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Mitchell v. State Farm Fire & Casualty Co.
State: Illinois
Court: 4th District Appellate
Docket No: 4-03-0045 NRel
Case Date: 09/26/2003

NO. 4-03-0045

IN THE APPELLATE COURT

OF ILLINOIS

FOURTH DISTRICT

BRUCE MITCHELL and DEBORAH MITCHELL,
               Plaintiffs-Appellants,
               v.
STATE FARM FIRE & CASUALTY COMPANY,
               Defendant-Appellee.
Appeal from
Circuit Court of
McLean County
No. 01MR196

Honorable
G. Michael Prall,
Judge Presiding.

_______________________________________________________________________________________________

MODIFIED UPON DENIAL OF REHEARING

JUSTICE COOK delivered the opinion of the court:

Plaintiffs, Bruce and Deborah Mitchell, filed suitagainst defendant, State Farm Fire and Casualty Company, tocompel defendant to provide coverage pursuant to an insurancepolicy. Defendant moved to dismiss on the basis that plaintiffs'suit was barred by a one-year limitations period found in theinsurance policy. The trial court granted defendant's motion todismiss, and plaintiffs appeal. We reverse and remand.

According to plaintiffs' second-amended complaint,their house burned down on November 11, 1999. Plaintiffs had aninsurance policy through defendant that would have covered theloss from the fire.

On November 23, 1999, defendant delivered a letter toplaintiffs regarding claim number 13-Y533-90. This letterdetailed the various steps the insurance policy requiredplaintiffs to take and documentation to provide within 60 daysafter the loss.

On May 8, 2000, defendant sent a letter to plaintiffs,notifying them of the decision to deny payment of their claim. The denial was based upon plaintiffs' failure to providedocumentation and submit to an examination under oath as requiredby the insurance policy. This letter further informed plaintiffsthat if they intended to proceed with litigation, strictcompliance with the policy provisions would be required. Specifically, the policy requires suit to be commenced within oneyear after the loss. This period of limitations is tolled fromthe date on which proof of loss is filed until the date the claimis denied in whole or in part. Because defendant had neverreceived a proof of loss, the letter explained, defendant did notbelieve there was any tolling of the period of limitations. Defendant suggested plaintiffs had to file suit on or beforeNovember 11, 2000, if they were so inclined. The letter ended byrecommending that plaintiffs consult their own legal advisor.

Shortly after receiving the May 8 letter, plaintiffshand delivered various documents to one of defendant's claimoffices in Bloomington, Illinois. Defendant responded with aletter dated May 16, 2000. This letter informed plaintiffs thatsome of the documentation satisfied defendant's prior requestsand that some of it did not. The letter finished by stating:

"This claim remains in a state of denial as

indicated in our letter May, 8, 2000. When

and if you comply with the requests noted

herein, we will consider whether such delayed

compliance is adequate for a reconsideration

of our position on your claim."

On November 3, 2000, plaintiffs delivered moredocumentation to defendant. On November 11, 2000, plaintiffsfiled a sworn proof of loss with their insurance agent. According to plaintiffs, their agent told them that theinvestigator gave the agent a list of things plaintiffs still hadto do. Plaintiffs then asked their agent if they needed to havean attorney now that defendant was requesting that moreinformation be submitted. Plaintiffs' agent responded that hedid not think defendant would be asking for more information ifdefendant were not willing to settle this claim.

On November 16, 2000, defendant sent a letter toplaintiffs, which informed them that their claim had been deniedon May 8, 2000, that the claim was still denied, and that as faras defendant knew currently, plaintiffs had failed to file suitwithin the one-year limitations period. The letter detailed thevarious documents plaintiffs had provided and how these documentsdid not satisfy defendant's requests. The letter finished bystating:

"To summarize, if the documents you submitted shortly before the period of limitationsexpired had been submitted in a timely fashion, they would have constituted the first steptowards compliance with the policy conditions but they would not have been adequate to fully comply with the policy conditions.Your untimely and incomplete attempts to reverse our stated denial of the claim are ineffective and the claim remains denied."

Plaintiffs filed their first complaint on October 24,2001. Defendant moved to dismiss on the basis that plaintiffs'suit was barred by a one-year contractual statute of limitations. The trial court granted defendant's motion to dismiss, andplaintiffs appeal.

This is an appeal from an order granting a motion todismiss pursuant to section 2-619 of the Code of Civil Procedure. 735 ILCS 5/2-619 (West 2000). When a cause of action isdismissed on a section 2-619 motion, the question on appeal iswhether there is a genuine issue of material fact and whetherdefendant is entitled to judgment as a matter of law. IllinoisGraphics Co. v. Nickum, 159 Ill. 2d 469, 494, 639 N.E.2d 1282,1293-94 (1994).

Section 143.1 of the Illinois Insurance Code (Code)provides in pertinent part:

"Whenever any policy or contract for insurance *** contains a provision limiting the period within which the insured may bring suit, the running of such period is tolled from the date proof of loss is filed, in whatever form is required by the policy, until the date the claim is denied in whole or in part."

