Brooks Fiveash v. Allstate Insurance Company , 603 F. App'x 773 ( 2015 )

Case: 13-15873 Date Filed: 02/25/2015 Page: 1 of 10
[DO NOT PUBLISH]
IN THE UNITED STATES COURT OF APPEALS
FOR THE ELEVENTH CIRCUIT
________________________
No. 13-15873
________________________
D.C. Docket No. 3:13-cv-00018-TCB
BROOKS FIVEASH,
BOBBIE FIVEASH,
Plaintiffs-Appellants,
versus
ALLSTATE INSURANCE COMPANY,
Defendant-Appellee.
________________________
Appeal from the United States District Court
for the Northern District of Georgia
________________________
(February 25, 2015)
Before WILLIAM PRYOR and JORDAN, Circuit Judges, and HAIKALA, *
District Judge.
*
Honorable Madeline Hughes Haiklala, United States District Judge for the Northern District of
Alabama, sitting by designation.
Case: 13-15873 Date Filed: 02/25/2015 Page: 2 of 10
PER CURIAM:
Brooks and Bobbie Fiveash appeal the district court’s order granting
judgment as a matter of law in favor of Allstate on their breach of contract claim.
With the benefit of oral argument, and for the reasons that follow, we reverse and
remand.
I
In May of 2009, the Fiveash home in Tallapoosa, Georgia, sustained fire
damage. The Fiveashes filed an insurance claim under their policy with Allstate.
Fire investigators concluded that the fire had been set intentionally, as the doors to
the home were locked at the time of the fire and there was no sign of forced entry.
Allstate conducted its own investigation, during which its investigators interviewed
Brooks and Bobbie Fiveash. Both stated during their examinations under oath that
only they and their son had keys to the house. Allstate later learned that the
Fiveashes’ daughter, Brooks Ann, also had a key, and Brooks Ann’s husband had
been seen near the home shortly before the fire. Thus, Allstate determined that the
Fiveashes had made a material misrepresentation when they failed to inform the
investigators that their daughter had a key to the home and denied the Fiveashes’
claim under the policy fraud provision: “We do not cover any loss or occurrence in
which any insured person has concealed or misrepresented any material fact or
circumstance.”
2
Case: 13-15873 Date Filed: 02/25/2015 Page: 3 of 10
The Fiveashes filed a complaint against Allstate alleging breach of contract
and bad faith in connection with the denial of payment under the policy. At trial,
both Brooks and Bobbie testified that Brooks Ann had a key to the house and that
they had failed to tell Allstate investigators about the key. They both further
admitted that they had not corrected this misstatement when they received the
errata sheets from their examinations under oath. They explained that their intent
was not to deceive Allstate, but rather that they had forgotten their daughter had a
key.
After the district court denied Allstate’s motion for judgment as a matter of
law, the jury found in favor of the Fiveashes. The court then granted Allstate’s
renewed motion, finding that the testimony regarding the number of keys was
material, and that the Fiveashes’ intent to deceive Allstate could be inferred from
the circumstances. The Fiveashes appeal the district court’s order granting
judgment as a matter of law to Allstate on their breach of contract claim. 1
II
We have diversity jurisdiction over this matter. See 28 U.S.C. § 1332.
Because the claim arose in Georgia, we apply Georgia substantive law. See
McMahan v. Toto, 256 F.3d 1120, 1131 (11th Cir. 2001). Moreover, the parties do
not dispute that Georgia substantive law governs.
1
The district court granted Allstate’s motion for judgment as a matter of law with respect to the
bad faith claim. The Fiveashes do not appeal from this decision.
3
Case: 13-15873 Date Filed: 02/25/2015 Page: 4 of 10
In a diversity case, we apply a federal standard in addressing the propriety of
a judgment as a matter of law. See Jones v. Miles Laboratories, Inc., 887 F.2d
1576, 1578 (11th Cir. 1989). “We review de novo a district court’s grant of
judgment as a matter of law, applying the same standard as the district court.”
Collins v. Marriott Int’l., Inc., 749 F.3d 951, 956-57 (11th Cir. 2014) (internal
quotation marks and citation omitted).
“A district court should grant judgment as a matter of law when the plaintiff
presents no legally sufficient evidentiary basis for a reasonable jury to find for him
on a material element of his cause of action.” Id. at 957 (internal quotation marks
and citation omitted). When determining whether judgment as a matter of law is
proper “the court should review all of the evidence in the record, but in doing so,
the court must draw all reasonable inferences in favor of the nonmoving party, and
it may not make credibility determinations or weigh the evidence.” Id. (citing
Reeves v. Sanderson Plumbing Prods., Inc., 530 U.S. 133, 150, 120 S. Ct. 2097,
2110 (2000) (internal quotation marks and alteration omitted). See also Davila v.
