THOMAS M. ROUSE, SANDY ROUSE,and FEDERAL INSURANCE COMPANY,
Plaintiffs v. WILLIAMS REALTY BUILDING COMPANY, INCORPORATED,
Defendants
No. COA00-209
(Filed 17 April 2001)
Insurance--fire--home under construction--full policy limits--ambiguity resolved in favor of
insured
The trial court did not err by granting summary judgment in favor of the individual plaintiffs
in an action to recover the full limit of liability of insurance proceeds of $2,369,000 with an offset
for the $1,774,381 already paid for loss by fire to plaintiffs' home while it was under construction,
because: (1) where policy language is reasonably susceptible to either construction by the parties,
the ambiguity is resolved in favor of the insured and against the insurer; (2) the insurance company's
construction of the policy paragraph entitled amount of insurance improperly substitutes the term
limit of liability for amount of insurance since express language to this effect could have been
used in the policy had the parties intended this construction; (3) plaintiffs' construction properly
contends the loss settlement paragraph of the policy determines the amount payable in the event
of a covered loss which is determined by whether the amount of insurance is more or less than
80% of the full replacement cost of the building; and (4) although the actual amount of insurance
at the time of loss is $1,774,381, that amount is only 75.4% of the replacement cost while the policy
requires the greater amount of 80% or $2,353,960 to be paid in addition to the reasonable expenses
for debris removal of $15,040 which brings the total amount due under the policy to the limit of
liability of $2,369,000.
Judge THOMAS dissenting.
Appeal by cross-claim defendant Federal Insurance Company from
order entered 25 October 1999 by Judge Ronald L. Stephens in
Superior Court, Wake County. Heard in the Court of Appeals 11
January 2001.
Everett Gaskins Hancock & Stevens, by E.D. Gaskins, Jr., for
cross-claim plaintiffs-appellees Thomas M. and Sandy Rouse.
BROWN, CRUMP, VANORE & TIERNEY, L.L.P., by Andrew A. Vanore,
III, for cross-claim defendant-appellant Federal Insurance
Company.
TIMMONS-GOODSON, Judge.
Federal Insurance Company (Federal) appeals from an award of
summary judgment for Thomas M. and Sandy Rouse (plaintiffs or
the Rouses) on the question of whether they were entitled to
receive the full limit of liability under a policy insuring their
residence against loss by fire while the home was under
construction. Having found no error of law, we affirm the ruling
of the trial court.
Plaintiffs contracted with Williams Realty & Building Company
(Williams Realty) for the construction of a residence at 2745
Lakeview Drive in Raleigh, North Carolina. Pursuant to the
agreement, an insurance agent for Williams Realty procured Federal
policy number 2911-95-15 on behalf of the Rouses to cover the
residence against fire and other perils while it was under
construction. The policy provided that the limit of liability for
Coverage A, the type of coverage applicable to the residence, was
$2,369,000. The initial term of the policy was from 15 November
1996 to 15 November 1997; however, on 3 October 1997, Federal
renewed and extended the policy through 15 November 1998. It is
undisputed that the Rouses paid all premiums due under the policy
and that the policy was in full force and effect when plaintiffs'
claim arose.
Williams Realty had nearly completed construction of the
residence when it was totally destroyed by fire on the morning of
19 December 1997. A Federal claims adjuster investigated the
damage and determined that plaintiffs suffered a total loss worth
$2,406,809. Plaintiffs, therefore, demanded payment in the amountof $2,369,000, the limit of liability under the policy. However,
citing the AMOUNT OF INSURANCE provision set forth in an
endorsement to the policy, Federal claimed that the limit of
liability was provisional and that the actual amount of coverage
afforded plaintiffs at the time of the loss was $1,774,381, which
amount Federal tendered.
The Rouses brought an action against Williams Realty for
negligence, breach of contract, and breach of fiduciary duty in
failing to procure adequate insurance coverage for the residence.
The Rouses also filed a cross-claim against Federal, who had been
joined as a plaintiff in the original action, alleging breach of
contract for failing to pay the full amount due under the policy.
