Evans Products Co. and Home Builders Mortgage Corp. v. West American Insurance Co., 736 F.2d 920, 3rd Cir. (1984)
Evans Products Co. and Home Builders Mortgage Corp. v. West American Insurance Co., 736 F.2d 920, 3rd Cir. (1984)
Evans Products Co. and Home Builders Mortgage Corp. v. West American Insurance Co., 736 F.2d 920, 3rd Cir. (1984)
2d 920
* This is an appeal from a judgment entered for Evans Products Co. and Home
Builders Mortgage Corp. (Evans) and against West American Insurance Co.
(West) in an action on an insurance contract. For the reasons set forth below,
we vacate and remand for further proceedings.
II
2
Steven and Patricia Brooks had obtained a homeowners' insurance policy from
West with a loss-payable clause in favor of Evans as mortgagee. The policy
provided fire-loss coverage on the dwelling in the maximum amount of
$43,000, on personal property in the maximum amount of $21,500, and on loss
of use in the maximum amount of $5,600.
A fire subsequently occurred at the Brooks' residence on May 20, 1980. The
Brooks' proof of loss statement, claiming $64,500 for total loss of the dwelling
and damage to personal property, was rejected by West. An Action in
Assumpsit against West subsequently was brought by the Brooks in the Court
of Common Pleas of Westmoreland County, Pennsylvania on December 30,
1980. In this action, the Brooks sought recovery for both the real and personal
property losses.
Evans then executed and returned a proof of loss statement to West on August
4, 1981. Evans' statement, claiming $43,000 for total loss of the dwelling, also
was rejected, whereupon it brought a diversity action in federal district court on
December 15, 1981 seeking to recover under the loss-payable clause of the
insurance policy.1
On October 14, 1982, while a decision on the merits of the action in federal
court was pending, West settled the Brooks' state court action and paid them
$7,000 for loss of personal property only. Evans and West subsequently
submitted the action below for resolution of the case stated without a jury on
the basis of stipulated facts and accompanying memoranda of law. Judgment
was entered for Evans.
III
6
Evans initially sought to recover in the complaint on the theory that it had
complied with all conditions precedent to recovery. West denied in its answer
that Evans had complied with all conditions precedent to recovery and
defended on the theory that Evans' suit was barred for failure to comply with a
provision in the insurance contract that any action against West be brought
within one year.2
West also revised the theory on which it defended in its memorandum of law
submitted for resolution of the case stated. West maintained therein that the
Pennsylvania Supreme Court had rejected the theory put forth by Evans. An
insurer, it argued, does not bear the burden, under Pennsylvania law, of
showing any prejudice to itself in order to bar recovery under a policy of
insurance for failure to comply with conditions set forth in the policy.
9
The district court ruled that the failure of Evans to comply with the requirement
that action be brought within one year did not bar recovery by Evans. It held
that Evans was entitled, by virtue of the loss-payable clause, to rely upon the
action by the Brooks in state court as protecting its interest. West then was
found in breach of that obligation to Evans when it settled with the Brooks on
October 14, 1982.
10
The basis upon which relief was granted to Evans was an event which occurred
more than seven months after West had answered the complaint--i.e., the
settlement on October 14, 1982 of the Brooks' state court action against West.
Evans neither amended nor supplemented its complaint to cite this particular
event as providing a basis for the relief sought. West made no reference to it in
its answer. Moreover, this particular event neither had been cited by Evans as
providing a basis for relief nor had been opposed by West in their memoranda
submitted for disposition on the merits.
11
The district court apparently was cognizant that the relief granted to Evans was
based on a consideration not addressed by the parties. It held, however, that this
did not matter because:
12
Plaintiff
would be permitted to amend its Complaint in the present action to assert
that the defendant breached its obligations under the loss-payable endorsement by
making settlement directly with the owners, without protecting plaintiff's interests.
IV
13
14
Not unexpectedly, Fed.R.Civ.P. 54(c) has been used to grant relief based on
theories of recovery different from those theories set forth in the pleadings. For
instance, an insurance policy may be reformed in an action seeking a
declaration of nonliability, Metropolitan Casualty Ins. Co. of New York v.