215 ILCS 5/143.1 (West 2000).

In this case, the insurance policy at issue contains a limitingprovision as described by the Code. This limiting provisionstates:

"6. Suit Against Us. No action shall be brought unless there has been compliance with the policy provisions. The action must be started within one year after the date of loss or damage. This one[-]year period isextended by the number of days between the date that proof of loss was filed and the date the claim is denied in whole or in part."

There is no question in this case that plaintiffsfailed to bring suit within one year of the date of loss due tothe fire. The fire occurred November 11, 1999, and plaintiffsfiled suit on October 24, 2001. Therefore, under the limitationprovision in the insurance policy, plaintiffs are precluded frombringing this suit.

Plaintiffs argue that they are not precluded frombringing suit, however, because the one-year limitations periodhas been tolled. Specifically, plaintiffs argue that the one-year period has been extended by the number of days between thedate that proof of loss was filed and the date the claim wasdenied in whole or in part.

In support of this argument, plaintiffs first arguethat the May 8, 2000, letter denying plaintiffs' claim was notactually a denial of their claim. Plaintiffs argue that they didnot file a claim until November 11, 2000, when they filed theirproof of loss. Therefore, according to plaintiffs, the May 8letter could not have been a denial of their claim because therewas no claim to deny. Plaintiffs further argue that the November16, 2000, letter, which defendant sent to plaintiffsacknowledging receipt of the proof of loss on November 11, 2000,but still denying the claim, was not a denial of the proof ofloss. Thus, plaintiffs argue, the one-year limitations period isstill being tolled because defendant has never denied plaintiffs'claim.

Defendant's May 8, 2000, letter was a denial ofplaintiffs' claim. That letter, however, was not final, and itis not correct that plaintiffs' only option was to file suit onor before November 11, 2000. Defendant had the obligation toconsider and respond to any information presented to it duringthe one-year period. The running of the one-year period "istolled from the date proof of loss is filed, in whatever form isrequired by the policy, until the date the claim is denied inwhole or in part." 215 ILCS 5/143.1 (West 2000). Defendant hadto respond to the proof of loss after it was filed; defendantcould not issue an absolute denial of the claim before the proofof loss was filed. Any contrary rule would allow an insurer toignore a meritorious proof of loss and to pretend to consider theproof of loss while it was only waiting for the one-year periodto expire.

A proof of loss was filed within the one-year period inthis case. The dissent complains that plaintiffs did not filesuit until October 24, 2001, almost one year after the one-yearperiod expired on November 11, 2000. When defendant responded tothe proof of loss on November 16, 2000, however, it did not tellplaintiffs that they had only a few days to file suit. Defendanttold plaintiffs that it was already too late, that they shouldhave filed suit by November 11, 2000, before defendant hadresponded to the proof of loss. Even if plaintiffs had filedsuit on November 16, 2000, they would have been too late. According to defendant even a filing on November 15 would havebeen too late. There was no reason for plaintiffs to quicklyfile suit after November 16, 2000. Plaintiffs acted reasonablyin filing suit within two years of the fire.

Alternatively, plaintiffs argue that defendant isequitably estopped from asserting the limitations defense. "Aninsurer will be estopped from raising a limitations defense whereits actions during negotiations are such as to lull the insuredinto a false sense of security, thereby causing him to delay theassertion of his rights." Hermanson v. Country Mutual InsuranceCo., 267 Ill. App. 3d 1031, 1035, 642 N.E.2d 857, 860 (1994). "Cases in which an insurer's conduct is found to amount toestoppel typically involve a concession of liability by theinsurer, advance payments by the insurer to the plaintiff incontemplation of eventual settlement, and statements by theinsurer which encourage the plaintiff to delay filing hisaction." Foamcraft, Inc. v. First State Insurance Co., 238 Ill.App. 3d 791, 795, 606 N.E.2d 537, 540 (1992).

In Hermanson, the court determined that the plaintiffhad not been lured into such a false sense of security becausethe defendant insurance company never expressed any desire tonegotiate its position. Hermanson, 267 Ill. App. 3d at 1035, 642N.E.2d at 860. In Foamcraft, the court found no estoppel becausethe defendant insurance company had not represented that it wouldsettle the claim, offered advance payment, or encouragedplaintiff not to sue. Foamcraft, 238 Ill. App. 3d at 795, 606N.E.2d at 540. In this case, however, defendant indicated thatit was amenable to reconsidering its decision if plaintiffsprovided the requested documentation. Further, according toplaintiffs, on November 11, 2000, the last day plaintiffs had tofile suit within the one-year period of limitations, plaintiffs'insurance agent requested more documentation from plaintiffs andindicated a willingness on defendant's part to settle the claim. Such actions, if proved true, could have lulled plaintiffs intobelieving that defendant was still interested in negotiating asettlement beyond the one-year limitations period. This createsa genuine issue of material fact that precludes dismissalpursuant to section 2-619. Illinois Graphics Co., 159 Ill. 2d at494, 639 N.E.2d at 1293-94. We must therefore reverse and remandfor further proceedings.

Reversed and remanded.

MYERSCOUGH, P.J., concurs.

McCULLOUGH, J., dissents.