Menendez, 717 F.3d 1179, 1184 (11th Cir. 2013) (explaining that the court, when
deciding whether to issue a judgment as a matter of law, “must refrain from
deciding the credibility of witnesses or weighing the evidence”) (internal quotation
marks, citation, and alterations omitted). In other words, judgment as a matter of
law “can be [entered] only when the evidence favoring the [movant] is so one-
4
Case: 13-15873 Date Filed: 02/25/2015 Page: 5 of 10
sided as to be of overwhelming effect.” EEOC v. Massey Yardley Chrysler
Plymouth, Inc., 117 F.3d 1244, 1250 (11th Cir. 1997).
III
Under a concealment or fraud provision in an insurance contract, coverage is
void if there has been a willful and intentional misrepresentation of material facts
made for the purpose of defrauding the insurer. See Perry v. State Farm Fire &
Cas. Co., 734 F.2d 1441, 1443 (11th Cir. 1984) (applying Georgia law).
Significantly, the Georgia Supreme Court “has repeatedly held that the burden [is]
upon the insurer to prove an affirmative defense, such as fraud on the part of the
insured in obtaining the policy, or that a loss apparently covered by the policy
came within an exclusionary clause contained in the policy.” Reserve Life Ins. Co.
v. Ayers, 121 S.E.2d 649, 654 (Ga. 1961). See also State Farm Mut. Auto. Ins. Co.
v. Wendler, 172 S.E.2d 360, 363 (Ga. Ct. App. 1969) (concluding that the “burden
was upon [the insurer] in asserting an affirmative defense[, in this case fraud,] to
establish all the material elements thereof”).
When considering questions of material misrepresentations in insurance
contracts, “Georgia courts employ a reasonableness test, an objective standard of
conduct against which to measure the effect of the insured’s false declarations.”
Woods v. Indep. Fire Ins. Co., 749 F.2d 1493, 1497 (11th Cir. 1985).
It must appear that these false statements were made willfully and
intentionally for the purpose of defrauding the insurer. Such a clause
5
Case: 13-15873 Date Filed: 02/25/2015 Page: 6 of 10
in the policy would not cover misstatements or exaggerated claims of
loss or perjury in connection therewith committed by the insured
during the trial. Neither would the misstatement by the insured in his
sworn statement to the company made shortly after the fire as to the
value of some of the property destroyed be covered by such a
condition unless it was shown that these misstatements were willfully
and intentionally made for the purpose of defrauding the insurer.
Am. Alliance Ins. Co. v. Pyle, 8 S.E.2d 154, 160 (Ga. Ct. App. 1940). See also
Superior Fire Ins. Co. v. Peters, 10 S.E.2d 94, 98 (Ga. Ct. App. 1940) (affirming
the denial of a motion for a new trial where “[t]he evidence show[ed] that the
plaintiff did not intentionally falsely swear in the proof furnished so as to work a
forfeiture of the policy”). An intent to defraud can be inferred when the
misrepresentation is made willfully and intentionally. See generally Claflin v.
Commonwealth Ins. Co., 110 U.S. 81, 95, 3 S. Ct. 507, 515 (1884).
Here, the parties do not dispute that the number of keys and who had access
to them was material to Allstate’s investigation of the fire. In fact, both Brooks
and Bobbie testified that they misstated the number of keys in their earlier
examinations under oath. And Bobbie acknowledged at trial that such information
was material. Thus, the only question is whether the Fiveashes’ failure to inform
Allstate that their daughter had a key was willful and intentional, and meant to
defraud Allstate.
Generally, the question of whether the insured acted with intent to deceive is
a question for the jury. See Ga. Farm Bureau Mut. Ins. Co. v. Richardson, 457
6
Case: 13-15873 Date Filed: 02/25/2015 Page: 7 of 10
S.E.2d 181, 184 (Ga. Ct. App. 1995) (explaining that if there is any evidence to
support a jury’s finding of intent, the court should not grant judgment as a matter
of law). “There must be a willful intent to defraud rather than an innocent
mistake.” Watertown Fire Ins. Co. v. Grehan, 74 Ga. 642, 656-57 (1885). See
also Am. Ins. Co. v. Jass, 22 F.2d 793, 794 (5th Cir. 1927) (concluding that it was
for the jury to decide whether the insured was simply mistaken or made the false
statement willfully); Camden Fire Ins. Ass’n v. Penick, 2 F.2d 964, 965 (5th Cir.
