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IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW MEXICO KENNETH LINCOLN Plaintiff, v. CV 18-652 MV/LF STATE FARM FIRE AND CASUALTY INSURANCE CO., Defendant. MEMORANDUM OPINION AND ORDER THIS MATTER comes before the Court on Defendant State Farmâs Motion for Summary Judgment on Claims of Violations of the Unfair Insurance Practices Act, §59A-16-20 NMSA 1997 (âMSJ on UIPA Claimâ) [Doc. 78], Defendant State Farmâs Motion for Summary Judgment on Claims of Bad Faith (âMSJ on Bad Faith Claimâ) [Doc. 79], and Plaintiffâs Motion to Strike Exhibits to Motion for Summary Judgment (âMotion to Strikeâ) [Doc. 83]. The Court, having considered the motions, briefs, and relevant law, and being otherwise fully informed, finds that the MSJ on UIPA Claim and MSJ on Bad Faith Claim are well-taken and will be granted and the Motion to Strike will be found as moot. BACKGROUND The undisputed facts material to the instant motions are as follows.1 On February 6, 2016, Plaintiff Kenneth Lincolnâs home in Santa Fe, New Mexico was damaged as a result of a house fire. Doc. 1-2 ¶2. At the time of the fire, Plaintiff carried a homeowner insurance 1 The Court has not included extraneous detail, party arguments, and âfactsâ presented with no evidentiary support in the record. 1 policy (the âPolicyâ) with Defendant State Farm Fire and Casualty Insurance Company (âState Farmâ). Id. ¶ 3. The coverage limit for Plaintiffâs dwelling was $533,644. Under the terms of the Policy, Plaintiff had certain âdutiesâ that obtained after âa lossâ to which the Policy applied, including providing Defendant, âas often as [it] âreasonably require[d],â any requested ârecords and documents, and âsubmitting to Defendant, âwithin 60 days after the loss,â Plaintiffâs âsigned, sworn proof of loss which sets forth, to the best of [his] knowledge and belief, . . . specifications of any damaged building and detailed estimates for repair of the damage.â Doc. 79-3. As a result of the fire, Plaintiff made a claim for benefits under the Policy. Doc. 1-2 ¶ 4. On March 17, 2016, Mike Martinez, a âClaims Specialistâ for Defendant, sent Plaintiff a letter indicating that Defendant was âcurrently working on an estimate for the cost of repairsâ to Plaintiffâs home. Doc. 79-5. The letter advised Plaintiff that, if he wished for Defendant âto consider a contractorâs estimate due to differences in either the price or scope of damages,â to âsubmit the contractorâs estimateâ to Defendant âprior to starting repairs.â Id. The letter specified that the âcontractorâs estimate will need to provide a room by room breakdown of materials and labor,â and that Defendant âmay request to co-inspect with the contractor.â Id. On May 12, 2016, Melissa Johnson, a âTeam Managerâ for Defendant, sent Plaintiff a letter enclosing payment of $344,081.61 based upon an estimate provided by Rockefellerâs Construction Inc. (âRockefellerâ) âfor the repairs to [Plaintiffâs] home.â Doc. 79-5. The letter notes that â[t]his payment represents the undisputed amount known by State Farm and is not a release of liability.â Id. The letter further notes that Plaintiffâs general contractor âexpressed concernsâ with âthe rebuild estimate provided by Rockefeller,â but that Plaintiff had not provided Defendant with âan estimate from [Plaintiffâs contractor] to identify areas of 2 differences in the estimate[s].â Id. Per Plaintiffâs request, the letter stated, Johnson would mail a copy of the Rockefeller estimate to Plaintiffâs contractor. Id. Finally, the letter noted that Rockefeller would âbe available to meet withâ Plaintiffâs general contractor âto review any scope and/or pricing concerns.â Id. In a letter to Campbell on March 14, 2017, Plaintiff, through his previous counsel, provided a reconstruction estimate prepared by Plaintiffâs contractors indicating that the cost of reconstruction would be $625,000, which exceeds the policy limits of $533,644. Doc. 86-1. The letter noted that this estimate âwas prepared by actual homebuilders,â while Defendantâs estimate in response was from Rockefeller, âan estimating company that was not prepared to perform the rebuildingâ for Plaintiff. Id. Thereafter, on August 28, 2017, Plaintiff, through his previous counsel, sent a letter to Ron Trujillo, a âClaim Specialistâ for Defendant, indicating that Plaintiff had consulted with additional contractors, and attaching rebuilding estimates prepared by Sarcon Construction and Ortega Concepts. Id. The letter notes that the bid from Sarcon is in the amount of $607,646.79. Id. The letter states that Plaintiff has ânow provided [Defendant] with three rebuilding estimates by licensed New Mexico contractors, all of which exceed the available coverage for rebuilding [Plaintiffâs] home by a wide margin,â while Defendant âhas provided only an estimate from Rockefeller, a company neither willing nor able to rebuild [Plaintiffâs home].