach, Plaintiffs
directed him to discontinue the case after State Farm filed a
motion to dismiss. Mr. Wallach attached to his letter a retainer
agreement electronically signed by Christopher Brown on February
24, 2012, emails from Mr. Brown enclosing claim documents, and
telephone logs showing calls between the firm and Mr. Brown. 6
STANDARD OF REVIEW
A motion to dismiss under Federal Rule of Civil Procedure
12(b)(6) may be granted only if, accepting all well-pleaded
allegations in the complaint as true and viewing them in the
light most favorable to the plaintiff, a court concludes that
the plaintiff failed to set forth fair notice of what the claim
is and the grounds upon which it rests. Bell Atlantic Corp. v.
Twombly, 550 U.S. 544, 555 (2007). A complaint will survive a
motion to dismiss if it contains sufficient factual matter to
“state a claim to relief that is plausible on its face.”
6
Mr. Wallach also refuted Ms. Drake’s claim that he failed to
return her calls regarding this matter by attaching a separate
telephone call log.
9
Ashcroft v. Iqbal, 556 U.S. 662, 663 (2009). Although a court
must accept as true all factual allegations in a complaint, that
tenet is “inapplicable to legal conclusions,” and “[a] pleading
that offers labels and conclusions or a formulaic recitation of
the elements of a cause of action will not do.” Id. at 678.
DISCUSSION
A.
State Farm’s motion to dismiss
State Farm asserts that Plaintiffs’ claims must be
dismissed based on four arguments: (1) Plaintiffs’ claims are
barred by res judicata; (2) Plaintiffs failed to comply with the
homeowners policy’s one-year suit limitation provision; (3)
State Farm did not issue Plaintiffs’ flood insurance policy and
there is thus no privity of contract between Plaintiffs and
State Farm as to the flood insurance policy; and (4) Plaintiffs
failed to comply with Rule 4(m), Fed. R. Civ. P. regarding
timely service.
Because this matter implicates a standard homeowners
policy, as well as a flood insurance policy purportedly issued
by State Farm under the National Flood Insurance Program
(“NFIP”), the Court begins with some background on the NFIP.
“The NFIP is a federally supervised and guaranteed insurance
program . . . administered by [FEMA] pursuant to the [National
Flood Insurance Act of 1968] and its corresponding regulations.”
Van Holt v. Liberty Mut. Fire Ins. Co., 163 F.3d 161, 165 (3d
10
Cir. 1998); see also C.E.R. 1988, Inc. v. Aetna Cas. & Sur. Co.,
386 F.3d 263, 266 (3d Cir. 2004). “Congress created the program
. . . to limit the damage caused by flood disasters through
prevention and protective measures, spread the risk of flood
damage among many private insurers and the federal government,
and make flood insurance available on reasonable terms and
conditions to those in need of it.” Id. (internal quotation
omitted).
In 1983, FEMA created the “Write Your Own” program under
which “private insurance companies . . . write their own
insurance policies.” Id. Although FEMA may issue Standard Flood
Insurance Policies (“SFIPs”) directly, “more than 90% are
written by WYO companies.” C.E.R. 1988, 386 F.3d at 267.
“[R]egardless whether FEMA or a WYO company issues a flood
insurance policy, the United States treasury funds pay off the
insureds’ claims.” Van Holt, 163 F.3d at 165. WYO companies are
fiscal agents of the United States, but not general agents. Id.
“FEMA fixes the terms and conditions of the flood insurance
policies, which, barring the express written consent of the
Federal Insurance Administrator, must be issued without
alteration as a [SFIP].” Id. at 165-66. Essentially, “the
insurance companies serve as administrators for the federal
program. It is the Government, not the companies, that pays the
claims. And when a claimant sues for payment of a claim, the
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responsibility for defending claims will be upon the Write Your
Own Company and defense costs will be part of the claim expense
allowance reimbursed by the government.” Residences at Bay Point
Condo. Ass’n, Inc. v. Standard Fire Ins. Co., Civ. 13-02380
(FLW), 2013 WL 6252692, at *2 (D.N.J. Dec. 4, 2013) (internal
quotation and alterations omitted).
