Court Opinion

ID: 9495510
Source: CourtListenerOpinion
Date Created: 2023-08-05 16:04:29.057863+00
Date Added: 2024-06-11T17:57:03.515381
License: Public Domain

TALLMAN, Circuit Judge,
dissenting:
Because I believe Pecarovich’s claim is proeedurally barred under well settled law, I respectfully dissent.
A claimant must strictly comply with the terms of the Standard Flood Insurance Policy (“SFIP”).1 Flick v. Liberty Mutual, 205 F.3d 386, 387 (9th Cir.2000) (concluding “that the strict compliance rule is applicable to policies written by private insurance companies under the National Flood Insurance Program”); Wagner v. FEMA, 847 F.2d 515, 518 (9th Cir.1988) (“The SFIP’s procedural requirements must be taken seriously: They constitute conditions precedent to a waiver by the federal government of its sovereign immunity.”). See also Federal Crop Ins. Corp. v. Merrill, 332 U.S. 380, 385, 68 S.Ct. 1, 92 L.Ed. 10 (1947) (recognizing the “duty of all courts to observe the conditions defined by Congress for charging the public treasury”). Thus, when seeking to avoid the procedural hurdles imposed by the SFIP, the claimant faces a “heavy burden.” Flick, 205 F.3d at 390.
Pecarovieh did not meet the SFIP procedural requirements. He did not file a proof of loss within 60 days of the alleged flood as required by the SFIP; in fact, he *660never filed a proof of loss. Consequently, his only avenue of recovery was under Article 9(J)(7) of the policy,2 which provides for a waiver of “a proof of loss in certain cases, in which event[the insured] will be required to sign and, at [Allstate’s] option, swear to an adjuster’s report .... ” Strict compliance with Article 9(J)(7) required that, at a minimum, (1) Allstate expressly waive the requirement that Pe-carovieh file a proof of loss, and (2) Pecaro-vich sign the adjuster’s report. Gowland v. Aetna, 143 F.3d 951, 954 (5th Cir.1998). Neither of these conditions precedent to a proper SFIP claim were satisfied by Peca-rovich.
In an understandable desire to help Mr. Pecarovieh get some compensation for his loss, the Court’s opinion is premised upon the incorrect assumption that Allstate waived the requirement that he file a proof of loss, though Pecarovieh himself admits that Allstate never expressly waived that requirement.3 Nonetheless, the Court holds that Allstate’s assurances to Pecaro-vich (that Allstate would satisfy the claim) somehow waived the proof of loss requirement.
When the uncontested evidence is fairly viewed, however, Allstate’s alleged statements neither create an express waiver to the proof of loss requirement nor give rise to an inference of waiver. Pecarovich’s own declaration, upon which the majority relies, provides, in relevant part:
I believe around mid-March and within a month of the loss, Mr. Rossi returned with a supervisor from Allstate. She told me that the reason she came out was to assure me that Allstate “would take care of everything” and that I was in good hands.
Either at that same time, or a few days later, in March Rossi told me he was having a problem with someone he had spoken to about the claim. He said, we “can’t proceed with adjustment of the claim unless I (Mr. Rossi) can establish certain information about the loss.” He then said he would therefore put together a report for me. He said that he would tell me what I had to do to be paid on the claim, and told me on no uncertain terms that he was calling the shots and I was just to take his direction. I asked him if there was anything else I needed to do, and he said no
Rossi repeatedly said that “he was in charge” and I could do nothing without his approval. I don’t recall his exact words, but by what he told me I understood that after he had the cost of repair he would meet with me, agree on the amount of loss, on the loss to be included in his report, and I would have to sign off on it.
*661Viewing this statement in the light most favorable to Pecarovich, Allstate never expressly waived the proof of loss requirement. The Allstate supervisor’s statement to Pecarovich that Allstate “would take care of everything” is not a waiver of the SFIP procedural requirements; it is mere puffery. Similarly, Adjuster Rossi’s assurances to Pecarovich never indicated that Allstate intended to waive the SFIP hurdles.
At most, Pecarovich can argue that (1) Allstate constructively waived the proof of loss requirement or (2) Allstate should be equitably estopped from denying a waiver. But, the case law has generally rejected such equitable theories of liability in the context of the SFIP since public monies are at stake. See, e.g., Flick, 205 F.3d at 394-95 (rejecting a substantial compliance standard in determining compliance with the SFIP procedural requirements); Gowland, 143 F.3d at 954-55 (dismissing theories of constructive waiver and equitable estoppel); Wagner, 847 F.2d at 519 (holding that equitable estoppel is narrowly defined in the context of the SFIP to include only “affirmative misconduct going beyond mere negligence”).4
Assuming arguendo that Allstate somehow acted to waive the proof of loss requirement, Pecarovich still needed to sign an adjuster’s report in order to strictly comply with Article 9(J)(7). Gowland, 143 F.3d at 954 (noting that the insured is required to sign an adjuster’s report in order to effect a waiver of the proof of loss requirement); Jamal v. Travelers Lloyds of Tex. Ins. Co., 131 F.Supp.2d 910, 918 (S.D.Tex.2001) (explaining that a signed adjuster’s report is a condition for waiving the proof of loss requirement). See also Mancini v. Redland Ins. Co., 248 F.3d 729, 734 (8th Cir.2001) (holding that claimants had not “signed” the proof of loss form by placing their names on a fax transmittal sheet). Viewing the evidence in the light most favorable to Pecarovich, this case is at best an example of substantial compliance with the SFIP provisions. But substantial compliance with the SFIP procedural requirement does not cure Pe-carovich’s failure to sign an adjuster’s report. His claim is still precluded. Flick, 205 F.3d at 394-95 (holding that substantial compliance with the SFIP terms is insufficient; a claimant “must comply strict; ly with the terms and conditions that Congress has established for payment”).
Pecarovich needed to file a proof of loss within 60 days of his loss in order to perfect his claim. He did not. There was no waiver of this requirement. Summary *662judgment in favor of Allstate was appropriate. Therefore, I respectfully dissent.