This does not mean, however, that there are no restrictions on the relief that
may be granted under Fed.R.Civ.P. 54(c). What a court may do ultimately is
limited by fundamental notions of due process and fair play. Sylvan Beach, Inc.
v. Koch, 140 F.2d 852, 861-862 (8th Cir.1944). Fed.R.Civ.P. 54(c) permits
relief based on a particular theory of relief only if that theory was squarely
presented and litigated by the parties at some stage or other of the proceedings.
Cioffe v. Morris, 676 F.2d 539, 541 (11th Cir.1981). Put another way, relief
may be based on a theory of recovery only if the theory was presented in the
pleadings or tried with the express or implied consent of the parties. Monod v.
Futura, Inc., 415 F.2d 1170, 1174 (10th Cir.1969).
16
When relief is based on a theory of recovery not raised in the pleadings, the
requirements of Fed.R.Civ.P. 15(b) may come into play. Cioffe, 676 F.2d at
541. Fed.R.Civ.P. 15(b) requires that unpled issues which are tried with the
express or implied consent of the parties are to be treated as if they were raised
in the pleadings. The court shall permit the pleadings to be amended to conform
to the evidence offered when the presentation of the merits of the action will be
subserved and the opposing party will not thereby be prejudiced.
17
18
As was pointed out, the theory of recovery on which relief was granted to
Evans had not been raised by the time the pleadings had closed. The event cited
as giving rise to the breach by West did not occur until more than seven months
after West had answered the complaint.
19
It also is clear that neither party expressly raised the issue whether the
settlement of the state court action between the Brooks and West constituted a
breach of an obligation West owed to Evans by virtue of the loss-payable
endorsement. This matter evidently was raised sua sponte by the district court.
20
As was pointed out previously, judgment was entered on the basis of stipulated
facts submitted by the parties. One such stipulated fact was the settlement
agreement between the Brooks and West on October 14, 1982. This particular
stipulation does not indicate that the parties implicitly consented to litigation of
the question whether such settlement constituted a breach on the part of West.
Rather, it was intended by the parties to bear only on the questions whether,
under Pennsylvania law, the burden is on the insurer to show that it was
prejudiced by the failure of the mortgagee to bring suit within the prescribed
time period and, if it does, whether West in fact had been prejudiced.
21
The theory on which relief was granted to Evans had neither been raised in any
of the pleadings nor been litigated with either the express or implicit consent of
the parties. West therefore was denied a fair opportunity to defend against the
theory that it had breached its obligation to Evans by virtue of the settlement
with the Brooks on October 14, 1982. The relief granted by the district court
thus was improperly granted because the theory upon which it was based had
not been squarely presented and litigated at any stage of the proceedings and
because West thereby had been prejudiced. See Cioffe, 676 F.2d at 541.
22
As was pointed out, the district court may, under Fed.R.Civ.P. 15(b), permit
amendments to conform to the evidence only if an issue has been tried with the
express or implied consent of the parties and the opposing party will not
thereby be prejudiced. Because the issue in question had not been tried with the
express or implied consent of the parties and West thereby was prejudiced,
amendment under Fed.R.Civ.P. 15(b) would be improper.
23
This case is remanded to permit the district court to consider allowing Evans to
amend its complaint. If, however, the district court does permit Evans to amend
its complaint to include the above claim for breach, West then may answer and
shall have fair opportunity to defend against that theory and to present further
evidence in its defense.
24
25
For over sixty years, Pennsylvania has by statute required that all fire insurance
contracts include the following provision:
26 suit or action on this policy for the recovery of any claim shall be sustainable in
No
any court of law or equity ... unless commenced within twelve months next after
inception of the loss.
27
28
I.
29
On May 20, 1980, a fire damaged the home and belongings of Steven and
Patricia Brooks. By mid-October 1980, the Brookses had mailed a proof-ofloss statement to their insurance agent, claiming over $64,500 in damage to
their real and personal property. This claim was rejected. Seeking payment
under their insurance contract, the Brookses filed an action in assumpsit against
West in Pennsylvania state court on December 30, 1980. The lawsuit, however,
never came to trial. In exchange for a $7,000 payment, the Brookses agreed on
October 26, 1982 to "release and forever discharge" West from any liability
"connected with fire damage to furnishings and other contents of [the
Brookses'] dwelling as a result of the fire occurring May 20, 1980." App. at
148a. The release agreement further specified that it "include[d] settlement and
discontinuance of the [Brookses'] lawsuit." Id. The agreement makes no
mention of any payment for damage to the Brookses' real property.