â Id. The letter concludes that Defendant âhas failed to provide any reputable documentation that rebuilding [Plaintiffâs] home will cost less than [his] policy limits.â Id. A letter dated December 4, 2017 from Johnson to Plaintiffâs previous counsel notes that, under the terms of the Policy, Plaintiff is required âto provide estimates of the damage.â Id. Johnson states that although Defendant ârequested copies of [Plaintiffâs] general contractorâs 3 estimate multiple times,â Plaintiff did not provide such estimate until July 21, 2016, five months after the fire damage to Plaintiffâs home. Id. In response to Plaintiffâs prior counselâs comments about Rockefeller, Johnson writes that Defendant has âno evidence that [Rockefeller] is unwilling or unable to rebuild Dr. Lincolnâs home.â Id. Further, she writes that, while Defendant feels âcomfortable that the estimate amount of $378,000 is accurate,â she âadvised Dr. Lincoln to let [Defendant] know once the repairs started and if there was hidden damage [Defendant] would reinspect to determine if it was related to the fire and issue a supplement if necessary.â Id. Johnsonâs letter also addresses the âthree rebuild estimatesâ provided by Plaintiff. Id. With regard to the first estimate, Johnson explains that it was âthoroughly reviewed on September 21, 2016â by Defendantâs representatives along with Plaintiffâs contractors âon a joint conference call,â and that, after âa line by line review,â âadditional itemsâ were added to the original Rockefeller estimate, and a âsupplementâ was issued. Id. As for the other two estimates, Johnson notes the inclusion of items that were ânon-coveredâ repairs. Id. Johnson goes on to state that, â[i]n order to determine whether any amounts of the other two estimates submitted are covered we need a breakdown and complete copy of the sub bids which State farm has requested multiple times in accordance with the [terms of the Policy].â Id. Johnson notes that âState Farm and Rockefeller[] both provided line item entr[ies] that show the specific measurement and price,â and that Defendant needed âto make sure that the amounts being charged are for the similar items and measurements of what was damaged.â Id. Thus, Johnson explained, â[i]n order to properly reconcile the Sarcon Construction estimate we need the sub-contractor bids that show specifically what the lump sum amount includes. This will ensure that the bid quoted is based on the type and quality of materials that were damaged in 4 the fire loss.â Id. Finally, Johnsonâs letter indicates that a total of $407,614.39 had been paid to date for the fire damage to Plaintiffâs home. Id. In two further letters to Plaintiffâs current counsel, one signed by Johnson and another by Trujillo sent on April 27, 2018 and June 11, 2018, respectively, Defendant again advised Plaintiff that, in order for Defendant to âreconcileâ Plaintiffâs construction estimate, Defendant needed âa complete estimate outlining each line item unit cost, measurement, and the individual sub bids that specif[y] the unit costs and measurements.â Doc. 78-5. The letters refer Plaintiff to his obligations under the Policy, and note that â[u]ntil Dr. Lincoln fulfills his conditions and duties after a loss, by providing a detailed estimate and sub bids as requested, we are unable to further consider amounts that are not substantiated.â Id. At his deposition, Trujillo testified that the purpose of requesting information regarding the Sarcon bid was so that Defendant could âdiligently try to evaluate all that is owed [to Plaintiff] and pay what [Defendant] owe[s]â; âso that [Defendant] could evaluate it and move towards a resolution.â Doc. 79-2 at 55-56. Trujillo further testified that Defendant did not receive the information requested regarding the Sarcon bid prior to Plaintiffâs filing of the instant lawsuit. Id. During his deposition, Plaintiff testified that he believes that Defendant owes him âthe differenceâ between the amount that Defendant has paid him and the policy limit of $533,644. Doc. 79-1 at 112. According to Plaintiff, because the house was beyond repair and, as a result, he âwas tearing [it] down . . . and rebuilding it,â he did not have to provide estimates to Defendant. Id. at 93. When asked whether Defendant denied any part of his claim, Plaintiff responded, âNo, they just delayed.â Doc. 78-1 at 127. When asked whether it was his position that Defendant did not promptly investigate his claim, Plaintiff testified, âNo, itâs not.