1924) (explaining that it is for the jury to decide whether the insured’s
misstatement was an innocent error).
In this case, both Bobbie and Brooks Fiveash told Allstate investigators, fire
department investigators, and their own investigator that only they and their son
had keys to the house. At no time did either of them correct this information. 2 At
trial, Bobbie testified that while she “did the best [she] could” answering questions
during the examination, she admittedly “end[ed] up guessing a lot.” Brooks
testified that he was not trying to mislead Allstate when he failed to mention his
daughter had a key. The jury also heard deposition testimony of the Fiveashes’ son
that he was unaware that his sister had a key to the house. Brooks further testified
2
In a subsequent deposition, the Fiveashes’ daughter, Brooks Ann, stated she had a key for at
least three years leading up to the fire. But this deposition was not introduced at trial, and
Brooks Ann did not testify as a witness.
7
Case: 13-15873 Date Filed: 02/25/2015 Page: 8 of 10
that he had added rooms on to the home to create space for family members over
the years and that he and Bobbie had lost many sentimental items in the fire.
Allstate presented testimony to show that the Fiveashes had tried to sell the
house some years before the fire, after Bobbie’s mother died, but had not been able
to do so. After their retirement, the Fiveashes wanted to travel more and were not
at the house for extended periods. Brooks had also made a previous insurance
claim for a lost ring. But after the ring was recovered, he never returned the
money to Allstate. And the Fiveashes’ good furniture had been moved out of the
house prior to the fire and replaced with inexpensive furniture at the time of the
blaze. Finally, Brooks testified that he handled all the finances and Bobbie never
wrote checks, but there was evidence in the record of checks Bobbie had signed.
In finding for the Fiveashes, the jury rejected Allstate’s argument that
Brooks and Bobbie acted willfully and with the intent to defraud. The question we
must ask is whether the evidence at trial was so one-sided that it required a finding
that the Fiveashes made the misrepresentations willfully and with the intent to
deceive.
We cannot say that it was. Rather, we conclude that where, as here, there
are “obvious conflict[s] in the evidence,” a judgment as a matter of law is
improper. See Allstate Ins. Co. v. Baugh, 327 S.E.2d 576, 578 (Ga. Ct. App. 1985)
8
Case: 13-15873 Date Filed: 02/25/2015 Page: 9 of 10
(explaining that where there is conflicting evidence as to insured’s misstatement to
insurance company, the court should deny a motion for a directed verdict).
Allstate relies on Meyers v. State Farm Fire and Casualty Company, 801 F.
Supp. 709 (N.D. Ga. 1992), as support for the district court’s order. The district
court in Meyers found that the insureds’ claims of innocent mistake were
“disingenuous at best” because the insureds had been uncooperative in the
investigation by failing to turn over financial records at State Farm’s request. Id.
at 715-16. Allstate argues that the Fiveashes were similarly uncooperative. We
disagree. The only thing the Fiveashes allegedly failed to submit were their cell
phone records. Allstate has not shown, much less argued, that these records were
relevant to its investigation, and the testimony at trial established that the Fiveashes
eventually submitted their cell phone records.3
We simply cannot, as the district court did, necessarily infer the Fiveashes’
intent to defraud the insurance company. The jury had the opportunity to assess
the credibility of the witnesses, and, having done so, believed the Fiveashes’
explanation that the misrepresentation was an innocent mistake. The jury further
heard evidence of motive and possible suspects, including Brooks Ann’s husband,
but chose to credit the Fiveashes’ version of events. Given the conflict in the
3
The Fiveashes gave Allstate their cell phone numbers and an authorization to obtain the
records directly from the cell phone company. Allstate was unable to obtain the records, and the
Fiveashes eventually obtained the records for them as requested.
9
Case: 13-15873 Date Filed: 02/25/2015 Page: 10 of 10
evidence and these credibility determinations, we cannot say that the only rational
conclusion was that Allstate met its burden in proving by a preponderance of the
evidence that the Fiveashes made their misrepresentation willfully and with intent
to defraud. Therefore, the district court erred by granting Allstate’s renewed
motion for judgment as a matter of law.
IV
We thus reverse the district court’s order and remand with instructions to
reinstate the jury’s verdict for the Fiveashes.
REVERSED and REMANDED.
10