30
In the meantime, the Brookses' mortgagee, Evans, had been notified of the fire
three weeks after it occurred in a letter from an insurance agent dated June 12,
1980. Evans tendered no proof-of-loss statement, however, until August 4,
1981, approximately 14 1/2 months after the fire, and filed no lawsuit against
West until December 15, 1981, almost 19 months after the fire.
31
32
Throughout these proceedings, West has pressed only one defense: that Evans'
suit is barred by the one-year limit in the insurance policy. Because West and
Evans tried this case on a stipulated record, including the stipulation that Evans
sustained a loss of $24,733.30, the entire case turns on the applicability of the
one-year limitations period set forth in the insurance policy. If Evans' action is
not time barred, then it should receive $24,733.30. If Evans' action is time
barred, then it should receive nothing.
33
Without citing any authority, the district court determined that the one-year
deadline did not bar Evans' lawsuit. The court's analysis consisted of the
following statement:
than bringing this action. But even accepting that contention, the ultimate outcome
would be the same. [Evans] would be permitted to amend its Complaint in the
present action to assert that [West] breached its obligations under the loss-payable
endorsement by making settlement directly with the owners, without protecting
[Evans'] interests.
36
Evans Products Co. v. West Am. Ins. Co., No. 81-5126, slip op. at 6 (E.D.Pa.
Apr. 19, 1983). Having thus resolved the one contested issue in the case in
favor of Evans, the district court entered judgment for Evans in the amount of
$24,733.30.
37
The majority opinion does not pass on the merits of the legal theory that was
adopted by the district court to salvage Evans' lawsuit. Rather, the majority
holds that this case should be remanded because the district court relied on a
theory that was neither pleaded nor argued. Contrary to the majority, I am
persuaded that we may not avoid the underlying legal issue in this case--the
applicability of the statutorily mandated one-year limitations provision. It is
squarely presented to us and, I believe, we are required to decide it.
II.
38
The fundamental flaw in the district court opinion is its failure to recognize that
a mortgagee and a mortgagor hold two separate agreements with the insurance
company. Under Pennsylvania law, the standard mortgage clause in a
homeowner's fire insurance policy creates a separate, distinct and independent
contract of insurance in favor of the mortgagee. Overholt v. Reliance Ins. Co. of
Phil., 319 Pa. 340, 344, 179 A. 554, 556 (1935); Beaver Falls B & L Ass'n v.
Allemania Fire Ins., 305 Pa. 290, 293-95, 157 A. 616, 617-18 (1931); Satchell
v. Ins. Placement Facility of Pa., 241 Pa.Super. 287, 297, 361 A.2d 375, 380
(1976); Guarantee Trust & Safe Deposit Co. v. Home Mut. Fire Ins. Co., 180
Pa.Super. 1, 4, 117 A.2d 824, 826 (1955). As a result of its independent legal
status, a mortgagee is both burdened and benefitted. The mortgagee's protection
cannot be nullified or diminished by acts of the mortgagor, but the mortgagee is
no more free to ignore the one-year limitations provision than is the mortgagor.
Satchell, supra, 241 Pa.Super. at 297, 361 A.2d at 380; Guarantee Trust, supra,
180 Pa.Super. at 4, 117 A.2d at 826; Miners Savings Bank v. Merchants Fire
Ins. Co., 131 Pa.Super. 21, 27-28, 198 A. 495, 497-98 (1938).
39
recovery on that breach. Guarantee Trust, supra, 117 A.2d at 826. Such suits,
however, derive from the insurer's duty to pay directly to the mortgagee any
money owing for fire damage to the mortgagee's insurable interest in the
property. Suits for breach of the mortgage clause are not premised on a
generalized duty of the insurer to volunteer payment for damage to the
mortgagee's property interest. Rather, the mortgage clause requires that if the
insurer makes a payment for damage to the mortgagee's interest, then that
payment must be made directly to the mortgagee.