â 5 Id. at 126. During his deposition, Plaintiff was unable to identify any facts, or any provision of the Policy, that Defendant misrepresented to him. Id. at 124. Plaintiff commenced the instant action in New Mexico state court on May 30, 2018. The sparse âFirst Amended Complaint for Breach of Insurance Contract, Unfair Claims Practices and Bad Faithâ is comprised of eight, one-sentence paragraphs in which Plaintiff asserts in conclusory fashion that, in partially honoring and partially rejecting Plaintiffâs claim for coverage benefits under his insurance policy, Defendant âintentionally breached its contract with Plaintiff by failing to honor its policy commitments,â âviolated the Unfair Claims Practices Act,â and âacted in bad faith by failing to timely settle and pay a first party claim.â Doc. 1-2. On July 9, 2018, Defendant removed the action to this Court. On the instant motions, Defendant seeks summary judgment on two of what appear to be three claims alleged by Plaintiff in his First Amended Complaint, namely, a claim for breach of the common law duty of bad faith and a claim for violation of the New Mexico Unfair Insurance Practices Act (âUIPAâ). Plaintiff opposes Defendantâs request for summary judgment on those claims and further moves to strike certain exhibits submitted by Defendant in support of its motions. STANDARD The court must âgrant summary judgment 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.â Fed. R. Civ. P. 56(a). The moving party need not âproduce evidence showing the absence of a genuine issue of material fact.â Celotex Corp. v. Catrett, 477 U.S. 317, 325 (1986). Rather, âthe burden on the moving party may be discharged by âshowingâ â that is, point out to the district court â that there is an absence of evidence to support the nonmoving partyâs case.â Id.; 6 see also Sports Unltd., Inc., v. Lankford Enter., Inc., 275 F.3d 996, 999 (10th Cir. 2002) (Although â[t]he burden of showing that no genuine issue of material fact exists is borne by the moving party,â when âthe moving party does not bear the ultimate burden of persuasion at trial, it may satisfy its burden by pointing to a lack of evidence for the nonmovant on an essential element of the nonmovantâs claimâ). Once the moving party has met this burden, the nonmoving party must âgo beyond the pleadings and by her own affidavits, or by the depositions, answers to interrogatories, and admissions on file, designate specific facts showing that there is a genuine issue for trial.â Id. at 324. In making this showing, the nonmoving party may not rely on âthe mere pleadings themselves.â Id. For purposes of Rule 56(a), a dispute is genuine âif there is sufficient evidence on each side so that a rational trier of fact could resolve the issue either way.â Becker v. Bateman, 709 F.3d 1019, 1022 (10th Cir. 2013). âAn issue of fact is material if under the substantive law it is essential to the proper disposition of the claim.â Id. (citation omitted). In other words, â[t]he question . . . is whether the evidence presents a sufficient disagreement to require submission to a jury or whether it is so one-sided that one party must prevail as a matter of law.â Id. (citation omitted). On summary judgment, the court âconstrue[s] the factual record and the reasonable inferences therefrom in the light most favorable to the nonmoving party.â Mata v. Saiz, 427 F.3d 745, 749 (10th Cir. 2005). DISCUSSION I. Plaintiffâs Motion to Strike As an initial matter, in his Motion to Strike, Plaintiff seeks to exclude from the record Defendantâs Exhibit D, which Plaintiff describes as âan internal memo summary account of a phone conversation involving several individuals.â Doc. 83 at 1. Additionally, Plaintiff takes 7 issue with the May 12, 2016 letter from Johnson to Plaintiff, marked as Exhibit E, to the extent that the letter indicates that it encloses documents which, according to Plaintiff, he never received. Id. at 3. In reaching its determination on the merits of Defendantâs motions for summary judgment, however, the Court has not considered either Exhibit D or the fact that the letter marked as Exhibit E notes the enclosure of other documents. Accordingly, Plaintiffâs Motion to Strike is moot. II. Defendantâs MSJ on Plaintiffâs Bad Faith Claim In the Complaint, Plaintiff summarily alleges that âDefendant has acted in bad faith by failing to timely settle and pay a first party claim.â Doc. 1-2 ¶ 7. âThe obligation to deal fairly and honestly rests equally upon the insurer and the insured.â Hauff v. Petterson, 755 F. Supp. 2d 1138, 1145 (D.N.M. 2010) (quoting Modiestte v. Found. Reserve Ins. Co., 427 P.2d 21, 25 (N.M. 1967)). In order to overcome summary judgment on his claim that Defendant violated this obligation by acting in bad faith, Plaintiff âmust cite evidence tending to show that [Defendant]âs actions were based on a âdishonest judgmentâ and that it âfailed to honestly and fairly balance its own interestsâ with [Plaintiff]âs.