Thereafter, plaintiffs voluntarily dismissed their claims against
Williams Realty without prejudice. The Rouses and Federal then
filed cross-motions for summary judgment, and following a hearing
on the motions, the trial court entered judgment for plaintiffs.
The court ordered Federal to pay plaintiffs the amount of
$2,369,000, the limit of liability under the insurance policy at
issue in this action, with an offset for the $1,774,381 previously
paid; making the total amount currently due $594,619, plus interest
at the legal rate from March 17, 1998, until paid. Federal gave
timely notice of appeal to this Court.
________________________________
By its sole assignment of error, Federal contends that in
awarding summary judgment for plaintiffs, the trial court
erroneously construed the provisions of the policy. Federal argues
that under the terms of the policy, the amount of coverage affordedplaintiffs for the loss of their residence was $1,744,381.
Therefore, Federal maintains that having tendered the total amount
due under the policy, Federal was entitled to summary judgment. We
cannot agree.
Summary judgment is an appropriate disposition if the
pleadings, depositions, answers to interrogatories, and admissions
on file, together with the affidavits, if any, show that there is
no genuine issue as to any material fact and that any party is
entitled to a judgment as a matter of law. N.C. Gen. Stat. § 1A-
1, Rule 56(c) (1999). The party moving for summary judgment has
the burden of demonstrating the absence of any factual issue of
consequence.
N.C. Farm Bureau Mut. Ins. Co. v. Mizell, 138 N.C.
App. 530, 532, 530 S.E.2d 93, 94 (2000). This can be done by: (1)
proving that an essential element of the opposing party's claim is
nonexistent; (2) showing through discovery that the opposing party
cannot produce evidence to support an essential element; or (3)
showing that the opposing party cannot surmount an affirmative
defense.
Id. at 532, 530 S.E.2d at 94-95.
An insurance policy is a contract between the parties, and
the intention of the parties is the controlling guide in its
interpretation.
Bank v. Insurance Co., 49 N.C. App. 365, 370, 271
S.E.2d 528, 531 (1980),
rev'd on other grounds, 303 N.C. 203, 278
S.E.2d 507 (1981). The parties' intent may be derived from the
language employed in the policy.
Kruger v. State Farm Mut. Auto.
Ins. Co., 102 N.C. App. 788, 789, 403 S.E.2d 571, 572 (1991).
Thus, when presented with policy language that is explicit, [o]urcourts have a 'duty to construe and enforce [the policy] as
written, without rewriting the contract or disregarding the express
language used. . . . The duty is a solemn one, for it seeks to
preserve the fundamental right of freedom of contract.'
Id.
(quoting
Fidelity Bankers Life Ins. Co. v. Dortch, 318 N.C. 378,
380-81, 348 S.E.2d 794, 796 (1986) (citation omitted)). Judicial
construction is appropriate only where the language used in the
policy is ambiguous and reasonably susceptible to more than one
interpretation,
Allstate Ins. Co. v. Chatterton, 135 N.C. App. 92,
94, 518 S.E.2d 814, 816 (1999),
disc. review denied, 351 N.C. 350,
342 S.E.2d 205 (2000), in which event, this Court will resolve the
ambiguity against the insurance company-drafter, and in favor of
coverage,
Ledford v. Nationwide Mutual Ins. Co., 118 N.C. App. 44,
51, 453 S.E.2d 866, 869 (1995).
Moreover,
[w]hen the policy contains a definition of a
term used in it, this is the meaning which
must be given to that term wherever it appears
in the policy, unless the context clearly
requires otherwise. . . . In the absence of
such definition, nontechnical words are to be
given a meaning consistent with the sense in
which they are used in ordinary speech, unless
the context clearly requires otherwise. . . .
If such a word has more than one meaning in
its ordinary usage and if the context does not
indicate clearly the one intended, it is to be
given the meaning most favorable to the
policyholder, or beneficiary, since the
insurance company selected the word for use.
