Gallegos v. Safeco Insurance Co. , 646 F. App'x 689 ( 2016 )

FILED
United States Court of Appeals
Tenth Circuit
May 16, 2016
UNITED STATES COURT OF APPEALS
Elisabeth A. Shumaker
TENTH CIRCUIT Clerk of Court
EUGENE GALLEGOS, DIANE
GALLEGOS,
Plaintiffs - Appellants,
v. No. 15-1238
(D.C. No. 1:14-CV-01114-WJM-MJW)
SAFECO INSURANCE COMPANY D. Colorado
OF AMERICA,
Defendant - Appellee.
ORDER AND JUDGMENT *
Before GORSUCH, MURPHY, and McHUGH, Circuit Judges.
I. INTRODUCTION
A home owned by Eugene and Diane Gallegos suffered a partial roof
collapse, caused, at least in part, by the accumulated weight of ice and snow. The
Gallegoses sought coverage under a homeowners insurance policy issued to them
by Safeco Insurance Co. (“Safeco”). Safeco denied the Gallegoses’ request for
*
This order and judgment is not binding precedent except under the
doctrines of law of the case, res judicata, and collateral estoppel. It may be cited,
however, for its persuasive value consistent with Fed. R. App. P. 32.1 and 10th
Cir. R. 32.1.
insurance benefits, asserting the collapse was caused, at least in part, by improper
maintenance and construction. The Gallegoses brought state law claims against
Safeco, asserting the denial of insurance benefits was improper and in bad faith.
The district court granted summary judgment to Safeco, ruling (1) it was
undisputed improper maintenance contributed to the roof collapse; (2) Safeco
preserved its right to rely on the improper-maintenance exclusion by raising the
issue in its reservation of rights letter; and (3) Safeco did not waive its coverage
defenses when, in the midst of the litigation, it paid to the Gallegoses the amounts
they expended to repair the roof. The Gallegoses appeal. Exercising jurisdiction
pursuant to 28 U.S.C. § 1291, this court affirms the district court’s grant of
summary judgment in favor of Safeco.
II. BACKGROUND
Safeco issued a homeowners insurance policy to the Gallegoses, effective
November 15, 2013 to November 15, 2014, for a home located in Colorado.
Sometime in late November or early December 2013, a storm deposited snow on
the roof of the Gallegoses’ residence. On December 9, 2013, they submitted a
claim to Safeco, reporting that the weight of ice and snow caused the roof to sag
and the living room ceiling to crack. Safeco retained Corey Schrauben, a
professional engineer, to inspect the loss. Schrauben concluded the damage to the
Gallegoses’ roof resulted not from the accumulation of ice and snow from a
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storm, but from poor roof construction/repair and historic gravity-loading events
that predated the Gallegoses’ ownership of the home. 1
On January 14, 2014, Safeco sent a letter to the Gallegoses denying their
claim. That letter specifically noted as follows:
As you are aware, this claim arises from damage to your roof
from the weight of ice and snow. Our investigation revealed that
your roof sustained damage from historic gravity-loading events on
your roof that occurred before the home was purchased. There is no
evidence that shows this damage occurred since the home was
purchased in 1999. Also, the sags in the ceiling’s drywall in the
living room is due to a fastener installation pattern that is insufficient
to support the weight of the drywall. Also, the moisture damage to
the drywall is long term, which produced a punching shear failure of
the fasteners.
The letter moved on to identify multiple exclusions in the policy that were
relevant to the coverage determination. 2 Finally, the denial letter stated that
1
Schrauben’s report observed the following conditions: “historic moisture
intrusion” into the attic; roof rafters spaced at “32-inches on center and knee
braces were visibly shifted”; and “historic repairs in the form of improvised 1x
knee braces to ceiling joists and sistered 2x4 rafters.” Based upon his inspection
of the home, examination of records at the county assessor’s office and historical
weather data, and his professional engineering experience, Schrauben concluded:
the “roof structure exhibited no damage that was consistent with a snow-loading
event that has occurred since” the Gallegoses’ 1999 purchase of the home;
“fractures in the roof framing were consistent with historic gravity-loading events
inclusive of dead loads, snow loads, and other live loads on the roof (such as
construction loads) that occurred prior to” the Gallegoses’ purchase of the
residence; and “sags in the ceiling sheetrock of the living room were consistent
with a fastener installation pattern that was insufficient to support the weight of
the sheetrock and/or a long-term, moisture-related deterioration of the sheetrock,
which produced a punching shear failure of the fasteners.”
