Court Opinion

ID: 9881472
Source: CourtListenerOpinion
Date Created: 2023-10-02 19:01:37.289452+00
Date Added: 2024-06-11T14:08:33.614860
License: Public Domain

NOT RECOMMENDED FOR PUBLICATION
                               File Name: 23a0417n.06

                                        Case No. 22-3508
                                                                                     FILED
                          UNITED STATES COURT OF APPEALS                         Oct 02, 2023
                               FOR THE SIXTH CIRCUIT                        DEBORAH S. HUNT, Clerk

                                                      )
MINDY CARPENTER; SHAWN CARPENTER,
                                                      )
        Plaintiffs-Appellants,                        )     ON APPEAL FROM THE UNITED
                                                      )     STATES DISTRICT COURT FOR
v.                                                    )     THE SOUTHERN DISTRICT OF
                                                      )     OHIO
LIBERTY INSURANCE CORPORATION,                        )
        Defendant-Appellee.                           )                                 OPINION
                                                      )

Before: KETHLEDGE, THAPAR, and MATHIS, Circuit Judges.

       THAPAR, Circuit Judge. When a fire broke out at Mindy and Shawn Carpenter’s house,

Liberty Insurance Corporation believed they had started the blaze themselves. So Liberty refused

to cover the damage. The Carpenters sued. And even though Liberty later approved a payout, the

Carpenters believe they’re entitled to more. The district court entered summary judgment for

Liberty. We affirm in part and vacate in part.

                                                 I.

       After Mindy and Shawn Carpenter’s house caught fire, they filed a claim with their

insurance company, Liberty Insurance Corporation. But when Liberty started investigating, red

flags turned up. For one, the fire marshal concluded the fire was deliberately set. Yet there were

no signs of forced entry. Indeed, the house doors were locked the morning of the fire, and the

Carpenters were the only ones with keys. And even though the Carpenters went camping the night

before, Mr. Carpenter was at his house the morning of the fire. Liberty also found motive: the
No. 22-3508, Carpenter v. Liberty Ins. Corp.

Carpenters appeared to be behind on their bills, and the house had significant mold growth and

water damage in the basement.

        Based on this investigation, Liberty concluded the Carpenters started the fire. Like most

insurance policies, the Carpenters’ excluded intentional losses. So Liberty denied their claim.

        The Carpenters sued, alleging breach of contract and insurer bad faith under Ohio law. In

addition to compensatory damages, they demanded consequential and emotional distress damages.

The district court granted summary judgment to Liberty on the bad-faith claim. And it capped the

Carpenters’ potential recovery at their policy’s limits.

        During the litigation, Liberty learned the Carpenters had been fixing up their house. To

Liberty, these repairs suggested they didn’t start the fire. So Liberty reversed course: it agreed to

reimburse them for certain repairs and a year of living expenses.

        But the Carpenters believed Liberty owed them more. In their view, Liberty owed them

the entire balance of their policy’s repair and replacement coverage. They also demanded living

expenses for the five years it took them to repair the house—not just the one year for which Liberty

paid.

        The parties agreed to resolve these issues through cross-motions for summary judgment.

To facilitate this, they stipulated that the remaining claims hinged on a few, narrow questions about

the Carpenters’ coverage. The district court resolved these questions in Liberty’s favor and granted

it summary judgment on the remaining issues.

        The Carpenters appeal that final judgment as well as the district court’s earlier rulings on

damages and the bad-faith claim.

                                                -2-
No. 22-3508, Carpenter v. Liberty Ins. Corp.

                                                 II.

        We review the district court’s grant of summary judgment de novo and draw all reasonable

inferences in the Carpenters’ favor. Hurst v. Caliber Home Loans, Inc., 44 F.4th 418, 424 (6th

Cir. 2022). The three major issues in this appeal are bad faith, breach of contract, and damages.

                                                 A.