Kruger, 102 N.C. App. at 790, 403 S.E.2d at 572 (quoting
Trust Co.
v. Insurance Co., 276 N.C. 348, 354, 172 S.E.2d 518, 522
(1970)(citations omitted)). In determining the meaning of a term, resort may be had to othe
r portions of the
policy and all clauses of it are to be
construed, if possible, so as to bring them
into harmony. Each word is deemed to have
been put into the policy for a purpose and
will be given effect, if that can be done by
any reasonable construction in accordance with
the foregoing principles [of construction].
Trust Co., 276 N.C. at 355, 172 S.E.2d at 522.
The policy at issue in the case
sub judice contains the
following relevant provision:
AMOUNT OF INSURANCE
The limit of liability stated in the
declarations for Coverage A is provisional.
The actual amount of insurance on any date
while the policy is in force will be a
percentage of the provisional amount. The
percentage will be the proportion that the
actual value of the property bears to the
value at the date of completion.
. . . .
POLICY PROVISIONS
All other provisions of this policy apply.
Federal contends that this paragraph determines the maximum amount
payable to plaintiffs under the policy. Focusing on the term
provisional, Federal takes the position that the stated limit of
liability is temporary and fluctuates based on the percentage of
the dwelling completed at the date of the loss. As Federal
explains,
In effect, the limit of liability
represents Federal's maximum exposure under
Coverage A for a loss. In the event of a
loss, however, one does not automatically
assume that the coverage is the provisional
limit of liability shown on the declarations
page. Rather, [the endorsement] provides
clear and unambiguous instructions fordetermining the limit of liability on any
date while the Policy is in force.
In the case at bar, that critical date is
December 17 [sic], 1997, the date of the fire.
In order to determine the actual limit of
liability provided under Coverage A, the
parties must determine the value of the
dwelling property on the date in question.
Next, they must determine the value that the
dwelling property would have at the date of
completion. These figures yield a percentage,
which is then applied to the provisional limit
of liability stated in the declarations page
to determine the actual limit of liability for
Coverage A on the particular date in question.
. . . [T]he parties have stipulated that
the actual value of the dwelling on December
19, 1997, was $2,353,960.00 and that the
completed value would have been $3,141,244.00.
These figures yield a percentage figure of
74.9%. Multiplying the provisional limit of
liability found on the declarations page for
Coverage A _ Dwelling by 74.9%, in turn,
yields a limit of liability in the amount of
$1,774,381.00. (Emphasis added.)
We note that Federal's construction of the paragraph entitled
AMOUNT OF INSURANCE substitutes the term limit of liability for
amount of insurance. Federal has thereby rewritten the second
sentence of the paragraph to read as follows: The actual amount of
insurance [limit of liability] on any date while the policy is in
force will be a percentage of the provisional amount. However,
had the parties intended this construction, express language to
this effect could have been used. We believe that by using the
term amount of insurance as opposed to limit of liability in
the above clause, the parties expressed their intent to accord
different meanings to the terms. Therefore, we reject Federal's
interpretation, inasmuch as it is repugnant to the plain language
of the provision.
Plaintiffs propose a construction complementary to the policylanguage. Plaintiffs contend that as its title implie
s, the Loss
Settlement paragraph of the policy determines the amount payable
in the event of a covered loss. Pertinently, the provision states
that:
Covered property losses are settled as
follows:
. . . .
b.
Buildings under Coverage A or B at
replacement cost without deduction for
depreciation, subject to the following:
(1) If, at the time of loss, the amount of
insurance in this policy on the damaged
building is 80% or more of the full
replacement cost of the building
immediately before the loss, we will pay
the cost to repair or replace, after
application of deductible and without
deduction for depreciation, but not more
than the least of the following amounts:
(a) the limit of liability under this
policy that applies to the building;
(b) the replacement cost of that part of
the building damaged for like
construction and use on the same
premises; or
(c) the necessary amount actually spent
to repair or replace the damaged
building.
(2) If, at the time of loss, the amount of
insurance in this policy on the damaged
building is less than 80% of the full
replacement cost of the building
immediately before the loss, we will pay
the greater of the following amounts, but
not more than the limit of liability
under this policy that applies to the
building:
(a) the actual cash value of that part
of the building damaged; or
(b) that proportion of the cost to
repair or replace, after applicationof deductible and without deduction
for depreciation, that part of the
building damaged, which the total
amount of insurance in this policy
on the damaged building bears to 80%
of the replacement cost of the
building. (Emphasis added.)
