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The Collaborative Clearinghouse for Lawsuits and Other Claims Against ACE Group Insurance Companies

GUNTHERT et al VS ACE AMERICAN INSURANCE COMPANY et al complaint

ATTENTION: It is possible that this information may no longer be current and therefore may be inaccurate. The index contains both open and closed cases and is not a complete list of cases in which an ACE Insurance Group company is involved. This information is provided to give interested persons an idea of the issues disputed in the indexed cases. For a full understanding of a case, one should read the rest of the court file, including the response. For the most up-to-date and complete information on a case, visit www.pacer.gov or contact the clerk of the relevant court.

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IN THE UNITED STATES DISTRICT COURT
FOR THE MIDDLE DISTRICT OF GEORGIA
MACON DIVISION
GERARD R. GUNTHERT and ABBY B. )
GUNTHERT, individuallyand on behalf )
of all those similarlysituated, )
)
)
Plaintiffs, ) CIVIL ACTION FILE
)
vs. ) NO.____________________
)
ACE AMERICAN INSURANCE )
COMPANY, ACE FIRE ) J URY TRIAL DEMANDED
UNDERWRITERS INSURANCE )
COMPANY, ACE GROUP )
HOLDINGS, INC., ACE PROPERTY )
AND CASUALTY INSURANCE )
COMPANY, BANKERS STANDARD )
FIRE ANDMARINE COMPANY, )
BANKERS STANDARD INSURANCE )
COMPANY, INDEMNITY INSURANCE )
COMPANY OF NORTH AMERICA, )
INSURANCE COMPANY OF NORTH )
AMERICA, PACIFIC EMPLOYERS )
INSURANCE COMPANY, and )
WESTCHESTER FIRE INSURANCE )
COMPANY, )
)
)
Defendants. )
___________________________________ )
5:16-CV-21-MTT
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 1 of 33
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CLASS ACTION COMPLAINT
COMES NOW Plaintiffs Gerard R. Gunthert and Abby B. Gunthert,
individually and on behalf of all others similarly situated, and file this Class Action
Complaint, respectfully showing:
INTRODUCTION
1. This action relates to Defendants’ failure, in violation of Georgia law
and in violation of their insurance policies with Plaintiffs and class members, to
assess for diminution in value to their insureds’ properties, and where it is found to
exist, to pay such diminution in value to their insureds.
2. Plaintiffs Gerard Gunthert and Abby Gunthert maintained homeowners
property insurance coverage with Defendants and timely reported a claim for direct
physical loss to their home resulting from water damage. Defendants were required
not only to pay the costs of repair, but also to assess for and pay any diminution in
the fair market value of the insured property. Defendants breached their insurance
contract with Plaintiffs by (1) failing to assess Plaintiffs’ property for diminution in
value resulting from the water damage and (2) failing to pay Plaintiffs for such
diminution in value—each of which gives rise to separate monetary damages.
3. Plaintiffs bring this action on behalf of themselves and other current
insureds of Defendants to obtain a declaration that, when presented with first-party
physical damage claims arising from direct physical losses, Defendants are obligated
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 2 of 33
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to assess insured properties for diminution in value and, where diminution in value
is found, to pay such diminished value. Plaintiffs seek a corresponding injunction
to the declaratory relief requested stating that Defendants must (1) develop
appropriate policies and procedures for assessing for diminished value, (2) submit
within a reasonable period those policies and procedures to this Court for its
approval, and (3) pay for diminished value where it is found or deny it. Plaintiffs
also seek to recover damages on behalf of themselves and current and former
insureds of Defendants who suffered direct physical losses to their insured properties
caused by water damage but for which Defendants failed to assess for and pay
diminution in value to those properties, in breach of their insurance contracts.
PARTIES, JURISDICTION, AND VENUE
4. Plaintiffs Gerard Gunthert and Abby Gunthert, a husband and wife,
reside and own the property located at 6230 River Chase Circle Northwest, Atlanta,
Georgia 30328-3547. Plaintiffs’ home and property are insured under an “ACE
Platinum Portfolio Home Policy” issued by Bankers Standard Insurance Company,
an ACE Group company, with Policy Number 267-90-29-63H (the “Policy”).
1
The
Policy was applied for and obtained in the State of Georgia.
5. Defendant ACE American Insurance Company (hereinafter sometimes
referred to as “ACE American”) is a Pennsylvania business corporation and
1
Plaintiffs’ Policy with Defendants provided for several coverages, including “Home” coverage.
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 3 of 33
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maintains its principal place of business at 436 Walnut Street, Philadelphia,
Pennsylvania 19106. ACE American is authorized to write property insurance in the
State of Georgia.
6. ACE American may be served with process through its registered agent
for service, CT Corporation System, located at 1201 Peachtree Street Northeast,
Atlanta, Georgia 30361.
7. Defendant ACE Fire Underwriters Insurance Company (hereinafter
sometimes referred to as “ACE Fire Underwriters”) is a Pennsylvania insurance
business corporation and maintains its principal place of business at 436 Walnut
Street, Philadelphia, Pennsylvania 19106. ACE Fire Underwriters is authorized to
write property insurance in the State of Georgia. Upon information and belief, ACE
Fire Underwriters is a direct subsidiary of Defendant ACE Property and Casualty
Insurance Company.
8. ACE Fire Underwriters may be served with process through its
registered agent for service, CT Corporation System, located at 1201 Peachtree
Street Northeast, Atlanta, Georgia 30361.