        Bad Faith. In Ohio, insurance companies owe their clients a duty of good faith. See Zoppo

v. Homestead Ins. Co., 644 N.E.2d 397, 399 (Ohio 1994). An insurer breaches this duty when it

refuses to pay a claim without “reasonable justification” in law or fact. Id. at 400.

                                                 1.

        The Carpenters’ insurance policy excludes intentional losses. In other words, if the

Carpenters intentionally damage their house, Liberty need not pay. Ohio calls this the “arson

defense.” Caserta v. Allstate Ins. Co., 470 N.E.2d 430, 433 (Ohio Ct. App. 1983). Under this

defense, insurers can deny claims if (1) the fire was “incendiary,” (2) the insured had a motive to

start the fire, and (3) they had an opportunity to do so. Id. Liberty had enough evidence to support

each element of the defense.

        First, both parties agree the fire was incendiary—in other words, the fire was intentionally

set, not a freak accident.

        Second, Liberty could reasonably conclude the Carpenters had motive to burn their house.

Their basement had recently flooded, leaving extensive mold and water damage. Credit reports

showed that the Carpenters faced tax liens, late payments, and delinquent accounts. And their

house was conspicuously empty: there was no television or cable box in the living room, no clothes

in the bedroom closet, and no toiletries in the bathroom. Moreover, nobody could identify anyone

else with a motive.

                                                -3-
No. 22-3508, Carpenter v. Liberty Ins. Corp.

       Third, Liberty could reasonably conclude the Carpenters had an opportunity to start the

fire. Mr. Carpenter was at the house the morning of the fire, and there was no sign of forced entry.

       Given these facts, Liberty was reasonably justified in applying the arson defense to the

Carpenters’ claim. Thus, Liberty’s denial wasn’t in bad faith.

                                                 2.

       The Carpenters offer five counterarguments. None succeeds.

       First, the Carpenters argue they weren’t the only ones who could access their house. That’s

true, but it doesn’t matter. The arson defense only requires that the Carpenters had an opportunity

to start the fire—not the exclusive opportunity. Caserta, 470 N.E.2d at 433. The Carpenters cite

one case suggesting otherwise, but that case didn’t involve the arson defense or bad-faith claims.

See Gedra v. Dallmer Co., 91 N.E.2d 256 (Ohio 1950) (involving a negligence suit). So it doesn’t

apply here.

       Second, the Carpenters argue the district court relied on inadmissible evidence when

granting summary judgment. See Fed. R. Civ. P. 56(c)(2). In particular, they object to the court’s

consideration of (1) the Carpenters’ credit reports, (2) laypeople’s statements about mold in their

basement, and (3) Mr. Carpenter’s refusal to undergo a voice stress test after reporting the fire.

Each of these objections fails.

       The Carpenters claim their credit reports are hearsay and immaterial. They’re wrong. First,

the credit reports aren’t hearsay. To be hearsay, a party must offer a statement to prove the truth

of its contents. See Fed. R. Evid. 801(c)(2). But Liberty doesn’t offer the credit reports to prove

the truth of their contents—i.e., to show the Carpenters were actually financially distressed.

Rather, Liberty offers the reports only to show it could reasonably conclude that they were. And

                                               -4-
No. 22-3508, Carpenter v. Liberty Ins. Corp.

Liberty could reasonably conclude that even if the reports later turn out to be inaccurate. That

means the reports aren’t hearsay. Id.

       The credit reports are also material. Evidence is “material” if it helps prove a fact that is

at issue in a case. McCormick on Evidence § 185 (8th ed. 2020); cf. Fed. R. Evid. 401(b). At issue

here is whether Liberty was reasonably justified in invoking the arson defense. Motive is an

element of that defense, and the credit reports suggest Liberty could reasonably conclude the

Carpenters had motive. After all, an insurance payout could have helped pay down those debts.

Thus, the credit reports are material.

       Next, the Carpenters argue that Liberty’s inspector was not qualified to opine on the

presence of mold. But it doesn’t take “scientific, technical, or other specialized knowledge” to

conclude the basement had mold. Fed. R. Evid. 701. Mold visibly coated their basement floor

and stairwell. And both Liberty’s employee and its consultant personally saw the mold, so their

opinions about it are admissible. Id.