According to plaintiffs, the amount of insurance to which
this provision refers is the sum calculated under the appropriately
titled AMOUNT OF INSURANCE paragraph contained in the
endorsement. Thus, the actual amount of insurance at the time of
the loss is $1,774,381. Under the Settlement Loss provision, the
payment amount is determined by whether the amount of insurance
is more or less than 80% of the full replacement cost of the
building. Here, the amount of insurance, $1,774,381, is 75.4% of
the replacement cost, which given these facts is $2,353,960.
Therefore, section b(2) of the provision applies, and the insurer
is required to pay the greater of the two amounts described in
subsections b(2)(a) & (b), but not more than the limit of
liability. Under our facts, the greater amount is that to which
subsection b(2)(a) refers--the actual cash value of the damaged
dwelling, which is $2,353,960. Accordingly, the Loss Settlement
due plaintiffs for the damage to their residence is $2,353,960.
The policy, however, also covers expenses for debris removal.
Under the OTHER COVERAGES section of the policy, Federal agrees
to pay [the insureds'] reasonable expense for the removal of . . .
debris of covered property if a Peril insured Against causes the
loss. The provision further states that [d]ebris removal expense
is included in the limit of liability applying to the damaged
property. Here, the cost to remove debris was $85,000. Thus,Federal is responsible for payment of $15,040 toward the debris
removal, which brings the total amount due plaintiffs under the
policy to the limit of liability, $2,369,000.
In sum, we conclude that under the plain language of the
policy, plaintiffs are entitled to recover the full limit of
liability. Notably, even if we were to conclude that the policy
language is reasonably susceptible to the interpretation offered by
Federal, plaintiffs' construction, nonetheless, demonstrates an
ambiguity, which would result in a construction against the
insurance company. See Ledford, 118 N.C. App. at 51, 453 S.E.2d at
869 (stating that where policy language is reasonably susceptible
to either construction by the parties, the ambiguity is resolved in
favor of the insured and against the insurer). Accordingly, we
hold that the trial court did not err in awarding summary judgment
for plaintiffs and in ordering Federal to pay plaintiffs the
amount of $2,369,000, the limit of liability under the insurance
policy . . ., with an offset for the $1,774,381 previously paid;
making the total amount currently due $594,619, plus interest[.]
The decision of the trial court is affirmed.
Affirmed.
Judge MARTIN concurs.
Judge THOMAS dissents.
==========================
THOMAS, Judge, dissenting.
The endorsement denominated Dwelling under Construction
appears to be controlling and exclusive in determining the
liability of Federal Insurance Company (Federal). Therefore, Irespectfully dissent.
An endorsement is defined as [a]n amendment to a contract,
such as an insurance policy, by which the original terms are
changed. American Heritage College Dictionary 454 (3d ed. 1997).
In the case at bar, the Dwelling Under Construction endorsement,
clearly listed on the Dwelling Fire Policy cover page,
establishes the amount of insurance available to plaintiffs Thomas
and Sandy Rouse (the Rouses) at any given time during construction.
As noted on the first page of endorsements, THIS ENDORSEMENT
CHANGES THE POLICY. PLEASE READ CAREFULLY.
The Dwelling Under Construction endorsement reads as follows
The limit of liability stated in the
declarations for Coverage A is
provisional.
The
actual amount of insurance on any date
while the policy is in force will be a
percentage of the provisional amount. The
percentage will be the proportion that the
actual value of the property bears to the
value at the date of completion.
Form DP 1143 (emphasis added).
When a provision in a contract contains a definition of a
term used in it, this is the meaning which must be given to that
term wherever it appears in the policy, unless the context clearly
requires otherwise. . . . Kruger v. State Farm Mut. Auto Ins.