2
The relevant provisions of the insurance policy identified in the denial
(continued...)
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Safeco “reserves any and all rights and defenses allowed under the policy of
insurance and the law. No action taken by [Safeco], its employees and/or agents,
2
(...continued)
letter are as follows:
We do not cover loss caused directly or indirectly by any of the
following excluded perils. Such loss is excluded regardless of any
other cause or event contributing concurrently or in any sequence to
the loss. These exclusions apply whether or not the loss event results
in widespread damage or affects a substantial area;
5. continuous or repeated seepage or leakage of water or steam, or
the presence or condensation of humidity, moisture or vapor which
occurs over a period of weeks, months or years.
6. a. wear and tear, marring, scratching, deterioration; b. inherent
defect, mechanical breakdown; c. smog, rust or other corrosion, or
electrolysis; d. smoke from agricultural smudging or industrial
operations; e. settling, cracking, shrinking, bulging, or expansion of
pavements, patios, foundations, walls, floors, roofs, ceilings,
swimming pools, hot tubs, spas, or chimneys; f. birds, vermin,
rodents, insects or domestic animals; g. pressure from or presence of
plant roots.
....
17. Weather that contributes in any way with a cause or event not
covered in this section to produce a loss. However, any ensuing loss
caused by a covered peril and not otherwise excluded is covered.
18. Planning, Construction or Maintenance, meaning faulty,
inadequate or defective: a. planning, zoning, development, surveying,
siting; b. design, specifications, workmanship, repair, construction,
renovation, remodeling, grading, compaction; c. materials used in
repair, construction, renovation or remodeling; or d. maintenance of
property whether on or off the insured location by any person or
organization. However, any ensuing loss not excluded is covered.
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is intended to be or should be considered to be a waiver of any of these rights or
defenses under the policy of insurance or the law.”
The Gallegoses filed suit. In a pre-trial scheduling order, the Gallegoses
claimed the cost to repair the damage was $9782. Safeco paid $9782 to Gallegos
in the midst of the litigation.
The Gallegoses retained a professional engineer, Scott Johnson, who issued
a report, dated November 20, 2014, which contains the following opinions:
The section of the roof that sagged was not well supported.
Although the framing system has lasted without a major failure over
the span of years that Mr. Gallegos has resided there, it was never in
a condition that was strong enough to be able to support the heavy
snow loading typical for that site. . . .
....
On page 71 through 73 of my deposition I estimated the
amount of weight I thought the roof would be able to handle without
causing damage to the ceiling. My estimation at the time was 20-30
pounds per square foot (psf). I have since performed additional
calculations . . . . These calculations show that I overestimated the
loading the roof was capable of supporting. Upon review of these
calculations, and the condition of the wood and framing I now feel
that the amount of snow loading the roof is capable of carrying
without causing the ceiling joist to sag further is roughly 6-8 pounds
per square foot. This translates to roughly 11-15 inches of snow at
10% snow water equivalent (SWE). This total is consistent with our
original report and our conclusion that enough snow and ice had
accumulated to cause the deflection in the roof and ceiling.
In his deposition, Johnson confirmed his opinions regarding the cause of the
damage to the property and agreed with Schrauben regarding the construction
deficiencies in the roofing system:
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Q. The next sentence says, “Roof rafters were spaced at 32
inches on center and knee braces were visibly shifted.” Do you agree
with that statement?
A. I do.
Q. Okay. The next sentence says, “Given the wider rafter
spacing and absence of bracing at the rafter mid-span, larger
deflections would necessarily be expected.”
