Degon v. USAA Cas. Ins. Co.
| Decision Date | 07 January 2021 |
| Docket Number | Case No. 3:19-cv-01152-IM |
| Citation | 511 F.Supp.3d 1144 |
| Parties | Amy DEGON, Plaintiff, v. USAA CASUALTY INSURANCE COMPANY, a Foreign Business Corporation, Defendant. |
| Court | U.S. District Court — District of Oregon |
Douglas M. Bragg, Frederick M. Millard, Melissa Young, Millard & Bragg, P.C., 419 Fifth Street, Oregon City, OR 97045. Attorneys for Plaintiff.
Damian P. Stutz, Joshua N. Kastan, Lindsey E. Marsh, DKM Law Group, 1050 SW 6th Avenue, Ste. 1100, Portland, OR 97204. Attorneys for Defendant.
This is an insurance contract dispute between Plaintiff Amy Degon and Defendant USAA Casualty Insurance Company ("USAA CIC"). The matter comes before the Court on Plaintiff's Motion for Partial Summary Judgment and Defendant's Motion for Summary Judgment. ECF 60; ECF 63. This Court held a hearing on the parties' motions on December 4, 2020. ECF 122. For the reasons that follow, Plaintiff's Motion for Partial Summary Judgment is GRANTED IN PART, and Defendant's Motion for Summary Judgment is GRANTED IN PART.
This action arises from Defendant's denial of insurance coverage for a burglary loss claim submitted by Plaintiff. The following facts are taken from the parties' summary-judgment materials.
Plaintiff rented a home in Happy Valley, Oregon, where she lived in May of 2018. Defendant is a Texas-based insurance company. Plaintiff entered into two contracts of insurance with Defendant, a Renters Insurance Policy ("Renters Policy"), and a Valuable Personal Property Policy ("VPP Policy"). The policies provided coverage against loss by theft, subject to terms, conditions, limitations, exceptions, and exclusions. ECF 56 at ¶¶ 6–9.
The Renters Policy provided coverage for personal property up to a $50,000 limit, less a $1,000 deductible. ECF 56-1 at 5. Under the Renters Policy, Plaintiff's duties following a loss included submission of a proof of loss when required by Defendant, and submission of receipts or other proof of ownership or value to Defendant. Id. at 23, 41. The Renters Policy states, in pertinent part:
ECF 56 at ¶ 32. The VPP Policy provides coverage for jewelry for up to $2,500 in value. Id. at ¶ 17. The VPP Policy also states in pertinent part:
On or about May 27, 2018, Plaintiff reported a burglary to the Clackamas County Sheriff's Department. Roughly three days later, Plaintiff told Defendant that a theft had occurred at her rental property in Happy Valley. Id. at ¶ 15. That same day, Plaintiff opened a claim under her Renters Policy with Defendant. Id. at ¶ 16. This was the fourth theft claim Plaintiff had filed with Defendant since 2012. Id. at ¶ 18.
Plaintiff submitted an initial loss inventory to Defendant on or about June 13, 2018, shortly after the burglary. See ECF 65 at ¶ 7; ECF 65-2 at 2, 7. The inventory listed numerous high value items purportedly stolen, including a Tag Heuer watch purchased from Fred Meyer Jewelers three years prior and worth an estimated $1,900. ECF 65-2 at 2. The total estimated value of items claimed under Plaintiff's Renters Policy exceeded $50,000. ECF 56 at ¶ 16.
Plaintiff's claims were referred to Defendant's Special Investigative Unit ("SIU") around June 25, 2018. An entry in Defendant's internal activity log in June states: "Claimed items/values, Questionable damage, Questionable documents, & Questionable Photos." Id. at ¶ 19. Another entry from June 28, 2018, states, "compare all photos and documents submitted in this loss to other prior losses and proof of purch/payment will be needed." Id. at ¶ 21. On or about July 3, 2018, Defendant opened a companion claim under the VPP Policy. Id. at ¶¶ 16–17. Roughly two days later, Defendant began an internal investigation of Plaintiff's claims based on her prior loss history. Id. at ¶¶ 18–19. Around July 31, 2018, as part of the internal investigation, Defendant retained a private investigative service, Veracity Research Company ("VRC") Investigations to investigate Plaintiff's claims. ECF 71 at 73–74; ECF 65 at ¶ 12.
