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Simon v. State Farm Fireaand Casualty Co.

United States District Court, E.D. Louisiana

November 6, 2014



MARTIN L. C. FELDMAN, District Judge.

Before the Court is State Farm Fire and Casualty Company's motion for summary judgment. For the reasons that follow, the motion is DENIED.


This litigation arises from an insurance coverage dispute that pits the insured's claim (that over $250, 000 worth of high end electronic devices were irreparably destroyed during a lightning storm) against the insurer's defense that the plaintiffs made material misrepresentations and submitted fabricated documents in support of their claim, thereby voiding the policy.

Mindy Simon, a homemaker, and Troy Lepine, a satellite TV installer, own a house located at 2746 Bayou Lours Court in Marrero, Louisiana, where they live with their two children.[1] On the evening of June 6, 2013 there were thunderstorms in Marrero. Mr. and Mrs. Lepine were watching television in the living room while their children were playing video games in the son's bedroom when they heard what "sounded like a bomb"; a bolt of lightning had struck their house.[2] In addition to causing structural damage to their house, the electricity surge damaged personal property, including appliances and the family's extensive collection of electronic devices.

The next day, Mrs. Lepine contacted their homeowners insurer, State Farm Fire and Casualty Company, to report that the house had been struck by lightning. At that time, the Lepine's house was insured under State Farm's homeowners insurance policy, which provided $259, 000 in dwelling coverage and $194, 250 in personal property coverage. Lightning is a covered peril under the policy, which also provides:

2. Concealment or Fraud
b. We do not provide any coverages under this policy for you or any other insured if you or any other insured under this policy, whether before or after the loss, has intentionally concealed or misrepresented any material fact or circumstance relating to this insurance.

Mrs. Lepine orally reported to State Farm that lightning struck their house and destroyed nearly all of the electrical systems and equipment in their house, including their air conditioning system, their security system, and their appliances and media electronics. In particular, the Lepines claimed that they had several hundred thousand dollars worth of high-end electronics in their house at the time of the storm, which they claimed were destroyed and required replacement.

After receiving notice of the loss, State Farm opened a claim and initiated adjustment. On June 11, 2013, an independent adjuster, Albert Vaughan & Associates, inspected the Lepine's house. On August 23, 2013, Brian Ditta, a licensed electrician, inspected the Lepine house and inspected the electronics, outlets, switches, and the breaker panel; he issued a letter report and an invoice in the amount of $525.00.[3] Thereafter, State Farm tendered $12, 435 in benefits to the Lepines for the damaged air conditioning unit and for a garage door.[4] A total of $193, 700 of coverage remained available under the Lepine's personal property coverage.[5]

After being notified of the claim, State Farm repeatedly advised the Lepines that they needed to prepare a personal property inventory form (PPIF), a standard proof of loss requirement that documents the damaged items and lists the age and value of each. A few months later, the Lepines complied;[6] they submitted the PPIF to State Farm on September 18, 2013 as part of their proof of loss.

A snapshot of the Lepine's 22-page PPIF:

Room Total Value Per Room Non-Electronics 1. Foyer $315.98 $15.98 2. Hall Bathroom $115.98 $115.98 3. Home Office $15, 195.92 4. Master Bedroom $4, 519.74 5. Master Bath $1, 089.98 6. Master Closet $107, 859.98 7. Daughter's Room $5, 540.47 8. Son's Room $7, 220.39 9. Family Room $30, 407.92 $2, 999.99 10. Kitchen $1, 049.47 $549.38 11. Laundry Room $605.99 $596.00

12. Theatre Room $73, 228.77 13. Game Room $14, 251.88 14. Garage $1, 193.74 $543.74 15. Side Yard $750.00 16. Patio $800.00 Total $264, 146.21 $4, 821.07

Thus, according to the PPIF, the Lepines had $264, 000 in damaged personal property; of that amount, approximately $260, 000 worth was home electronics. Accompanying the PPIF, the Lepines also submitted receipts purporting to show purchase history and price. Based on the receipts submitted in support of their PPIF, the majority of electronics were purchased from two companies, Bayou Audio Sales and Diversified Security Systems, totaling $272, 305.78 in a six month time frame summarized in part as follows:

November 1, 2010 Diversified Security $65, 739.38 November 26, 2010 Diversified Security $27, 194.17 January 2, 2011 Bayou Audio Sales $49, 807.47 March 21, 2011 Diversified Security $33, 875.63 April 8, 2011 Diversified Security ...

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