The Court notes at the outset that, as a matter of law,
Plaintiffs are mistaken as to the nature of their flood
insurance policy. Because it is integral to and specifically
relied upon in Plaintiffs’ Complaint, the Court has considered
the declarations page of a FEMA-issued flood insurance policy
bearing the same policy number as that referenced in Plaintiffs’
Complaint. (Fisher Decl., Ex. S [Docket Item 23-5.]) This
document makes clear that Plaintiffs’ flood insurance policy was
not issued by State Farm as a WYO carrier, but by FEMA. 7
Moreover, it explains why Plaintiffs received a denial letter
directly from FEMA. Because Plaintiffs’ flood insurance policy
was issued by FEMA, not State Farm, and they have failed to show
that State Farm was a party to the contract or a third-party
beneficiary, they must seek relief from FEMA. See Doe v.
Pennsylvania Bd. of Prob. & Parole, 513 F.3d 95, 106 (3d Cir.
7
State Farm notes in their reply brief that during an October 7,
2014 conference call with the Court Plaintiffs’ counsel
acknowledged that FEMA issued the flood policy. (State Farm
Reply [Docket Item 35] at 11.)
12
2008). Based on allegations that State Farm was a WYO carrier
under the NFIA, FEMA was terminated from this action
automatically pursuant to the HSCMO, as explained above, and
Plaintiffs did not move to reinstate claims against FEMA within
the 30-day period provided in the HSCMO. Nevertheless, it is
evident by the Government’s filing of an answer on January 14,
2015 [Docket Item 47] that FEMA is a proper defendant in this
action and the Court will direct the Clerk to reinstate FEMA on
the docket.
The Court next turns to Plaintiffs’ homeowners policy and
finds that Plaintiffs’ claims against State Farm are barred by
the policy’s limitation of suit provision. State Farm’s alleged
denial of Plaintiffs’ claim under their homeowners policy is
integral to Plaintiffs’ breach of contract claim against State
Farm. State Farm has provided a copy of Plaintiffs’ policy, as
well as a denial letter from State Farm dated January 7, 2013.
Plaintiffs’ homeowners policy explicitly states that a suit
against State Farm “must be started within one year after the
date of loss or damage.” (Reid Decl., Ex. A at 14.) There is no
question that a one-year statute of limitations provision in an
insurance contract is enforceable under New Jersey law. See
Gahnney v. State Farm Ins. Co., 56 F. Supp. 2d 491, 495 (D.N.J.
1999).
13
It is well-settled under New Jersey law that the
limitations period begins to run on the date of the casualty,
but it is tolled “from the time an insured gives notice until
liability is formally declined.” Peloso v. Hartford Fire Ins.
Co., 56 N.J. 514, 521 (1970); Solomon Lieberman & Chevra Lomdei
Torah v. Interstate Fire & Cas. Co., 768 F.2d 81, 82 (3d Cir.
1985). State Farm issued a formal denial letter to Plaintiffs
dated January 7, 2013. The letter states the following:
Based upon the results of our discussion, site inspection,
and investigation, it was determined that flood and/or
surface water caused damage to your property. Damage caused
by flood and/or surface water is not covered by your policy.
(Reid Decl., Ex. E [Docket Item 23-11] at 1.) The letter then
quotes the relevant homeowners policy provisions regarding
“losses not insured,” as well as the “Suit Against Us” provision
containing the one-year limitations language.
Even if the limitations period commenced on January 7,
2013, the date of the formal denial letter from State Farm,
irrespective of any tolling, Plaintiffs’ Complaint, filed April
1, 2014, would still be untimely by nearly three months.
Plaintiffs contend that the limitations period remains tolled
because State Farm has not rendered a decision on all claims
previously submitted. However, this argument is belied by the
January 7, 2013 letter unambiguously denying Plaintiffs’
homeowners’ policy claims. Therefore, the plain language of
14
Plaintiffs’ homeowner policy requires dismissal of Plaintiffs’
claims against State Farm. 8
B.
Colonial’s motion to dismiss
Colonial argues that Plaintiffs’ claims against it for
breach of contract and breach of fiduciary duty regarding
Plaintiffs’ flood insurance claims must be dismissed because
they are preempted by federal law. In response, Plaintiffs
contend that Colonial, through their employee, Paul Neier, was
an agent of the NFIP, assigned to process Plaintiffs’ insurance
claims under the terms of Plaintiffs’ flood policy. Neier’s
alleged failure to abide by the terms of the NFIP policy caused
Colonial to breach the contract between Plaintiffs and NFIP. It
appears undisputed, and therefore this Court assumes, that
Colonial was only involved in adjusting claims under the flood
insurance policy.