A. I agree with that also.
....
Q. And then skipping down—skipping the next sentence and
starting with “Coincident with the aforementioned fractures, historic
repairs in the form of improvised 1-by knee braces to ceiling joists
and sistered 2-by-4 rafters were observed.” Did you observe similar
construction?
A. I did observe some rather interesting carpentry.
Finally, Johnson opined that the construction deficiencies and deterioration of the
roof, combined with ice loading, caused the roof and ceiling to sag:
A. It’s ice loading that caused the problem, number one.
Number two, the braces that were out of place were—if you believe
that Mr. Gallegos didn’t make any modifications—were already there
when he bought the property, they may have already been out of
place when he bought the property, but that still wouldn’t have
stopped them from transmitting force from the roof downward.
And, as I said, that roof, in my opinion, without going into
forensics and stuff like that, was just not a very—the wood was
damaged or deteriorated, however you want to put it. The wood
wasn’t as good as it could be. And, therefore, it would—it wouldn’t
take as much of a load to cause trouble for that roof as if it was a
brand-new roof, I don’t think I’d argue at all about the spacing being
excessive on the rafters and the joists.
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The district court granted summary judgment in favor of Safeco,
concluding it was undisputed that improper maintenance/construction of the roof
supports contributed to the collapse of the Gallegoses’ roof. In particular, the
district court ruled the insurance policy contained an “anti-concurrent causation”
clause that significantly limits Safeco’s liability. That provision states that the
policy does “not cover loss caused directly or indirectly by any of [the
specifically excluded perils]. Such loss is excluded regardless of any other cause
or event contributing concurrently or in any sequence to the loss.” 3 Based on the
opinion offered by Johnson, the district court concluded no reasonable jury could
conclude that improper maintenance and/or construction of the roof was not a
cause, at least in part, of the roof collapse. The district court rejected the
Gallegoses’ claim that Safeco had waived reliance on the relevant policy
exclusions by either (1) failing to identify them in the January 14, 2014, letter
denying the claim, or (2) paying the costs of the roof repair in the midst of the
litigation. The Gallegoses appeal.
3
Anti-concurrent causation clauses are enforceable under Colorado law.
See Colo. Intergovernmental Risk Sharing Agency v. Northfield Ins. Co., 207 P.3d
839, 842 (Colo. App. 2008).
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III. ANALYSIS
A. Standard of Review
This court reviews a grant of summary judgment de novo, applying the
same legal standard used by the district court. Sigmon v. CommunityCare HMO,
Inc., 234 F.3d 1121, 1124 (10th Cir. 2000). Summary judgment is appropriate “if
the movant shows that there is no genuine dispute as to any material fact and the
movant is entitled to judgment as a matter of law.” Fed. R. Civ. P. 56(a). If there
exist no genuine disputes of material fact, this court must determine if the district
court correctly applied the law. See Wolf v. Prudential Ins. Co. of Am., 50 F.3d
793, 796 (10th Cir. 1995).
B. Discussion 4
1. Coverage
Although the Gallegoses attempt to make it complicated, the issue on
appeal is quite simple. The question is whether any reasonable juror could
conclude that a specifically excluded cause (i.e., improper construction and/or
4
In resolving this appeal, we do not consider issues not raised before the
district court or issues only alluded to in a perfunctory manner in the Gallegoses’
appellate briefs. See United States v. Windrix, 405 F.3d 1146, 1156 (10th Cir.
2005) (declining to address an issue the party “did not argue in district court,”
because “in general we will not consider an argument not raised below,” and the
party did “not argue on appeal that any special circumstance requires us to
address this contention despite lack of preservation below”); Femedeer v. Haun,
227 F.3d 1244, 1255 (10th Cir. 2000) (“On appeal . . . parties must do more than
offer vague and unexplained complaints of error. Perfunctory complaints that fail
to frame and develop an issue are not sufficient to invoke appellate review.”
(quotation and alterations omitted)).