â Id. (quoting Sloan v. State Farm Mut. Auto. Ins. Co., 85 P.3d 230, 237 (N.M. 2004)). â[A]n insurer who fails to pay a first-party claim has acted in bad faith where its reasons for denying or delaying payment of the claim are frivolous or unfounded.â Sloan, 85 P.3d at 236. ââUnfoundedâ is defined not as âerroneousâ or âincorrect,â but rather the failure to exercise care for the interests of the insured, an arbitrary or baseless refusal to pay, lacking support in the language of the policy or the circumstances of the claim.â American Nat. Property & Cas. Co. v. Cleveland, 293 P.3d 954, 958 (N.M. Ct. App. 2012). Accordingly, âan insurer has a right to refuse a claim without exposure to a bad faith claim if it has reasonable grounds to deny 8 coverage.â Id. Generally, âreasonable groundsâ to deny or delay coverage âflow[] from a reasonable investigation of the claim.â Id. Notably, â[w]here the insurer had a legitimate reason to question the amount of damages claimed by the insured, a finding of bad faith is improper.â Hauff, 755 F. Supp. 2d at 1145 (citing United Nuclear Corp. v. Allendale Mut. Ins. Co., 709 P.2d 649, 654 (N.M. 1985)). Here, it is undisputed that, within three months of the fire, Defendant provided Plaintiff with a payment of approximately $344,000 for the damage to his home. Doc. 79-5. Further, as of December 4, 2017, Defendant had paid to Plaintiff a total amount of approximately $408,000 for the damage to his home. Doc. 86-1. Accordingly, the record shows that Defendant has not âfailed to pay a first party claim,â as alleged in the Complaint. While admitting that Defendant has not âdeniedâ his claim, Plaintiff contends that Defendant has âdelayedâ paying his claim. Plaintiff, however, has provided no evidence to support his theory that Defendant, in bad faith, failed to timely settle his claim. In fact, the record reflects consistent efforts on the part of Defendant to âreconcileâ Rockefellerâs estimate with those of Plaintiffâs own contractors for the purpose of evaluating âall that is owedâ to Plaintiff and âmov[ing] towards a resolution.â Doc. 79-2 at 55-56. Johnsonâs letter enclosing the original payment specifically noted that the amount paid represented only âthe undisputed amount known by State Farmâ and was not âa release of liability,â and offered to have Rockefeller âmeet withâ Plaintiffâs own general contractor âto review any scope and/or pricing concerns.â Doc. 79-5. As to Plaintiffâs rebuild estimates, Johnsonâs December 4, 2017 letter reflects that Defendant âthoroughly reviewedâ the first estimate submitted by Plaintiff and that, after a âline by line reviewâ with Plaintiffâs contractors, âadditional itemsâ were added to the original Rockefeller estimate, and a âsupplementâ was issued. Doc. 86-1. Johnsonâs letter 9 also reflects that Defendant needed further information to determine whether Plaintiffâs other two estimates, including the Sarcon bid, related to âcoveredâ repairs. Id. Pointing to the terms of the Policy, which required Plaintiff to submit âdetailed estimates for repair of the damageâ to his home, Johnsonâs letter notes that Defendant requested, âmultiple times,â a âbreakdown and complete copy of the sub bidsâ underlying those estimates. Id. Until June 2018, Defendant continued to advise Plaintiff that in order to âreconcileâ Plaintiffâs construction estimate, Defendant needed âa complete estimate outlining each line item unit cost, measurement, and the individual sub bids that specif[y] the unit costs and measurements.â Doc. 78-5. Repeatedly pointing to Plaintiffâs obligations under the Policy to provided âdetailed estimates,â Defendant made clear that it would not be able to âfurther consider amountsâ unless those amounts were âsubstantiated.â Id. In the face of this evidence, Plaintiff does no more than argue, without any evidentiary support, that Defendantâs repeated requests for more detailed information were merely a âdelay tacticâ that âmisstate[d]â the Policy, and were taken to avoid Defendantâs obligation to Plaintiff under the Policy. Doc. 85 at 3. Plaintiff fails to support his contention that Defendantâs repeated references to Plaintiffâs obligations under the Policy were misstatements. Indeed, during his deposition, Plaintiff was unable to identify any facts, or any provision of the Policy, that Defendant misrepresented to him. Doc. 78-1 at 124. According to Plaintiff, the level of detail that Defendant required would be âan absurd way to bid new construction,â and Sarconâs bid âwas perfectly acceptable.