40
The district court misconstrued the duty imposed by the mortgage clause under
Pennsylvania law. In holding that Evans "had the right to rely upon ... [the
Brookses'] action as protecting its interests," App. at 158a, the district court
incorrectly assumed that the insurable interests of the Brookses and Evans were
coextensive. The Brookses were protected under their fire loss policy against
two types of loss: damage to their share of the real estate and damage to their
personal property. In fact, the Brookses pressed to settlement only a claim for
damage to their personal property, ultimately agreeing to dismiss their lawsuit
in exchange for a $7,000 reimbursement of personal property losses. Given
their distinct contractual relationship with West, the Brookses were entitled to
settle their lawsuit on these terms.
41
Evans had the right to rely upon the Brookses' lawsuit only insofar as the
Brookses pursued a claim for damage to their real property. By its explicit
language, the mortgage clause protects a mortgagee's right to receive direct
payment for "any loss payable under Coverage A or B," App. at 31a, that is,
any damage sustained by the "dwelling" or "other structures on the residence
premises." App. at 25a. The Brookses did not obtain any payment for losses to
the "dwelling" or to "other structures," and so the mortgage clause simply did
not apply to their settlement. Evans cannot now claim breach of the mortgage
clause to avoid the one-year bar.
III.
42
estoppel. Lardas, supra, 426 Pa. at 52, 231 A.2d at 742; Petraglia v. Amer.
Motorists Ins. Co., 284 Pa.Super. 1, 8-9, 424 A.2d 1360, 1364 (1981), aff'd,
498 Pa. 32, 33, 444 A.2d 653 (1982); Satchell, supra, 241 Pa.Super. at 295, 361
A.2d at 379.
43
Neither the complaint, the evidence nor the district court's opinion lends any
support to the suggestion that any action by West induced Evans' late filing.
Prior to the expiration of the one-year limit, Evans had only two contacts with
West. About 11 months after the fire, Evans' attorney called West's attorney "to
announce ... his intent to pursue a claim for [Evans] as mortgagee under the
insurance policy." App. at 14a. Then, just two days before the one-year limit on
lawsuits had expired, Evans sent a letter to West "demanding payment" and
"requesting appropriate forms for the filing of a proof of loss." Id. The record is
absolutely barren of evidence indicating that, during these two contacts or at
any other time, West did anything that would lead Evans to believe the oneyear limit would not be asserted. Indeed, West's vigorous defense from the start
against Evans' claim suggests the opposite. Since Evans has entirely failed to
meet its burden of coming forward with facts demonstrating waiver or estoppel,
and since the district court identified no such facts, nothing in this case suggests
that Evans' late filing may be excused.
IV.
44
Before the district court, Evans advanced only one argument against enforcing
the limitations provision. Evans contended that under Pennsylvania law, West
was required to prove that it would be prejudiced by Evans' late filing. West
correctly responded that this proposition had been squarely rejected in 1982 by
the Pennsylvania Supreme Court in Schreiber.4 Apparently recognizing that
Evans' argument was foreclosed by Schreiber, the district court raised sua
sponte an alternative theory of recovery--breach of the mortgage clause--and
entered judgment on that basis. As the majority notes,
45 theory on which relief was granted to Evans had neither been raised in any of
The
the pleadings nor been litigated with either the express or implicit consent of the
parties.... The relief granted by the district court thus was improperly granted....
46
Maj.Op. at 924.
47
Given this wholly correct observation, I do not understand how the majority can
conclude by remanding this case so that "the district court may consider
allowing Evans to amend its complaint" to claim breach of the mortgage clause.
Maj.Op. at 924. This appeal comes to us not from a dismissal of a complaint
and not from a grant of summary judgment, but rather from a complete bench
trial at which no evidence was excluded, and at the conclusion of which the
district court entered a final judgment awarding damages to the plaintiff. No
authority supports, nor can logic sustain, the proposition that a plaintiff, having
tried its claim and failed to make out a case, should be awarded a second chance
by an appellate court to litigate its claim under a new theory of recovery.