       The Carpenters object to one more piece of evidence: Mr. Carpenter’s refusal to undergo

a voice stress analysis when firefighters arrived. But this doesn’t pose an issue, either. Even

ignoring his refusal, Liberty had enough evidence to reasonably conclude the Carpenters had

motive and opportunity.

       Third, the Carpenters allege that Liberty’s investigation was so inept that it amounted to

bad faith. In support of this allegation, they claim Liberty didn’t follow national fire investigation

guidelines. And they note Liberty didn’t consult police about property crime in the area. But that

isn’t enough to show bad faith.

       To be sure, egregiously inadequate investigations can constitute bad faith. In Zoppo, the

Ohio Supreme Court reinstated a bad faith finding for an insurance company that denied a bar’s

                                                -5-
No. 22-3508, Carpenter v. Liberty Ins. Corp.

claim for fire damage. Zoppo, 644 N.E.2d at 400–01. There, the insurer failed to interview two

patrons whom the bar had recently kicked out. Id. Those two had publicly claimed responsibility

for attempted arson of the bar three weeks before the fire in question. Id. One of them even

promised he’d go back to the bar to “finish the job.” Id. Additionally, the insurance company

never bothered to check where the bar’s owner was on the day of the fire. Id.

        Contrast that with the facts here. The Carpenters haven’t identified anyone with a motive

to burn their house, much less someone who’s publicly claimed responsibility. And unlike the

insurer in Zoppo, Liberty tracked down Mr. Carpenter’s whereabouts during the fire: he was at

the house. Moreover, Liberty had enough other evidence to reasonably conclude that the arson

defense applied. Thus, it’s okay that Liberty didn’t talk with the police. Liberty’s alleged

noncompliance with the National Fire Protection Association Guide for Fire and Explosion is

similarly irrelevant. The Carpenters cite no authority suggesting the Guide is the standard for good

faith. Thus, there’s no basis to conclude Liberty’s investigation was inadequate.

        Fourth, the Carpenters argue that Liberty’s subsequent approval of their claim proves that

the original denial was in bad faith. But Liberty changed its mind only after learning the Carpenters

had repaired their house. If anything, this demonstrates Liberty’s good faith: once it found

evidence suggesting the Carpenters didn’t start the fire, it approved their claim. So this argument

fails, too.

        Fifth, the Carpenters marshal an array of facts suggesting they lacked the motive and

opportunity to start the fire. They say this proves Liberty’s bad faith. But Liberty doesn’t

need undisputed evidence that the Carpenters had motive and opportunity. To prevail against the

bad-faith allegation, Liberty only needs to show a reasonable justification to deny their claim.

Thomas v. Allstate Ins. Co., 974 F.2d 706, 711 (6th Cir. 1992). It’s met that burden.

                                                -6-
No. 22-3508, Carpenter v. Liberty Ins. Corp.

        For these reasons, we affirm the grant of summary judgment on the bad-faith claim.

                                                B.

        Breach of Contract. This claim hinges on three questions: (1) whether the fire damage

constituted a “total loss” of the Carpenters’ house, (2) whether the insurance policy’s “Actual Cash

Value” provision entitles them to additional payment, and (3) whether the policy’s “Additional

Living Expenses” coverage requires more than twelve months of payments.

                                                 1.

        First, the total loss claim. Ohio law requires insurers to pay out the “whole amount” of

certain policies if there’s a “total loss” to an insured building. Ohio Rev. Code Ann. § 3929.25.

To be a total loss, the building must have “lost its identity and specific character as a building.”

Paterson-Leitch Co. v. Ins. Co. of N. Am., 366 F. Supp. 749, 757 (N.D. Ohio 1973) (citing Pa. Fire

Ins. Co. v. Drackett, 57 N.E. 962, 963 (Ohio 1900)). It must be “of no value in repairing or

rebuilding.” Pa. Fire, 57 N.E. at 963.