â Doc. 85 at 3. The only support that Plaintiff provides for this contention is the affidavit of Rob Wing, Senior Project Manager for Sarcon, in whose opinion â[t]he Sarcon bid is totally acceptable in the Santa Fe construction community and is similar to what other qualified contractors in the Santa Fe area 10 would prepare.â Doc. 86-1 ¶ 8. Further, Mr. Wing states that âit wouldnât make senseâ to do a âbid by unit cost and measurements for each room.â Doc. 86-1 ¶ 8. But the opinion of Mr. Wing, who does not profess to have any expertise in insurance claim investigation and processing, is insufficient to support Plaintiffâs contention. Hauff, 755 F. Supp. 2d at 1148 (holding that it was not enough for plaintiff to rely on testimony of his expert for his description of industry standards that defendant allegedly failed to meet). â[T]he mere expression of an opinion without [factual] support is insufficient to raise a triable issue of material fact.â Id. (quoting 29 Charles Alan Wright & Victor James Gold, Federal Practice and Procedure: Evidence § 6293 (2010)). Mr. Wing cites to âno facts, studies, or data compilations to support his opinion.â Hauff, 755 F. Supp. 2d at 1148. Accordingly, Mr. Wingâs opinion is no more than argument, and as such does not constitute âfacts showing that there is genuine issue for trial.â Celotex, 477 U.S. at 999. Essentially, Plaintiffâs argument is that he is entitled to his policy limit of $533,644, and that Defendantâs refusal to âsettleâ his claim for that amount, or even for the amount proposed by Plaintiff during mediation, is unreasonable. See, e.g., Doc. 85 at 6-7 (âEven after suit was filed[, Defendant] offered a measly $20,000, which doesnât come close to the policy limits.â). Aside from submitting Mr. Wingâs affidavit, which, as discussed above, is not evidence, Plaintiff provides nothing to substantiate his position that Defendantâs assessment of Plaintiffâs claim was unreasonably low. âThat [Plaintiff] found the offer to be low, in itself, does not make [Defendant]âs offer unreasonable or the product of bad faith.â Hauff, 755 F. Supp. 2d at 1147. There is nothing in the record that âsuggests that the amount was a product of bad faith.â Id. Plaintiff argues that summary judgment is improper because, as Defendant admits, there remains âa dispute over the value of the claim.â Doc. 85 at 6. This argument misses the mark, 11 however, as Plaintiffâs bad faith claim turns not on the value of Plaintiffâs claim â or even whether Defendant incorrectly assessed the value of claim â but rather on whether Defendant had a legitimate reason to question Plaintiffâs valuation of his claim. Accordingly, in order to overcome summary judgment on his bad faith claim, Plaintiff is required to cite evidence tending to show that Defendantâs refusal to pay further amounts in connection with the fire damage to Plaintiffâs home, without first receiving more detailed estimates from Plaintiffâs contractors, was âfrivolous or unfounded,â i.e., arbitrary or baseless, and lacking support in the language of the Policy. Plaintiff fails to meet this burden. Defendant thus is entitled to summary judgment on Plaintiffâs bad faith claim. III. Defendantâs MSJ on Plaintiffâs UIPA Claim In the Complaint, Plaintiff claims that âDefendant violated the Unfair Claims Practices Act, specifically section 59A-16-20 paragraphs A, B, C, E, G, H, M and N,â without alleging any conduct by Defendant that purportedly constitutes such a violation.2 Doc. 1-2 ¶ 6. The UIPA provides that certain enumerated practices, âknowingly committed or performed with such frequency as to indicate a general business practice, are unfair and deceptive,â and thus âare prohibited.â N.M. Stat. Ann. § 59A-16-20. The UIPA âdoes not ârequire insurers to settle cases they reasonably believe to be without merit or overvalued.â Hauff, 755 F. Supp. 2d at 1148 (quoting Hovet v. Allstate Ins. Co., 89 P.3d 69, 78 (N.M. 2004)). âAny insurer that objectively exercises good faith and fairly attempts to settle its cases on a reasonable basis and in 2 In his response brief, Plaintiff cites subsection D of § 59A-16-20, and includes a one-sentence argument that Defendant ârejected Lincolnâs three contractor bids, which would constitute a denial of coverage up to the policy limit, thereby violating paragraph D.â Plaintiff may not, for the first time in response to a motion for summary judgment, attempt to amend his complaint to add a new allegation. See Fed. R. Civ. P. 15 (setting forth rules for amending a pleading). Accordingly, the Court will not consider Plaintiffâs argument as it applies to § 59A-16-20(D). 12 a timely manner need not fear liability.