Court Opinion

ID: 9367959
Source: CourtListenerOpinion
Date Created: 2023-02-02 17:00:40.611684+00
Date Added: 2024-06-11T17:16:03.916524
License: Public Domain

USCA11 Case: 22-10668    Document: 40-1     Date Filed: 02/02/2023   Page: 1 of 7

                                                  [DO NOT PUBLISH]
                                   In the
                United States Court of Appeals
                        For the Eleventh Circuit

                          ____________________

                                No. 22-10668
                          Non-Argument Calendar
                          ____________________

       MARY ANN GUZY,
                                                     Plaintiff-Appellant,
       versus
       QBE SPECIALTY INSURANCE COMPANY,

                                                   Defendant-Appellee.

                          ____________________

                 Appeal from the United States District Court
                     for the Southern District of Florida
                    D.C. Docket No. 1:20-cv-23169-MGC
                          ____________________
USCA11 Case: 22-10668     Document: 40-1     Date Filed: 02/02/2023    Page: 2 of 7

       2                      Opinion of the Court               22-10668

       Before ROSENBAUM, JILL PRYOR, and GRANT, Circuit Judges.
       PER CURIAM:
              QBE Specialty Insurance Company insured a Miami
       residential property owned by Mary Ann Guzy. In late November
       or early December 2016, a pipe leaked and caused damage to
       Guzy’s unit. The parties disputed the value of the loss and
       ultimately entered into an appraisal agreement. That agreement
       provided that the “Award of Appraisal shall address only loss or
       damage caused by the reported water loss occurring on or about
       November 30, 2016, and shall not consider damage caused by any
       other events or non-covered perils.” In this action, Guzy argues
       that QBE breached this agreement by sending an email to the
       appraisal umpire with evidence that the damage Guzy claimed
       resulted from the November 2016 leak instead resulted from a
       subsequent 2017 leak. The district court dismissed Guzy’s Second
       Amended Complaint with prejudice, and we affirm. The appraisal
       agreement required the consideration of other losses to ensure that
       the final appraisal award related only to the November 2016 loss.
       Accordingly, Guzy has not stated a claim for breach of the appraisal
       agreement.
                                        I.
             In April 2016, Guzy and QBE entered into a residential
       insurance agreement covering Guzy’s Miami condominium unit.
       The policy period was effective for one year. In late November or
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       22-10668                Opinion of the Court                         3

       early December 2016, a pipe leaked above Guzy’s unit and caused
       damage to her property. She timely filed a claim with QBE and
       QBE issued various payments to Guzy totaling $367,000.
               About sixty days after the first leak, Guzy’s property suffered
       a second loss. Guzy alleges that she notified QBE of this second
       loss and QBE indicated that no further payments stemming from
       the first loss would be made. Guzy then filed an action in state
       court for breach of contract. Guzy claimed that the actual value of
       the first loss exceeds the $367,000 she received up to that point.
       QBE removed that action to the Southern District of Florida, and
       about a year later that lawsuit was dismissed without prejudice on
       a joint stipulation of the parties. The parties instead entered into a
       Memorandum of Appraisal. The terms of the appraisal agreement
       provided that an appraisal panel would be established consisting of
       one appraiser chosen by each party and an umpire chosen by the
       appraisers. The agreement of two out of the three was required to
       set the amount of the loss.
              In this action, Guzy alleges that QBE violated the appraisal
       agreement. The agreement provides that the “Award of Appraisal
       shall address only loss or damage caused by the reported water loss
       occurring on or about November 30, 2016, and shall not consider
       damage caused by any other events or non-covered perils.” Guzy
       says that QBE caused this provision to be violated when its
       appraiser sent an objection email to the umpire stating that the
       second loss was the “more significant event” and caused a
       “majority of the damage.” Guzy’s theory is that this violated the
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       4                         Opinion of the Court                     22-10668

       appraisal agreement because it forced a determination of the size
       and scope of the second loss. 1
              Shortly after QBE’s email, Guzy withdrew from the
       appraisal process and filed this suit in state court. QBE again
       removed the action to the Southern District of Florida. Guzy’s
       complaint was dismissed twice without prejudice before she filed
       the now-operative Second Amended Complaint. That complaint
       brings two counts for breach of the appraisal agreement and breach
       of the underlying insurance policy.
              The district court dismissed the Second Amended
       Complaint with prejudice. The court found that QBE’s email urges
       the umpire “not to consider damage that occurred after the
       November 30, 2016 incident.” This request was therefore
       consistent with the terms of the appraisal agreement and did not
       amount to a breach. And because Guzy did not allege a breach of
       the appraisal agreement, the district court held that she also did not
       allege a breach of the underlying policy. This appeal followed.