Co., 102 N.C. App. 788, 790, 403 S.E.2d 571, 572 (1991) (emphasis
added). Here, the Dwelling Under Construction form is an
endorsement to the policy, which necessarily alters it. Because
endorsements are utilized to change or modify other provisions in
the policy which ordinarily would be binding in establishing
coverage or determining liability, anything else in the policy with
which it conflicts becomes a nullity. See generally Greenway v.North Carolina Farm Bureau Mutual Ins. Co., 35 N.C. App. 308, 313,
241 S.E.2d 339, 342-43 (1978).
As used, the distinction between amount of insurance and
actual limit of liability is not meaningful. Further, the Rouses
point to nothing in the contract, case law or the General Statutes
that forbids Federal to use amount of insurance interchangeably
with limit of liability. It is common knowledge that the amount
of insurance an insured has on property is the limit of liability
for the insurer. This does not contravene the plain language
meaning of the policy terms. Hence, there is no ambiguity. It is
important to note that the most fundamental rule [in interpreting
insurance policies] is that the language of the policy controls. .
. . [T]he court must enforce the policy as written and may not
reconstruct [it] under the guise of interpreting an ambiguous
provision. Ledford v. Nationwide Mutual Insurance Company, 118
N.C. App. 44, 50, 453 S.E.2d 866, 869 (1995) (quoting Nationwide
Mutual Ins. Co. v. Mabe, 115 N.C. App. 193, 198, 444 S.E.2d 664,
667 (1994). Thus, the provision stands as exclusive.
This is a Builder's Risk policy. See generally Baldwin v.
Lititz Mutual Insurance Company, 99 N.C. App. 559, 393 S.E.2d 306
(1990). One of the crucial words in the endorsement is
provisional, which sets the amount of insurance available, or the
liability assumed by Federal, to be a changing amount as
construction proceeds. As the percentage of the construction
increases, the amount of insurance on the property increases. This
was the parties' bargain. It is logical for a dwelling under
construction to have varying coverage limits as it comes closer toits completion. Accordingly, the limit of liability is
provisional, or temporary.
Federal was concerned with the potential for suffering a large
loss. Correspondence was introduced as part of Federal's summary
judgment motion, showing that the company had expressed such
concern to its agent, Gilliams, Barbour, Barefoot & Yancey, Inc.,
who forwarded notice of Federal's list of critical
recommendations to the Rouses and defendant Williams Realty &
Building Company in January 1997. The list included placing fire
extinguishers on site and installing a fire alarm system to be
utilized during construction. The recommendations also contained
a section that explained while on site it was noted that the
property had been vandalized. In an attempt to discourage future
vandals, it is recommended that a driveway gate be installed
throughout construction. R. pp.57 and 61. In the letter from the
insurance agent to the Rouses, it was observed that [t]he largest
losses that Chubb [Federal's parent company] has had have occurred
during construction. They recently had a $800,000 loss under a
Builder's Risk. (Sic). R. p. 62. In the letter to the Rouses
the agent said, Chubb is the best company in the country for large
homes like yours but they are very strict. They recently paid a
$800,000 fire loss on a dwelling under construction. R. p. 63.
The house was destroyed by fire, set by vandals, on 19
December 1997.
If the insurance coverage had been increased, or if
calculations had been for the building to necessarily remain in a
lower state of completion for a longer period of time, it wouldhave been reasonable to expect a proportionate increase in the
safeguards demanded by Federal. The amount of the premium paid by
the Rouses, likewise, was based on a set of expectations.
It is undisputed that the provisional limit of liability was
$2,369,000. It was stipulated that the actual value of the house on
19 December 1997 was $2,353,960 with the estimated completed cost
to be $3,141,244. The house was therefore 74.9% complete at the
time of the fire and, accordingly, the amount of insurance was
74.9% of $2,369,000, which totals $1,774,381. That is the amount
already paid by Federal to the Rouses.
Indeed, if the building had been completed within the cost
expectations which formed the basis of the policy _ that
construction would be completed at a total cost of $2,369,000 _ the
Rouses would have either moved in prior to the time of the
vandalism and fire or, certainly, would have had a more secure
structure with completion exceeding 99%.
For these reasons, I respectfully dissent and vote to reverse
the trial court's denial of Federal's summary judgment motion and
the grant of the Rouses' motion for summary judgment.
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