â Hauff, 755 F. Supp. 2d at 1148 (quoting Hovet, 89 P.3d at 78). Subsection A of § 59A-16-20 prohibits âmisrepresenting to insureds pertinent facts or policy provisions relating to coverages at issue.â As Plaintiff admits, during his deposition, he was unable to identify any facts, or any provision of the Policy, that Defendant misrepresented to him. Doc. 86 at 2; Doc. 78-1 at 124. And in his response, Plaintiff does no more than argue, without any evidentiary support, that Defendantâs repeated requests for more detailed information were merely a âdelay tactic and misrepresentation of the [P]olicyâ Doc. 86 at 4. For the reasons noted above, Mr. Wingâs opinion that Defendantâs requests for detailed estimates âwouldnât make senseâ is not evidence that the Sarcon bid was âperfectly acceptableâ under the terms of the Policy, or that Defendant misrepresented the Policy by requesting more detail than Sarcon provided in its estimate. Doc. 86-1 ¶ 8; Doc. 86 at 11. Nor, as Plaintiff contends, is Johnsonâs April 27, 2018 letter a âperfect exampleâ of Defendantâs misrepresentation of the Policy. Id. at 4. According to Plaintiff, although the Policy does not require that a computer program called Xactimate be used to calculate an estimate, Johnsonâs letter âpretendsâ that Sarconâs estimate âis unreliableâ because Sarcon did not use Xactimate to create its bid. Id. Nowhere, however, does Johnsonâs letter state that Sarconâs bid was âunreliableâ in the first instance, much less that its unreliability resulted from Sarconâs failure to use Xactimate in calculating it. Rather, Johnson notes that Rockefeller used Xactimate in calculating its bid, and advises that, in order to reconcile the Sarcon estimate with that of Rockefeller, Defendant needed âa complete estimate outlining each line item unit cost, measurement, and the individual sub bids that specif[y] the unit costs and measurements.â Doc. 78-5. Accordingly, Johnsonâs letter does not misrepresent the Policyâs requirements. 13 Similarly, the Court cannot agree that Johnsonâs December 4, 2017 letter contains an âegregiousâ example of Defendantâs misrepresentations of the Policy. Doc. 86 at 10. In that letter, Johnson wrote that the âNorth Wing also referred to as the office or casita was not structurally compromised as a result of the fire to the main structure. The North Wing is included in Dr. Lincolnâs total Coverage A limits of $533.644 and didnât require total replacement due to fire damage.â Doc. 86-1. From this language, Plaintiff gleans that Johnson was conveying that âthe hypothetical cost to rebuild [the casita] (whatever that is) will have to be deducted from the limit of $544,644 on the principal dwelling, thereby reducing the amount of money available to pay this claim.â Doc. 86 at 10. Admittedly, this language is confusing in that it appears, perhaps mistakenly, to indicate that, for purposes of the $544,644 policy limit, Plaintiffâs home includes the casita. This, however, is of no moment, as it is undisputed that there was no damage to the casita, and thus that no amount was deducted, or intended to be deducted, from Plaintiffâs policy limit in connection with the casita. Further, Plaintiff fails to support his argument that Defendant misrepresented âpertinent facts or policy provisionsâ because its âstated policy is [] not the same as how [it] handled this claim.â Doc. 86 at 5. Contrary to Plaintiffâs contention that Defendant âcompletely ignoredâ Plaintiffâs three estimates, id., as discussed in detail above, the record demonstrates consistent efforts on the part of Defendant to âreconcileâ Rockefellerâs estimate with those of Plaintiffâs own contractors for the purpose of evaluating âall that is owedâ to Plaintiff and âmov[ing] towards a resolution.â Doc. 79-2 at 55-56. Nor has Plaintiff provided any support for his claim that the Rockefeller estimate âwas not an actual bid to rebuild the houseâ for the stated amount. Doc. 86 at 5. Again, Mr. Wingâs opinion as to whether the house could be rebuilt for that amount is not evidence. Moreover, Plaintiff himself cites to an excerpt of the deposition of 14 a Rockefeller representative that belies Plaintiffâs claim that Rockefeller âis not in the business of building houses from the ground up.â Doc. 86 at 7. Specifically, when asked whether he would not have âreferences of houses [he] built from the ground up because thatâs not really what [he does],â Cole Borgeson responded, âwe do build houses from the ground up that are related to an insurance claim.