On or about September 21, 2018, Plaintiff submitted an Itemized Statement of Loss to Defendant, which included an inventory of items purporting to be items stolen in the burglary. Included in that statement was a description of a "Womans tag watch" worth $1,900. Plaintiff also submitted a receipt for the watch indicating it was purchased by her former boyfriend, Fred Ayala, at Fred Meyer Jewelers on February 10, 2015. ECF 56 at ¶¶ 23–24.
On or about October 11, 2018, Judy Kimble, a property adjuster for Defendant, called Fred Meyer Jewelers to verify the receipt for the $1,900 Tag Heuer watch. Ms. Kimble discovered that the watch had actually been returned by Mr. Ayala for a full refund on February 16, 2015. Id. at ¶ 25; ECF 56-3; ECF 65 at ¶ 10. When confronted with this discovery, Plaintiff said she had no knowledge that the watch had been returned by Mr. Ayala. ECF 56 at ¶¶ 12, 26.
Plaintiff never submitted another receipt for the watch, and on November 19, 2018, requested that Defendant withdraw it from her claims. Id. at ¶ 28. On or about November 30, 2018, Defendant denied Plaintiff's claim for reimbursement under the VPP Policy based on its determination that Plaintiff intentionally misrepresented and/or concealed material facts in the presentation of her claim. Id. at ¶ 29. On or about December 28, 2018, third-party entity USAA Savings Bank elected to close Plaintiff's credit card account "due to unacceptable behavior or activity." Id. at ¶ 35. That same day, another third-party entity, USAA Federal Savings Bank, closed Plaintiff's checking account. Id. at ¶ 36.
Plaintiff contacted Defendant on or about December 30, 2018, to request reconsideration of her claim under the VPP Policy. She told Defendant she had since learned from Mr. Ayala that he had replaced the February, 10, 2015 Tag Heuer watch with a cheaper one purchased from an associate who owed him money. Plaintiff further acknowledged that the watch Mr. Ayala returned to her was not the one she originally believed it to be, and that there was no receipt for the replacement watch. Id. at ¶ 30. Defendant still refused to provide coverage under the VPP Policy. On or about March 8, 2019, Defendant also denied Plaintiff's claim for reimbursement under the Renters Policy. The denial was based upon Defendant's determination that Plaintiff willfully misrepresented and/or concealed material facts in the presentation of her claim. Id. at ¶¶ 31–32. To date, Defendant has not reimbursed Plaintiff for her claims. Id. at ¶ 33.
On June 3, 2019, Plaintiff filed this action against Defendant bringing claims breach of contract, breach of the implied covenant of good faith and fair dealing, and defamation per se in Oregon state court. ECF 1-5 at ¶¶ 3–32. Plaintiff seeks $52,500.00 in damages, prejudgment interest, and attorney's fees and costs pursuant to O.R.S. § 742.061 for her breach of contract claims, and economic damages and prejudgment interest for her defamation per se claim. Id. at 7–8. Plaintiff has withdrawn her claim for noneconomic damages. See ECF 42 at 2.
The case was removed to federal court on July 25, 2019, ECF 1, and this Court subsequently denied Plaintiff's motion to remand the case back to state court, ECF 15. On August 21, 2020, Plaintiff filed a motion for partial summary judgment, ECF 60, and on that same day Defendant filed a motion for summary judgment, ECF 63. Each motion is addressed in turn.
A party is entitled to summary judgment 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). The moving party has the burden of establishing the absence of a genuine dispute of material fact. Celotex Corp. v. Catrett , 477 U.S. 317, 323, 106 S.Ct. 2548, 91 L.Ed.2d 265 (1986). The court must view the evidence in the light most favorable to the non-movant and draw all reasonable inferences in the non-movant's favor. Clicks Billiards, Inc. v. Sixshooters Inc. , 251 F.3d 1252, 1257 (9th Cir. 2001). Although "[c]redibility determinations, the weighing of the evidence, and the drawing of legitimate inferences from the facts are jury functions, not those of a judge ... ruling on a motion for summary judgment," the "mere existence of a scintilla of evidence in support of the [non-movant's] position [is] insufficient ...." Anderson v. Liberty Lobby, Inc. , 477 U.S. 242, 252, 255, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986). "Where the record taken as a whole could not lead a rational trier of fact to find for the non-moving party, there is no genuine issue for trial." Matsushita Elec. Indus. Co. v. Zenith Radio Corp. , 475 U.S. 574, 587, 106 S.Ct. 1348, 89 L.Ed.2d 538 (1986) (citation and quotation marks omitted).
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