        The Carpenters’ house was not a total loss. The house suffered no noticeable exterior

damage. Indeed, the Carpenters were able to repair the house and sell it for $258,000. Thus, the

house didn’t lose its “identity and specific character” as a building. Nor was it without “value in

repairing.” Id. And because there’s no total loss, the statute doesn’t apply. We affirm the district

court’s grant of summary judgment on this issue.

                                                 2.

        Next, the “actual cash value” provision, which we’ll call the “repair and replacement

coverage.” Under that coverage, Liberty only pays the actual cost of damage until the Carpenters

finish repairs. Once they do, Liberty must reimburse them for the cost of repair, up to several

limits in the policy.

                                               -7-
No. 22-3508, Carpenter v. Liberty Ins. Corp.

        In their stipulations, the parties narrowly framed the legal question regarding this coverage.

They stipulated that Liberty owes more money only if the sale of the house for $258,000 entitled

the Carpenters to an additional payment. The district court accepted this stipulation. And it found

that nothing in the policy ties the house’s sale price to the Carpenters’ rights to payment. So it

granted Liberty summary judgment on this issue.

        There was one problem with accepting this stipulation—stipulations about insurance

coverage don’t bind a court. Crow v. Nationwide Mut. Ins. Co., 824 N.E.2d 127, 130 (Ohio Ct.

App. 2004). While parties may stipulate facts, they can’t stipulate their own version of the law.

Est. of Ralston v. Metro. Prop. & Cas. Ins. Co., 767 N.E.2d 789, 792 (Ohio Ct. App. 2001). And

questions about coverage under an insurance policy are matters of law, not fact. Nationwide Mut.

Fire Ins. Co. v. Guman Bros. Farm, 652 N.E.2d 684, 686 (Ohio 1995). Thus, “[p]arties or their

attorneys cannot by agreement require the court to give to a written contract an effect other than

its legal import.” Crow, 824 N.E.2d at 131 (citation omitted). Once a contract is made, courts

decide its legal significance, not the parties.

        Here, Liberty has already paid the Carpenters some money, but it did not exhaust the limits

under the repair and replacement coverage. And the Carpenters argue Liberty owes them more

under that coverage. How much more, if any? That will hinge on several factual issues that aren’t

yet resolved. For example, Liberty’s remaining liability depends on whether the Carpenters’

unreimbursed repairs were “necessar[y].” R. 47-2, Pg. ID 361. And it depends on whether the

repairs used “like construction” to the original fixtures. Id.

        Because the district court accepted the parties’ stipulations, the parties didn’t squarely

address these issues in their briefing. As a result, there are unresolved “material facts.” Fed.

                                                  -8-
No. 22-3508, Carpenter v. Liberty Ins. Corp.

R. Civ. P. 56. Thus, on the issue of repair and replacement coverage, we affirm the denial of

summary judgment to the Carpenters and vacate the grant of summary judgment to Liberty.

                                                 3.

        Third, the “additional living expense” coverage. Under that coverage, Liberty agreed to

reimburse certain living expenses while the Carpenters’ house was unlivable. The coverage lasts

until the Carpenters finish repairs or find a new place to live. An endorsement modifies that policy.

It reads:

               [Liberty] will pay the amount of loss covered by [the additional
               living expense coverage] which is actually sustained by you during
               the 12 consecutive months following the date of loss, subject to the
               periods of time [specified elsewhere in the policy]. R. 47-2, Pg. ID
               362.

        The district court correctly interpreted this endorsement as limiting coverage to twelve

months. Every other court to analyze these or similar provisions has reached the same conclusion.

