Ordinary Diligence Requirement of the Insured
The insureds brought an action against the insurer and the insurance agent, alleging that the agent negligently failed to obtain 100 percent dwelling loss replacement coverage on the insureds' home, which subsequently sustained substantial fire damage. This case is Groce v. American Family Mut. Ins. Co., 5 N.E.3d 1154 (2014).
In 1997, the Groces purchased a home and obtained a homeowners policy from American Family. In 2007, the home sustained substantial fire damage, and a dispute arose regarding the amount of insurance claim benefits payable under the policy. The insureds filed a lawsuit contending that the agent failed to obtain a fire insurance policy that would have paid the entire cost of reconstructing the house. The circuit court granted summary judgment to the insurer and the agent. The insureds appealed.
The Supreme Court of Indiana noted that Indiana law requires that the cause of action in tort accrues and the statute of limitations begins to run when the plaintiff knew, or in the exercise of ordinary diligence, could have discovered that an injury had been sustained as a result of the tortious act of another. Moreover, a claim against an agent for negligent procurement of the wrong coverage begins at the start of coverage if the breach was discoverable at the time through ordinary diligence, that is, generally when the policy is issued.
The policy issued to the Groces provided that the insurer would pay for the full cost to repair or replace the damaged building but not exceeding repair costs and the limit in the policy for the building. The insurer calculated the repair cost at $225,245, but the policy limit was $191,500. The insurer paid the latter amount in accordance with the policy language. The insureds claimed they were entitled to the full replacement amount because the agent asked them if they wanted replacement cost coverage, they said "yes," and the agent replied "I'll get this written up."
The court said that the insurer issued a homeowners policy to the Croces for ten years and that the insureds were advised by the insurer of the amount of their dwelling loss coverage limits and reminding the insureds to read the policy. Therefore, the court said, the Groces could have discovered that their dwelling loss replacement coverage did not exceed the applicable policy limits. The court found from the undisputed facts that the Groces, in the exercise of ordinary diligence in reviewing the homeowners policy, could have timely discovered that the insurer's replacement cost liability was capped at the dwelling loss coverage limit.
Thus, in accordance with Indiana law, the statute of limitations in this case began to run no later than the first policy renewal. The insureds did not comply with the statute of limitations, and the trial court's grant of summary judgment to the insurer and agent was affirmed.
Editor's Note: The Indiana Supreme Court affirmed the judgment of the trial court that the insureds had a duty to read their policy, that is, to exercise ordinary diligence in understanding the coverage limits in the policy language. If the agent had insisted that a particular hazard is covered or made representations to the insureds that, if true, would have covered their loss, thereby tolling the running of the limitations period, an exception to the insureds' duty to read the policy would have been created. However, that did not happen in this instance and the insureds had to settle for the stated policy limits. |