JUSTICE McCULLOUGH, dissenting:

The majority finds that defendant is estopped fromdenying coverage under the insurance policy. I disagree. Defendant kept plaintiffs informed of the policy provisions andthe time limitations as to filing suit.

On November 23, 1999, defendant, by letter, detailedthe various steps the insurance policy required, thedocumentation to be provided within 60 days after the loss. Morethan 60 days later, sometime shortly after May 8, 2000, plaintiffsent some documents to defendant.

Defendant's May 8, 2000, certified-mail, return-receipt-requested letter, made it clear "[a]lthough theinvestigation is incomplete, we deem it appropriate to make adecision without further delay. A decision has now been made todeny payment of your claim." Defendant had requested variousdocuments from plaintiffs, which defendant stated had not beenprovided. The letter also informed plaintiffs as follows:

"If you intend to proceed withlitigation, strict compliance with policyprovisions will be required. The policyrequires that suit be commenced within oneyear after the loss. However, by statute inIllinois the period of limitations is tolledfrom the date on which the proof of loss isfiled, in whatever form is required by thepolicy, until the date the claim is denied inwhole or in part. We have never received aproof of loss, and therefore, we believethere is no tolling of the period oflimitations. If correct, that means you mustfile suit on or before November 11, 2000 ifyou are so inclined. We recommend that youconsult with your own legal advisor well inadvance of that time. He may wish toindependently compute the tolling period andthe expiration of the limitation period. Thestatute is found at 215 ILCS 5/143.1.

Rule 9.19 of the Rules and Regulationsof the Illinois Department of Insurancerequires that we advise you that if you wishto take this matter up with the IllinoisDepartment of Insurance, it maintains aConsumer Division in Chicago at 100 WestRandolph Street, Suite 15-100, Chicago,Illinois 60601; and in Springfield at 320West Washington Street, Springfield, Illinois62767."

On May 13, 2000, defendant received a letter fromplaintiffs. In response thereto, defendant sent a letter datedMay 16, 2000, to plaintiffs acknowledging receipt of plaintiffs'letter and telling plaintiffs they had not complied with thepolicy condition to provide a personal property inventory andproof of loss within 30 days, as required by the policy. The May16 letter made it clear to plaintiffs that the claim remained ina state of denial as indicated in the May 8 letter, and againtelling plaintiffs they could take the matter up with theIllinois Department of Insurance.

The record shows defendant, on November 16, 2000, againwrote a letter to plaintiffs. The first sentence of the letteragain told plaintiffs the claim had been denied and that the"denial letter of May 8, 2000 quoted certain policy conditionsand duties." The November 16 letter made it clear plaintiffs hadnot complied with the policy provisions and spelled out whatplaintiffs had failed to do.

The majority refers to plaintiffs' argument that "theone-year limitations period has been tolled" and "that the one-year period has been extended by the number of days between thedate that proof of loss was filed and the date the claim wasdenied in whole or in part." Slip op. at 5. This argument doesnot excuse the failure to file suit until October 24, 2001,almost 2 years after the fire of November 11, 1999, and almostone year after the one-year period to file suit. Defendant'sactions during negotiations did not lull the insured into a falsesense of security. Defendant made it clear to plaintiffs thatthe claim was denied on several occasions and stressed toplaintiffs the need to file suit as required by the policy. Plaintiffs point to nothing that occurred to excuse the latefiling.

A review of the documents attached to plaintiffs' briefmake it clear defendant was even-handed and clearly informedplaintiffs of the limitation period and what plaintiffs needed todo. Plaintiffs refused to cooperate. Hermanson and Foamcraftsupport the trial court's decision.

In Foamcraft, the court stated:

"There are no facts in the record to supportan assertion that defendant represented thatit would settle the claim, that defendantoffered advance payment, or encouragedplaintiff not to sue. In fact, after thesecond denial of the claim, plaintiff hadevery reason to believe that defendant wouldnot settle. At that time, plaintiff had fourmonths remaining within which it could havefiled a timely suit, but did not do so." Foamcraft, 238 Ill. App. 3d at 795, 606N.E.2d at 540.

In Hermanson, the court found:

"[P]laintiff was in no way lulled into afalse sense of security which caused him todelay filing suit. Country Mutual at no timewavered from its position denying plaintiff'sclaim." Hermanson, 267 Ill. App. 3d at 1035,642 N.E.2d at 860.

I agree with defendant's argument in its petition forrehearing that the decision of the majority is inconsistent withprior decisions, specifically Vala v. Pacific Insurance Co., 296Ill. App. 3d 968, 695 N.E.2d 581 (1998), wherein this court foundthe insured's complaint was time-barred and the motion to dismisswas properly granted.

By its decision, the majority has effectivelyeliminated the provisions of the policy as to proof of loss, theone-year limitation period of filing suit, and the purpose andmeaning of section 143.1 of the Code. The majority cites noauthority for its statement "Plaintiffs acted reasonably infiling suit within two years of the fire" (slip op. at 7), andhas effectively overruled Valas, wherein we affirmed the trialcourt's dismissal based upon a factual background not nearly aspersuasive as in this case.

The trial court should be affirmed.

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