It is clear that Plaintiffs’ state law claim for breach of
fiduciary duty in a WYO case is preempted by the NFIA. C.E.R.
1988, Inc. v. Aetna Cas. & Sur. Co., 386 F.3d 263, 268 (3d Cir.
2004) (“The reasoning of our decision in [Van Holt v. Liberty
Mut. Fire Ins. Co., 163 F.3d 161 (3d Cir. 1998)] compels the
8
Because the Court finds that Plaintiffs’ claims against State
Farm must be dismissed for lack of privity and failure to comply
with the policy’s limitations period, the Court need not address
State Farm’s arguments regarding res judicata and timely
service.
15
conclusion that state-law claims are preempted by the NFIA.”);
Pepe v. Fid. Nat. Prop. & Cas. Ins. Co., Civ. 11-3746 (JEI),
2011 WL 4916290, at *3 (D.N.J. Oct. 17, 2011) (“[E]xtracontractual and negligence claims are barred against all persons
involved in the claims adjustment process, including the WYO
company.”); Sutor v. F.E.M.A., Civ. 06-1371, 2009 WL 2004375, at
*4 (E.D. Pa. July 9, 2009) (“[T]he NFIA preempts state law
claims that are based on the handling and disposition of SFIP
claims.”).
Moreover, FEMA is the only proper defendant in this action
as to Plaintiffs’ breach of contract claim based on the flood
insurance policy. As discussed above, despite Plaintiffs’
allegations to the contrary, it is apparent that this is not a
case involving a WYO carrier. Instead, FEMA issued the flood
policy directly to Plaintiffs which forms the basis of their
breach of contract claim.
The plain language of the NFIA permits suits against FEMA
upon the improper denial of claims under a SFIP. 9 42 U.S.C. §
9
42 U.S.C. § 4072 provides in pertinent part:
In the event the program is carried out as provided in section
4071 of this title, the Administrator shall be authorized to
adjust and make payment of any claims for proved and approved
losses covered by flood insurance, and upon the disallowance
by the Administrator of any such claim, or upon the refusal
of the claimant to accept the amount allowed upon any such
claim, the claimant, within one year after the date of mailing
of notice of disallowance or partial disallowance by the
Administrator,
may
institute
an
action
against
the
16
4072; Van Holt v. Liberty Mut. Fire Ins. Co., 163 F.3d at 166.
“By contrast, there is no provision in the NFIA or FEMA
regulations that permits policyholders to sue independent
adjusters for claims arising from the handling of SFIPs.” Sutor,
2009 WL 2004375, at *6; see also Pepe, 2011 WL 4916290, at *3.
As the Sutor court observed, this reading of the statutory
language, which does not permit claims against adjusters, is
buttressed by traditional insurance law principles. See 3 Couch
on Ins. § 48:64 (3d ed.) (noting that adjuster’s acts will be
imputed to his or her principal and the actions can be
challenged, and that “an insured cannot maintain an action
against the insurance adjuster for breach of contract or breach
of fiduciary duty” because “[a]n insured is not a third-party
beneficiary to a contract between an insurer and an independent
insurance adjuster hired by the insurer to investigate a loss,
and an insurer’s assignment of the independent adjuster to
adjust the insured's claim does not create a fiduciary
relationship between the insured and the adjuster.”). Plaintiffs
have identified no authority to the contrary. As Plaintiffs’
Administrator on such claim in the United States district
court for the district in which the insured property or the
major part thereof shall have been situated, and original
exclusive jurisdiction is hereby conferred upon such court to
hear and determine such action without regard to the amount
in controversy.
42 U.S.C. § 4072.
17
claims clearly arise from the allegedly improper adjustment of
claims under a SFIP issued by FEMA, the only proper defendant in
this action regarding flood insurance claims is FEMA, and any
breach by the flood-insurance claim adjuster with regard to the
flood insurance claims process is attributable to FEMA.
Therefore, the Court will grant Colonial’s motion to dismiss all
claims against it arising from Plaintiffs’ flood insurance
policy.
CONCLUSION
In light of the foregoing, the Court will grant the motions
to dismiss by both State Farm and Colonial. FEMA shall be
reinstated upon the docket as a defendant and the case for flood
insurance benefits may proceed against FEMA. An accompanying
Order will be entered.
March 12, 2015
Date
s/ Jerome B. Simandle
JEROME B. SIMANDLE
Chief U.S. District Judge
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