       1 Guzy also alleges that QBE violated the term of the appraisal agreement that
       required the parties to “make their best efforts” to “complete the appraisal
       within 90 days.” Though the appraisal process was not complete within 90
       days, the appraisal agreement also provides that failure to do so shall not be
       considered a breach of the agreement. The district court held that Guzy
       abandoned this claim by not addressing it in opposition to QBE’s motion to
       dismiss, and she does not raise it on appeal.
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       22-10668                Opinion of the Court                         5

                                         II.
              We review the dismissal of a complaint for failure to state a
       claim de novo. Henley v. Payne, 945 F.3d 1320, 1326 (11th Cir.
       2019). We must accept allegations in the complaint as true and
       construe them in the light most favorable to the plaintiff. Id. “To
       survive a motion to dismiss, a plaintiff needs to allege facts that are
       ‘plausible on their face,’ and ‘raise a right to relief above the
       speculative level.’” Dorman v. Aronofsky, 36 F.4th 1306, 1312
       (11th Cir. 2022) (quoting Bell Atl. Corp. v. Twombly, 550 U.S. 544,
       555, 570 (2007) (alterations adopted).
                                        III.
              On appeal, Guzy acknowledges that to “measure the
       amount only of the covered loss required intentional knowledge of
       and exclusion of the second loss.” Nonetheless, Guzy maintains
       that the appraisal agreement “prohibited” consideration of the
       second loss evidence. Guzy’s position appears to be that the
       appraisal agreement both required the appraisal process to separate
       out the damage caused by the two losses and prohibited entirely
       consideration of the second loss.
             We do not agree with this absurd result. The appraisal
       agreement requires that the “Award of Appraisal” shall not
       consider damage caused by other events. As a matter of logic, to
       ensure that the award only covered damage caused by the
       November 2016 leak, the appraisal process necessarily must
       consider other possible causes for the damage claimed. As a matter
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       6                      Opinion of the Court                 22-10668

       of law, the Florida Supreme Court has stated that “an assessment
       of the amount of a loss” necessarily includes a determination
       “whether or not the requirement for a repair or replacement was
       caused by a covered peril or a cause not covered.” State Farm Fire
       & Cas. Co. v. Licea, 685 So. 2d 1285, 1288 (Fla. 1996). Guzy’s
       reading of the appraisal agreement contravenes this basic principle
       and is implausible.
              The appraisal agreement thus required the appraisal process
       to determine the extent of the damage caused by the November
       2016 loss, rather than any subsequent loss event. QBE’s objection
       email was consistent with the terms of the agreement. In the email,
       QBE identifies newly received photographs documenting the
       second leak that dispute Guzy’s claim that the leak was only a
       minor event that caused minimal damage. QBE was clear that it
       raised the second leak because the “appraisal may only determine
       the damage arising from the November 29, 2016 loss.” In QBE’s
       view, the photographs demonstrated that “a majority of the
       damage that Ms. Guzy relates to the claim at issue resulted from a
       second loss and other losses afterward.” And in the end, the
       resulting appraisal award—issued after Guzy’s withdrawal—values
       the damages resulting only from the November 2016 loss. Guzy’s
       allegations, taken as true, do not establish a breach of the appraisal
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       22-10668               Opinion of the Court                         7

       agreement. Accordingly, we affirm the district court’s order
       dismissing the Second Amended Complaint.2
              Finally, the district court did not abuse its discretion in
       dismissing with prejudice. Guzy did not move to amend her
       complaint another time. As a counseled civil litigant, she is
       therefore not entitled to leave to amend. See Wagner v. Daewoo
       Heavy Indus. Am. Corp., 314 F.3d 541, 542 (11th Cir. 2002) (en
       banc). And even if she had moved to amend, a district court is not
       required to allow an amendment where, as here, there has been
       “repeated failure to cure deficiencies by amendments previously
       allowed.” Bryant v. Dupree, 252 F.3d 1161, 1163 (11th Cir. 2001).
                                  *      *      *
            The district court’s order dismissing the Second Amended
       Complaint with prejudice is AFFIRMED.

       2On appeal Guzy does not challenge the dismissal of the Second Amended
       Complaint’s claim that QBE breached the underlying insurance policy.