48
The majority relies in part on Rule 54(c) of the Federal Rules of Civil
Procedure. This rule presumes that a defendant's liability has been properly
established at trial; it does not authorize the trial court to devise a new theory of
recovery. The purpose of the rule is to free courts from the old formalism
whereby a plaintiff's inartful pleading might preclude a trial court from
awarding the most appropriate form of relief. Thus, under Rule 54(c), a trial
judge may mold an appropriate remedy despite a plaintiff's failure to request
that particular form of relief. Rule 54(c) does not, however, permit a trial court
to ignore the essential antecedent issue--that is, whether the plaintiff has proven
liability under some theory of recovery. See 10 C. Wright, A. Miller & M.
Kane, Federal Practice and Procedure Sec. 2664 at 153-54 (1983). The problem
in this case is not that Evans requested the wrong remedy; no one contests that
if West is liable, Evans should receive money damages in the amount of
$24,733.30. The problem, rather, is the antecedent one of liability, which is not
addressed by Rule 54(c). The question thus becomes whether, when the
plaintiff pleads the wrong theory of recovery, the trial court may construct a
new theory after trial is completed.
49
50
When
issues not raised by the pleadings are tried by express or implied consent of
the parties ..., [s]uch amendment of the pleadings as may be necessary to cause them
to conform to the evidence and to raise these issues may be made upon motion of
any party at any time, even after judgment.
51
been tried with the express or implied consent of the parties and West thereby
was prejudiced, amendment under Fed.R.Civ.P. 15(b) would be improper."
Maj.Op. at 924. Nonetheless, the majority remands this case for possible
amendment of the complaint and retrial of the case under the district court's
new theory of recovery. Absent a determination that Evans was prejudiced by
trial error, this disposition is, in my view, wholly improper.
V.
52
The theory adopted by the district court--that West breached the mortgage
clause--is at odds both with the proof offered at trial and with Pennsylvania
law. No other basis for excusing Evans' untimely filing can be gleaned from the
record. Sitting in diversity, we owe a special duty of adherence to the mandate
of a state's legislature and its courts. Because I believe that Pennsylvania law
requires a reversal of the district court's decision and the entry of judgment for
West, I must respectfully dissent.
The Honorable Hubert I. Teitelbaum, Chief Judge, United States District Court
for the Western District of Pennsylvania, sitting by designation
12
Mortgage Clause
The word "mortgagee" includes trustee.
If a mortgagee is named in this policy, any loss payable under Coverage A or B
shall be paid to the mortgagee and you, as interests appear. If more than one
mortgagee is named, the order of payment shall be the same as the order of
precedence of the mortgages.
If we deny your claim, that denial shall not apply to a valid claim of the
mortgagee, if the mortgagee:
a. notifies us of any change in ownership, occupancy or substantial change in
risk of which the mortgagee is aware:
b. pays any premium due under this policy on demand if you have neglected to
pay the premium;
c. submits a signed, sworn statement of loss 60 days after receiving notice from
us of your failure to do so. Policy conditions relating to Appraisal, Suit Against
Us and Loss Payment apply to the mortgagee. If the policy is cancelled by us,
the mortgagee shall be notified at least 10 days before the date cancellation
takes effect.
If we pay the mortgagee for any loss and deny payment to you:
a. we are subrogated to all the rights of the mortgagee granted under the
mortgage on the property; or
b. at our option, we may pay to the mortgagee the whole principal on the
mortgage plus any accrued interest. In this event, we shall receive a full
assignment and transfer of the mortgage and all securities held as collateral to
the mortgage debt.
Subrogation shall not impair the right of the mortgagee to recover the full
amount of the mortgagee's claim.
2
Suit Against Us. No action shall be brought unless there has been compliance
with the policy provisions and the action is started within one year after the
occurrence causing loss or damage
First National Bank of Hollywood v. American Foam Rubber Corp., 530 F.2d
450, 453 n. 3 (2d Cir.1976)
Thomas v. Pick Hotels Corp., 224 F.2d 664, 666 (10th Cir.1955)
The predecessor of this provision was included in the Act of May 17, 1921, P.L.
682, Art. V, Sec. 522. Although re-enacted many times since 1921, the text of
this provision today remains essentially the same as in the original legislation
When a Pennsylvania fire insurance contract omits the one-year provision, the
six-year limitations period controls. Marshall v. Aetna Cas. & Sur. Co., 643
F.2d 151 (3d Cir.1981)