â Doc. 86 at 7. Because Plaintiff thus fails to provide evidentiary support for his claim that â[t]here were significant misrepresentations of the [P]olicy provisions,â id. at 14, Plaintiff equally fails to show a genuine issue for trial as to Defendantâs alleged violation of § 59A-16-20(A). Next, Section B of § 59A-16-20 prohibits âfailing to acknowledge and act reasonably promptly upon communications with respect to claims from insured arising under policies.â In his response, Plaintiff addresses this provision with no more than the following sentence: âAs to paragraph B, State Farm acted promptly at first and paid the personal property claim. But once they saw how much it would really cost to build a new house, they became increasingly argumentative.â Doc. 86 at 14. This unsupported statement is argument, not evidence, and is contrary to the undisputed evidence. First, when asked at his deposition whether it was his position that Defendant did not promptly investigate his claim, Plaintiff testified, âNo, itâs not.â Doc. 78-1 at 126. Further, beginning approximately one month after the fire, Defendant communicated with Plaintiff, initially with a letter indicating that Defendant was âcurrently working on an estimate for the cost of repairsâ to Plaintiffâs home, followed a month later with a letter enclosing the initial payment of $344,081.61 and thereafter with several additional letters repeatedly requesting additional information in order to reconcile Plaintiffâs estimates with its own. See Doc. 79-5. Conspicuously absent from the correspondence between the parties is any indication that Defendant failed to acknowledge or act reasonably promptly on Plaintiffâs 15 communications. Failing to adduce such evidence, Plaintiff equally fails to show a genuine issue for trial as to Defendantâs alleged violation of § 59A-16-20(B). Section E of § 59A-16-20 prohibits ânot attempting in good faith to effectuate prompt, fair and equitable settlements of an insuredâs claims in which liability has become reasonably clear.â Section H of § 59A-16-20 prohibits âattempting to settle a claim by an insured for less than the amount to which a reasonable person would have believed he was entitled by reference to written or printed advertising material accompanying or made part of an application.â As to these provisions, Plaintiffâs response states that these paragraphs âare similar,â and argues that Defendant violated them both because it âmade no offer to settle prior to filing suit.â Doc. 86 at 14. This generalized argument, without more, is insufficient to overcome summary judgment. Plaintiff has provided no proof that Defendant did not attempt in good faith to effectuate âa prompt, fair, and equitableâ settlement of his claim, that Defendantâs liability â above and beyond that which it has already paid â has become âreasonably clear,â or that the amounts already paid to Plaintiff on his claim are âless than the amount to which a reasonable person would have believed he was entitled by referenceâ to the Policy. Indeed, as detailed (repeatedly) above, Defendant never refused to pay Plaintiff amounts in addition to the approximately $408,000 it paid to him for the damage to his home, but rather made repeated and consistent efforts to âreconcileâ its estimate of the rebuild with those of Plaintiffâs own contractors, asking in the process for detailed estimates in accordance with the Policy. As with Plaintiffâs bad faith claim, the crux of Plaintiffâs argument here is that Defendant refused to settle for the full amount of Plaintiffâs limit under the Policy or for the amount proposed by Plaintiff during mediation. But again, Plaintiff has failed to substantiate his position that Defendantâs assessment of Plaintiffâs claim was unreasonably low, based on the Policy or otherwise. 16 Without such a showing, Plaintiff fails to establish a genuine issue for trial as to whether Defendant violated § 59A-16-20(E) and (H). See Hauff, 755 F. Supp. 2d at 1148 (nothing that the UIPA does not require insurers to settle cases they reasonably believe to be overvalued). Section G of § 59A-16-20 prohibits âcompelling insureds to institute litigation to recover amounts due under policy by offering substantially less than the amounts ultimately recovered in actions brought by such insureds when such insureds have made claims for amounts reasonably similar to amounts ultimately recovered.â As to this provision, Plaintiffâs response states only that âhad Lincoln not filed suit, the claim would still be in limbo and not resolved. Whether or not Lincoln receives a substantial award in damages remains to be seen.â Doc. 86 at 14. Plaintiff âprovides no proof that unreasonably low settlement offers compelled him to litigate.â Hauff, 755 F. Supp. 2d at 1148. Nor has Plaintiff submitted any evidence that Defendant offered him âsubstantially less than similar claimants recover.