TONY PING YEW VS. FMI INSURANCE COMPANY (DC-000912-19, SUSSEX COUNTY AND STATEWIDE)

NOT FOR PUBLICATION WITHOUT THE
APPROVAL OF THE APPELLATE DIVISION
This opinion shall not "constitute precedent or be binding upon any court ." Although it is posted on the
internet, this opinion is binding only on the parties in the case and its use in other cases is limited. R. 1:36-3.
SUPERIOR COURT OF NEW JERSEY
APPELLATE DIVISION
DOCKET NO. A-4947-18T3
TONY PING YEW,
Plaintiff-Appellant,
v.
FMI INSURANCE COMPANY,
Defendant-Respondent.
_____________________________
Submitted May 11, 2020 – Decided June 22, 2020
Before Judges Messano and Ostrer.
On appeal from the Superior Court of New Jersey, Law
Division, Sussex County, Docket No. DC-000912-19.
Tony Ping Yew, appellant pro se.
Methfessel & Werbel, attorneys for respondent (James
Victor Mazewski, of counsel and on the brief).
PER CURIAM
Defendant FMI Insurance Company insured plaintiff Tony Ping Yew
under a homeowner's policy when Yew's sump pump failed on March 3, 2018,
and damaged his home. But, his policy excluded coverage for water damage
caused by sump pump failure. In his suit against FMI, Yew alleged it was
negligent and breached the covenant of good faith and fair dealing, because it
failed to advise him that he could add supplementary sump pump coverage each
year he renewed his policy. In granting FMI's motion for summary judgment,
the trial court found no legal basis for the negligence and bad faith claim,
observing that FMI had notified Yew of the optional coverage in advance of a
policy renewal several years earlier, and the Department of Banking and
Insurance (DOBI) had rejected Yew's administrative complaint.
Yew appeals from summary judgment and the denial of his motion for
reconsideration. Having reviewed Yew's arguments in light of the record and
applicable law, we affirm.
Yew had been insured by FMI for many years. Back in 2012, he received,
along with a general renewal notice, a "special notice" from FMI informing him
that FMI was consolidating all sump pump coverage in a separate endorsement
that he could add to his policy for an additional premium; and, if he did not
affirmatively select the coverage, his policy would exclude claims for damage
caused by sump pump failure. The notice stated:
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SPECIAL NOTICE TO POLICYHOLDERS
SUMP PUMP FAILURE SUPPLEMENTAL
COVERAGE
If you have a working sump pump in your home, this
notice applies to you.
WHAT HAS FMI DONE?
FMI has consolidated all coverage for damage caused
by overflow or failure of a sump pump, including
resulting mold damage, into one endorsement – FM
152. If endorsement FM 152 is not attached to your
policy, there is no coverage for this damage in any other
form or endorsement attached to your policy. FMI has
also increased the amount of insurance you can
purchase for this coverage from a minimum of $3,000
to a maximum of $10,000.
WHAT MUST YOU DO?
If you wish to add, continue or increase coverage for
damage caused by overflow or failure of a sump pump,
including resulting mold damage, you must complete
the COVERAGE SELECTION shown below, sign this
Notice and return it to us in the enclosed envelope. We
will send a bill for the amount of insurance you have
selected.
WHAT WILL HAPPEN IF YOU DO NOTHING?
If you do nothing, your policy will automatically
exclude all damage caused by overflow or failure of a
sump pump.
The notice then included a list of optional coverage amounts, ranging between
$3000 and $10,000, with accompanying premiums.
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Yew admitted he saw the notice, but elected not to purchase the coverage.
He stated in his complaint, "Plaintiff being a busy person like most people, just
signed off the renewal form, pa[id] his premium and d[id] not bother to
investigate further . . . ." FMI did not send a similar notice, specifically
addressing the optional sump pump coverage, with subsequent renewal notices.
After flooding from his sump pump damaged his basement in 2018, Yew
filed a claim under his homeowner's policy. FMI denied the claim, noting that
Yew had not selected the sump pump endorsement, and the policy excluded
coverage for the damage. Yew asked DOBI to review FMI's decision. DOBI
conducted a formal investigation, and concluded FMI's denial of Yew's claim
did not violate any insurance laws or regulations.
In his subsequent pro se complaint against FMI, Yew alleged that FMI
acted negligently and in bad faith by failing to notify him annually that
supplemental sump pump coverage was available. Had FMI done so, he alleges
not that he would have purchased it; but that he would have secured coverage
from a different insurer at a lower price.
