Opinion ID: 1206059
Heading Depth: 2
Heading Rank: 2

Heading: Theft Claim

Text: Filasky and her husband, Jeff, were separated but not divorced at the time events gave rise to the three claims. Jeff discovered that a burglary had occurred at his wife's home when he went to the home to remove some personal effects on June 26, 1982. Filasky returned home from the hospital on June 28 and reported the theft on July 7 to her agent, Jack Seibert. Gordon visited the home between July 7 and July 12. Filasky gave Gordon a copy of a handwritten list of stolen items that had been attached to a police report. Gordon testified that he told Filasky that he needed additional information, such as dates of purchase, age of item, model, etc. Filasky testified that Gordon said the handwritten report was all that he needed to take care of the report that I was filling out for him. Gordon then mailed or personally delivered a proof-of-loss form, inventory sheets, and an instruction letter to Filasky. The instruction letter requested an item description, quantity, owner, date and place of purchase, and replacement cost of each stolen item. Filasky testified that it was requested that I transfer the [hand]written form onto the Preferred Risk form. On July 19, 1982, Gordon discussed certain items on the handwritten list with Jeff during an authorized taped telephone conversation. When asked about the ownership of certain camera equipment, Jeff responded: Uh, to my knowledge, they must have belonged to Linda's boyfriend, Chuck. Because we didn't have any of that equipment to my knowledge. When Gordon asked about a Sony TV, Jeff responded: I don't know anything about that. When Gordon asked if Jeff knew anything about a Sony stereo, Jeff responded: No the only stereo that I know about I don't even know what the name of it was.... In a file memo dated July 23, 1982, Gordon wrote: Husband told agent [Seibert] wife wanted to claim things that he has at his apartment as stolen; said the insurance company wouldn't know. At trial, Jeff denied ever telling either Gordon or Seibert that his wife wanted to defraud Preferred Risk and that his only comments on her ownership of certain items were those quoted above. Seibert did not testify. During the week of July 26, 1982, Gordon personally interviewed Filasky. She claimed ownership of all stolen items. At trial, Gordon could not recall asking Filasky about ownership of the camera equipment, Sony TV, and Sony stereo. Filasky testified that Gordon did not challenge her ownership of these items during the interview. On August 2, 1982, Preferred Risk received Filasky's proof-of-loss form indicating losses of $16,119. Of this amount, approximately $12,500 was for stolen jewelry. The policy, naming both Jeff and Linda as insureds, limited jewelry coverage to $500. Gordon testified that he had told Filasky to list all stolen jewelry and to ignore coverage limits. The entire amount reported stolen then could later be used for income tax verification purposes. Jeff had not signed the proof-of-loss form. The form also did not list an Owner, Date of Purchase, and Place of Purchase for numerous items, including the camera equipment, TV, and stereo. On September 7, 1982, Gordon sent Filasky a letter rejecting her theft claim. The letter contained no reasons for rejection. On October 20, 1982, Preferred Risk received a copy of the Filasky divorce decree. It specifically stated that all right, title, and interest to any proceeds from the theft and casualty losses and any proceeds from any personal injuries belonged solely to Linda. At trial, Novak acknowledged having read the above provision. Filasky asked her attorney to handle her theft claim after its rejection. She then was asked to complete another proof-of-loss form. On December 1, 1982, Filasky called Novak and asked why her earlier claim was rejected. Novak responded, because it is not completely filled out as to who the owners are and so forth.... [W]e need the places of purchase with the approximate date.... Novak did not mention any ownership concerns. When Filasky requested personal assistance in completing the form, Novak responded, I will be happy to send you out a form letter we use on simple theft claims and it is quite clear.... [W]e can't afford to have some adjuster come. Filasky then took a copy of her earlier rejected proof-of-loss form and completed the missing information. She re-submitted this claim on January 21, 1983. Once again the claim was rejected. Filasky testified that she could not remember if Preferred Risk gave reasons at that time for the rejection; no one for Preferred Risk testified that reasons were given at that time. At trial, numerous reasons were suggested. Novak insisted that Jeff had to sign the form because he was a named insured and had a community-property interest. However, Novak also acknowledged receipt of the divorce decree designating Linda as sole owner of any interest in the theft claim. He also acknowledged that Jeff had disclaimed ownership of any stolen items. Another reason Novak gave at trial was that Preferred Risk questioned ownership of items listed as purchased prior to Jeff's move out of the house but of which Jeff had no knowledge. Yet, Filasky testified that no one at Preferred Risk questioned her ownership of the disputed items until her deposition on October 28, 1983. Novak also testified that he was dissatisfied with certain replacement values used on Filasky's proof-of-loss form. If Filasky was unable to remember the exact price of an item, she looked it up in a LaBelle's catalogue and listed the retail price. Novak believed Filasky should have used the cheaper price offered to LaBelle's customers. At trial, however, Novak admitted that it did not matter what replacement price was used by the insured; ultimately it was the claims adjuster's responsibility to determine a reasonable replacement price. Filasky refused to complete another proof-of-loss form and initiated legal action in May 1983. During her deposition in October 1983, Filasky became aware for the first time of Preferred Risk's ownership concerns. She explained that the stereo was a gift to her daughter from a friend and the camera equipment and Sony TV were gifts to her from her friend, Buff. Dates of acquisition listed on the January 1983 proof-of-loss form were dates on which her friend and Buff acquired the items. She testified that she had never asked Jeff to sign the proof-of-loss form because she did not want Jeff to know about Buff's gifts to her, nor did she desire to flaunt the gifts in Jeff's face. Only at her deposition did Filasky learn that Gordon had already talked to Jeff. On January 25, 1984, nineteen months after the burglary, Preferred Risk settled Filasky's theft claim for $3,900.08.