See Hayes v. Liberty Ins. Corp., 526 F. App’x 564, 566 (6th Cir. 2013); Amro v. Liberty Ins. Corp.,

CV 12-2753, 2014 WL 12600975, at *1 (D. Minn. Sept. 11, 2014); Liberty Pers. Ins. Co. v. Mayes,

5:20-CV-00967, 2022 WL 2427726 (W.D. La. Feb. 11, 2022), R. & R. adopted, 2022 WL 2427746

(W.D. La. Mar. 4, 2022). And for good reason. To interpret the policy otherwise would render

the twelve-month provision meaningless. And Ohio law requires courts to interpret contracts in a

way that gives meaning to every provision. Sunoco, Inc. (R & M) v. Toledo Edison Co., 953

N.E.2d 285, 295 (Ohio 2011).

        Both parties agree Liberty paid twelve months of coverage, so there’s no breach. Thus, we

affirm the district court’s grant of summary judgment to Liberty.

                                                -9-
No. 22-3508, Carpenter v. Liberty Ins. Corp.

                                                  C.

       Damages. In its first grant of summary judgment, the district court limited Liberty’s

possible liability to the insurance policy’s limits. The Carpenters argue the court should allow

emotional distress and consequential damages, too.

       But those aren’t available here. First, Ohio law limits emotional distress damages to

specific kinds of contracts. Brainard v. Am. Skandia Life Assur. Corp., 432 F.3d 655, 665 (6th

Cir. 2005). Insurance contracts aren’t one of them. See Frechette v. Health Recovery Servs., Inc.,

2:19-CV-4453, 2022 WL 974383, at *4 (S.D. Ohio Mar. 31, 2022) (noting Ohio law has only

allowed emotional distress damages for contracts involving builder-vendors, funeral home

services, and settlement agreements for stalking).

       The Carpenters fare no better with consequential damages. In some states, plaintiffs can

recover damages beyond their policy’s limit when an insurer wrongfully delays or refuses to pay

out. See 47 A.L.R.3d 314 (1973). Ohio isn’t one of those states. See Haas v. Pac. Mut. Life Ins.

Co., 41 N.E.2d 263, 266 (Ohio Ct. App. 1941) (upholding dismissal of a claim for consequential

damages, even though insurer had foreseen those damages). In Ohio, insureds can’t recover

beyond their policy’s limits for a breach of contract.

       Thus, we affirm the district court’s grant of summary judgment as to damages.

                                                 III.

       Waiver and Estoppel. The Carpenters argue that because Liberty waited years before

approving their claim, it has waived its rights to enforce their policy’s limits. They also say Liberty

should be estopped from enforcing those limits. Both arguments fail.

                                                - 10 -
No. 22-3508, Carpenter v. Liberty Ins. Corp.

          First, waiver. In Ohio, litigants can’t use the doctrine of waiver to expand insurance

coverage beyond a policy’s terms. Hybud Equip. Corp. v. Sphere Drake Ins. Co., 597 N.E.2d

1096, 1104 (Ohio 1992). Because that’s what the Carpenters attempt here, their argument fails.

          Next, estoppel. To invoke equitable estoppel, the Carpenters need to show (1) Liberty

caused them to believe certain facts and (2) the Carpenters detrimentally changed their position in

reliance on those facts. Chubb v. Ohio Bureau of Workers’ Comp., 690 N.E.2d 1267, 1270 (Ohio

1998). If the Carpenters can make this showing, they can stop Liberty from backpedaling on those

facts. Id. For example, imagine Liberty initially told the Carpenters that it would cover all their

repairs. And imagine that the Carpenters, relying on Liberty’s promise, spent money repairing

their house. In that scenario, a court could prevent Liberty from later denying the Carpenters’

claims.

          But this case presents the reverse scenario. Liberty led the Carpenters to believe that it

would not cover their repairs. And the Carpenters cite no case suggesting Liberty’s initial denial

prevents it from continuing to deny certain coverage later. In other words, Liberty wouldn’t be

allowed to promise full coverage and then deny it. But Liberty is allowed to promise denial and

then deny coverage. So estoppel is no help for the Carpenters, either.

                                           *      *       *

          We affirm in part, vacate in part, and remand for further proceedings on the breach-of-

contract claim.

                                                - 11 -