â Id. at 1149. Indeed, the record is replete with evidence of Defendantâs willingness to consider payments in addition to those already made to Plaintiff on his claim. In contrast, it appears that Plaintiff consistently refused to provide the detailed estimates requested by Defendant, instead taking the position that he was owed the full amount of Policy limit and was not required to provide the requested estimates in order to obtain that amount. See Doc. 79-1 at 112, 127. In the absence of evidence that Defendant offered Plaintiff substantially less than amounts ultimately recovered by other insureds with similar claims, Plaintiff fails to show the existence of a genuine issue as to whether Defendant violated § 59A-16-20(G). Section C of § 59A-16-20 prohibits âfailing to adopt and implement reasonable standards for the prompt investigation and processing of insuredsâ claims arising under policies.â Section M of § 59A-16-20 prohibits âfailing to settle an insuredâs claims promptly where liability has 17 become apparent under one portion of the policy coverage in order to influence settlement under other portions of the policy coverage.â Section N of § 59A-16-20 prohibits âfailing to promptly provide an insured a reasonable explanation of the basis relied on in the policy in relation to the facts or applicable law for denial of a claim or for the offer of a compromise settlement.â In his response, Plaintiff makes no mention of these provisions and provides no evidence to substantiate the allegation in the Complaint that Defendant violated these provisions. The Court construes Plaintiffâs failure to respond to Defendantâs motion as it relates to Sections C, M, and N as consent to the Courtâs granting of summary judgment. D.N.M. LR-Civ. 7.1(b) (âThe failure of a party to file and serve a response in opposition to a motion within the time prescribed for doing so constitutes consent to grant the motion.â). Because Plaintiff fails to adduce any evidence of Defendantâs alleged violation of § 59A-16-20(C), (M), or (N), no genuine issue exists as to whether Defendant violated these provisions. IV. Plaintiffâs Remaining Claim In the Complaint, Plaintiff claims that âDefendant intentionally breached its contract with Plaintiff by failing to honor its policy commitments.â Doc. 1-2 ¶ 5. The sole factual allegation (conclusory though it might be) to support this claim is that âPlaintiff made a claim for coverage benefits under his insurance policy. Said claim was partially honored and partially rejected.â Id. ¶ 4. This is the same factual allegation from which Plaintiffâs bad faith and UIPA claims arise. See id. ¶¶ 4-7. The material facts relevant to this allegation appear to be undisputed and now before the Court on the record submitted in connection with Defendantâs MSJ on Bad Faith Claim and MSJ on UIPA Claim. Accordingly, the Court hereby gives notice that, pursuant to Rule 56(f)(3) of the Federal Rules of Civil Procedure, it may consider summary judgment on Plaintiffâs breach of contract claim. Before so considering, the Court will give the 18 parties an opportunity to file memoranda of law addressing whether summary judgment as to Plaintiffâs breach of contract claim should be entered. CONCLUSION Plaintiff has failed to show that there is a genuine issue for trial on his bad faith claim and on his UIPA claim. Accordingly, summary judgment in favor of Defendant is proper on those claims. In reaching this decision, the Court has not considered the exhibits to which Plaintiff objects and thus Plaintiffâs objection to those exhibits is moot. After giving the parties an opportunity to respond, the Court may consider whether summary judgment is proper on Plaintiffâs breach of contract claim. IT IS THEREFORE ORDERED that: (1) Defendant State Farmâs Motion for Summary Judgment on Claims of Violations of the Unfair Insurance Practices Act, §59A-16-20 NMSA 1997 [Doc. 78] is GRANTED as follows: Plaintiffâs claim that Defendant violated the Unfair Claims Practices Act is dismissed with prejudice; (2) Defendant State Farmâs Motion for Summary Judgment on Claims of Bad Faith [Doc. 79] is GRANTED as follows: Plaintiffâs claim that Defendant acted in bad faith is dismissed with prejudice; (3) Plaintiffâs Motion to Strike Exhibits to Motion for Summary Judgment [Doc. 83] is FOUND AS MOOT; and 19 (4) Pursuant to Rule 56(f)(3) of the Federal Rules of Civil Procedure, the parties may file memoranda of law no later than October 21, 2020 addressing whether the Court should grant summary judgment on Plaintiffâs claim for breach of contract. DATED this 30th day of September 2020. Celie MARTHA SAZQUE âUnited States District Judge 20
Case Information
- Court
- D.N.M.
- Decision Date
- September 30, 2020
- Status
- Precedential