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maintenance) did not contribute to the collapse of the Gallegoses’ roof. Like the
district court, this court concludes that the answer to that question is an emphatic
“no.”
The insurance policy at issue in this case contains multiple exclusions for
wear and tear; deterioration; and faulty design, construction, repair, and
maintenance. Johnson, the Gallegoses’ own engineering expert, confirmed in his
report that excluded events contributed to the loss. He opined that two factors
caused the roof collapse. The first was “ice loading.” The second was the
deteriorated condition of the framing supporting the roof and the faulty,
inadequate, or defective design, construction, and repair of the roof’s framing. In
his deposition, Johnson identified several deficiencies in the framing of the
roofing system to explain why the roof “deflected” under the relatively modest
amount of snowfall reported during the relevant storm. These deficiencies
included: (1) faulty design, construction, repairs, and maintenance; (2) shrinking
and cracking of the framing; (3) presence of water over a period of years; and (4)
general wear and tear and deterioration. According to Johnson, these factors, all
of which are excluded under the terms of the policy, combined with the weight of
ice and snow from the storm to cause the roof to collapse. Accordingly, by the
Gallegoses’ expert’s own admissions, weather was only one contributing factor to
the loss which combined with other, excluded events, to cause the collapse. That
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being the case, no reasonable juror could conclude improper construction and/or
maintenance of the roof did not, at least in part, contribute to the roof’s collapse.
The Gallegoses argue, without any factual or legal support, that Safeco
cannot rely upon the wear and tear exclusion because there is no evidence of
“abnormal” wear and tear. The exclusion is not, however, limited to “abnormal
wear and tear,” but rather encompasses all “wear and tear.” See Lovell v. State
Farm Mut. Auto. Ins. Co., 466 F.3d 893, 902 (10th Cir. 2006) (applying Colorado
law and holding that when the language used in an insurance contract is plain and
its meaning is clear, the agreement must be enforced as written). The policy at
issue here unambiguously excludes losses caused, “directly or indirectly,” by
“wear and tear, marring, scratching, deterioration.” Furthermore, the Gallegoses
have not identified a single piece of evidence in the record upon which a juror
could conclude the maintenance/construction defects identified by Johnson
amount to nothing more than “normal” wear and tear.
2. Reservation of Rights
Colorado law provides that an insurer must raise or reserve all defenses
known to it within a reasonable time or those defenses may be waived or the
insurer may be estopped from asserting them. U.S. Fidelity & Guar. Co. v.
Budget Rent–A–Car Sys., Inc., 842 P.2d 208, 210 n.3 (Colo. 1992). When an
insurer denies coverage on a specific ground it waives the right to later assert
additional defenses to coverage. Flatiron Paving Co. v. Great Sw. Fire Ins. Co.,
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812 P.2d 668, 671 (Colo. App. 1990) (holding unaffected by Brodeur v. Am.
Home Assurance Co., 169 P.3d 139, 148 n.10 (Colo. 2007)). “[W]hile an insurer
may be estopped by its conduct or its knowledge from insisting upon a forfeiture
of a policy, the coverage, or restrictions on coverage, cannot be extended by the
doctrine of waiver or estoppel.” Hartford Live Stock Ins. Co. v. Phillips, 372
P.2d 740, 742 (Colo. 1962).
The Gallegoses assert that the January 14, 2014, letter from Safeco denying
coverage for the roof collapse did not raise the defenses to coverage asserted by
Safeco in this litigation. Thus, they claim Safeco has waived the right to rely on
those defenses. In particular, the Gallegoses argue that Safeco denied their claim
due to long-term moisture damage and improper maintenance, but seeks to
exclude coverage in this litigation because of improper construction and/or
maintenance. The Gallegoses’ arguments in this regard fail for two primary
reasons.
This court concludes the denial-of-coverage letter sufficiently raised and/or
reserved each of the exemptions to coverage relied upon by Safeco in this case.