FMI eventually moved for summary judgment, arguing it did not owe Yew
a duty to advise him about supplemental coverage every year. FMI argued that
the standard relationship between a carrier or its agents and its insured did not
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oblige the carrier to advise the insured of the possible need for higher policy
limits. As noted, the trial court granted FMI's motion.
We review a summary judgment order de novo, applying the same
standard a trial court uses. Davis v. Brickman Landscaping, Ltd., 219 N.J. 395,
405 (2014). Summary judgment shall be entered "if the pleadings, depositions,
answers to interrogatories and admissions on file, together with the affidavits, if
any, show that there is no genuine issue as to any material fact challenged and
that the moving party is entitled to a judgment or order as a matter of law. " R.
4:46-2(c); Brill v. Guardian Life Ins. Co. of Am., 142 N.J. 520, 540 (1995).
It is well-settled that "to render a person liable on the theory of negligence
there must be some breach of duty, by action or inaction, on the part of the
defendant to the individual complaining, the observance of which duty would
have averted or avoided the injury." Brody v. Albert Lifson & Sons, Inc., 17
N.J. 383, 389 (1955). The existence of a duty "is largely a question of fairness
or policy," and "'[t]he inquiry involves a weighing of the relationship of the
parties, the nature of the risk, and the public interest in the proposed solutions. '"
Wang v. Allstate Ins. Co., 125 N.J. 2, 15 (1991) (quoting Kelly v. Gwinnell, 96
N.J. 538, 544 (1984)). Whether a duty exists may depend on the facts of the
case. Ibid.
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A contractual relationship does not give rise to a tort remedy, such as one
sounding in negligence, "unless the breaching party owes an independent duty
imposed by law." Saltiel v. GSI Consultants, Inc., 170 N.J. 297, 316 (2002).
Our Supreme Court concluded, "there is no common law duty of a carrier or its
agents to advise an insured concerning the possible need for higher policy limits
upon renewal of the policy." Wang, 125 N.J. at 11-12. The Court held that a
homeowner's insurer did not have a duty to inform its insureds that their current
level of coverage "was inadequate to protect their assets" from a third -party's
claim, in light of inflationary trends, rising recoveries, and increased home
values. Id. at 16-17. The Court added, "If such a duty would be in the public
interest, it is better established by comprehensive legislation, rather than by
judicial decision." Id. at 12.
An exception may arise if there is a "special relationship" between the
insurance company or its agent and the policyholder. Id. at 15; see also 3 Couch
on Insurance § 46:61 (3d. ed.) (stating a duty to advise a policyholder about the
adequacy of a policy's coverage may arise when a special relationship exists
between the insurer or its agent and the policyholder). A special relationship
can exist through evidence of "an inquiry or request by the insured or a specific
representation by the agent or broker." Wang, 125 N.J. at 18; see also 3 Couch
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on Insurance § 46:61 (stating that to establish a special relationship creating a duty
to advise about adequacy of insurance, "there must be a long-standing relationship
between the parties, some type of interaction on the question of coverage, and
reliance by the insured on representations of the insurance agent to the insured's
detriment").
Yew has not established a basis for finding a special relationship between
FMI and himself that would give rise to a duty to inform him of the need to buy
sump pump coverage, or to inform him annually of the option to do so. Yew
has presented no evidence that he consulted with FMI regarding any special
insurance needs, nor that FMI made any representations to him about the
adequacy of his coverage. We reject the notion that because FMI provided
notice to Yew in 2012, it was obliged to provide similar notices every year
thereafter. As the notice stated, it was prompted by a consolidation of sump
pump coverages in a single endorsement. 1 The notice informed Yew that his
underlying policy form excluded sump pump coverage. Yew does not contend
that the exclusion itself was somehow unclear or ambiguous. He had no reason
1
The record does not reflect how sump pump coverage was handled before that,
for example, whether some limited coverage was included in the policy, and
additional coverage had to be purchased through an endorsement. Neither party
provided a copy of the pre-notice policy.
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to assume his policy included coverage in subsequent years without purchasing
the endorsement.
To the extent not addressed, Yew's remaining points lack sufficient merit
to warrant discussion in a written opinion. R. 2:11-3(e)(1)(E).
Affirmed.
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