. The SFIP contract signed by Pecarovieh also requires strict compliance with all procedural terms. Article 9(R) ("You may not sue us to recover money under this policy unless you have complied with all the requirements of the policy.”).

. This is assuming that the "We” in Art. 9(f)(7) means "Allstate” as the majority contends. If "We” means “FEMA,” then Pecaro-vich’s claim is necessarily precluded without further analysis because FEMA never waived the proof of loss requirement.

. In Allstate’s deposition of Pecarovieh, the following colloquy occurred:
Q Were you ever advised by Mr. Rossi or any Allstate representative as to what coverage decision had been made on your claim?
A No.
Were you ever advised at any point in time by Mr. Rossi or any Allstate representative that a decision had been made not to pay your claim? O
No. >
Have you ever been advised by Mr. Rossi or any Allstate representative as to what coverage decision had been made to pay your claim? O
A No.
Q Did Mr. Rossi ever tell you, "Don't fill out a proof of loss form”?
A No.

. Similarly, any other affirmative conduct taken by Allstate (i.e., pursuing the' claim after the 60-day deadline to file a proof of loss had expired) did not waive SFIP conditions. See, e.g., Phelps v. FEMA, 785 F.2d 13, 19 (1st Cir.1986) (finding claimant’s reliance on the assurances of the NFIP representative unreasonable); Riverdale Mills Corp. v. American Modem Home Ins. Co., 122 F.Supp.2d 114, 118-120 (D.Mass.2000) (ruling that insurer’s letter holding open an additional 30 days to file claim past the 60-day deadline for filing the proof of loss did not operate as a waiver of the deadline). Furthermore, the plain language of the SFIP should have put Pecarovich on notice that he was not entitled to rely upon the representations of Allstate in deciding whether or not to file a proof of loss. Article 9(J)(6) of the SFIP provides:
The insurance adjuster whom we hire to investigate your claim may furnish you with a proof of loss form, and she or he may help you to complete it. However, this is a matter of courtesy only, and you must still send us a proof of loss within 60 days after the loss even if the adjuster does not furnish the form or help you to complete it.
(emphasis added). Thus, "the SFIP 'candidly warns’ the insured not to rely upon the insurer for assistance in complying with the proof of loss requirement.” Riverdale Mills, 122 F.Supp.2d at 118 (citing Humphrey v. NFIP, 885 F.Supp. 133, 137 (D.Md.1995) and Wagner, 847 F.2d at 520).