While the denial letter certainly does cite moisture damage and “historic gravity-
loading events” that occurred prior to the Gallegoses’ purchase of the home as
bases for denying the claim, the letter also specifically stated that “damage due to
improper maintenance” is excluded from coverage. Furthermore, the letter
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contained language describing specific exclusions, 5 including wear and tear;
deterioration; weather; and faulty construction, design, or maintenance that were
particularly applicable to the denial of the Gallegoses’ claim. That being the
case, this court concludes the denial letter preserved all relevant grounds for
denial of coverage put forward by Safeco in this case.
Even if Safeco’s denial-of-coverage letter had not properly preserved the
relevant exclusions from coverage by specifically identifying them, that failure
would not estop Safeco from relying on the exclusions in this case. The decision
of the Colorado Supreme Court in Hartford Live Stock makes clear that while an
insurer can waive a defense that amounts to a “forfeiture of a policy,” coverage
and exclusion issues are not subject to waiver. Id. at 742. It is uncontested that
Safeco’s defenses to the Gallegoses’ coverage claim in the instant litigation
depend entirely on exclusions which define the parameters of coverage provided
by the insurance policy. That being the case, Hartford Live Stock makes clear the
issues are not subject to waiver.
The district court correctly concluded that Safeco preserved in its denial-of-
coverage letter its ability to rely on exclusions from coverage set out in the
5
That is, the denial-of-coverage letter did not recite a list of all exclusions
from coverage contained in the insurance policy. Instead, it listed only some of
the exclusions. It is those specific exclusions that were identified in the letter
that form the basis for Safeco’s arguments regarding coverage in the instant
litigation.
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insurance policy. In any event, coverage exclusions are not subject to waiver or
estoppel in the manner asserted by the Gallegoses.
3. Payment of Claim
The Gallegoses assert that Safeco’s voluntary payment of the repair costs
for the roof, in the midst of the litigation, serves as a waiver of Safeco’s right to
rely on coverage exclusions set out in the insurance contract. The law in
Colorado is clear, however, that “a waiver ‘cannot have created liability where
none existed under the policy.’” Compass Ins. Co. v. City of Littleton, 984 P.2d
606, 620 (Colo. 1999) (quoting Empire Cas. Co. v. St. Paul Fire & Marine Ins.
Co., 764 P.2d 1191, 1198 (Colo. 1988)); see also Hartford Live Stock Ins. Co.,
372 P.2d at 742 (“[T]he doctrine of waiver cannot be invoked to create a primary
liability and bring within the coverage of the policy risks not included or
contemplated by its terms.”).
Rudnick v. Ferguson, 179 P.3d 26 (Colo. App. 2007) is not to the contrary.
In Rudnick, a Colorado statute capped available damages against the defendants at
$150,000. Id. at 29. Before trial, the defendants deposited $150,000 with the
court registry and, thereafter, the trial court dismissed the case as moot. Id. at 30.
Rudnick held that “the trial court did not err in permitting the [defendants] to
tender $150,000 into the court registry and in dismissing the case as moot without
requiring the [defendants] to confess judgment, to admit their liability, or to enter
into a settlement with the [plaintiffs].” Id. at 31.
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The Gallegoses contend Rudnick stands for the proposition that because
Safeco paid them directly, rather than depositing funds into the district court
registry pursuant to Fed. R. Civ. P. 67, Safeco has confessed liability. This
reading of Rudnick is untenable and stretches the case well beyond its context.
Contrary to the Gallegoses’ assertions, Rudnick simply stands for the proposition
that when a defendant has paid to the plaintiff the maximum amount the plaintiff
could recover, the case is properly dismissed as moot. The rule set out in Rudnick
has no relevance to this case.
The district court correctly ruled that the payment by Safeco to the
Gallegoses for roof-repair costs did not constitute a waiver of the coverage
exclusions set out in the insurance policy.
IV. CONCLUSION
For those reasons set out above, the order of the district court granting
summary judgment in favor of Safeco is hereby AFFIRMED.
ENTERED FOR THE COURT
Michael R. Murphy
Circuit Judge
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