9. Defendant ACE Group Holdings, Inc. (hereinafter sometimes referred
to as “ACE Group”) is a Delaware corporation and maintains its principal place of
business at 436 Walnut Street, Philadelphia, Pennsylvania 19106.
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 4 of 33
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10. ACE Group may be served with process by delivering a copy of the
Complaint and Summons to an officer of ACE Group, managing or general agent of
ACE Group, or any other agent authorized by appointment or by law to receive
service of process of behalf of ACE Group.
11. Defendant ACE Property and Casualty Insurance Company
(hereinafter sometimes referred to as “ACE Property and Casualty”) is a
Pennsylvania insurance business corporation and maintains its principal place of
business at 436 Walnut Street, Philadelphia, Pennsylvania 19106. ACE Property and
Casualty is authorized to write property insurance in the State of Georgia.
12. ACE Property and Casualty may be served with process through its
registered agent for service, CT Corporation System, located at 1201 Peachtree
Street Northeast, Atlanta, Georgia 30361.
13. Defendant Bankers Standard Fire and Marine Company (hereinafter
sometimes referred to as “Bankers Fire and Marine”) is a Pennsylvania insurance
business corporation and maintains its principal place of business at 436 Walnut
Street, Philadelphia, Pennsylvania 19106. Bankers Fire and Marine is authorized to
write property insurance in the State of Georgia. Upon information and belief,
Bankers Fire and Marine is a direct subsidiary of Defendant Bankers Standard
Insurance Company.
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 5 of 33
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14. Bankers Fire and Marine may be served with process through its
registered agent for service, CT Corporation System, located at 1201 Peachtree
Street Northeast, Atlanta, Georgia 30361.
15. Defendant Bankers Standard Insurance Company (hereinafter
sometimes referred to as “Bankers”) is a Pennsylvania insurance business
corporation and maintains its principal place of business at 436 Walnut Street,
Philadelphia, Pennsylvania 19106. Bankers is authorized to write property insurance
in the State of Georgia.
16. Bankers may be served with process through its registered agent for
service, CT Corporation System, located at 1201 Peachtree Street Northeast, Atlanta,
Georgia 30361.
17. Defendant Indemnity Insurance Company of North America
(hereinafter sometimes referred to as “Indemnity Insurance Company NA”) is a
Pennsylvania insurance business corporation and maintains its principal place of
business at 436 Walnut Street, Philadelphia, Pennsylvania 19106. Insurance
Company NA is authorized to write property insurance in the State of Georgia.
18. Indemnity Insurance Company NA may be served with process through
its registered agent for service, CT Corporation System, located at 1201 Peachtree
Street Northeast, Atlanta, Georgia 30361.
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 6 of 33
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19. Defendant Insurance Company of North America (hereinafter
sometimes referred to as “Insurance Company NA”) is a Pennsylvania insurance
business corporation and maintains its principal place of business at 436 Walnut
Street, Philadelphia, Pennsylvania 19106. Insurance Company NA is authorized to
write property insurance in the State of Georgia.
20. Insurance Company NA may be served with process through its
registered agent for service, CT Corporation System, located at 1201 Peachtree
Street Northeast, Atlanta, Georgia 30361.
21. Defendant Pacific Employers Insurance Company (hereinafter
sometimes referred to as “Pacific”) is a Pennsylvania insurance business corporation
and maintains its principal place of business at 436 Walnut Street, Philadelphia,
Pennsylvania 19106. Pacific is authorized to write property insurance in the State of
Georgia. Upon information and belief, Pacific is a direct subsidiary of Defendant
ACE American.
22. Pacific may be served with process through its registered agent for
service, CT Corporation System, located at 1201 Peachtree Street Northeast, Atlanta,
Georgia 30361.
23. Defendant Westchester Fire Insurance Company (hereinafter
sometimes referred to as “Westchester”) is a Pennsylvania insurance business
corporation and maintains its principal place of business at 436 Walnut Street,
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 7 of 33
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Philadelphia, Pennsylvania 19106. Westchester is authorized to write property
insurance in the State of Georgia.
24. Westchester may be served with process through its registered agent for
service, CT Corporation System, located at 1201 Peachtree Street Northeast, Atlanta,
Georgia 30361.
25. Plaintiffs refer to Defendants collectively herein as “ACE.”
26. ACE has numerous agents and places of business in Georgia, some of
which were located in Macon, Georgia, at the time the causes of action alleged herein
accrued. ACE continues to maintain agents and places of business in Macon,
Georgia.
27. Upon information and belief, Defendants ACE American, ACE Fire
Underwriters, ACE Property and Casualty, Bankers Fire and Marine, Bankers,
Indemnity Insurance Company NA, Insurance Company NA, Pacific, and
Westchester are indirect, wholly owned subsidiaries of ACE Group.
28. Defendants have a common administrative or principal place of
business located at 436 Walnut Street, Philadelphia, Pennsylvania 19106.
29. Upon information and belief, Defendants share and have in common
several officers and/or directors, including J ohn J . Lupica, who signed Plaintiff’s
policy declarations page.
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 8 of 33
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30. Defendants coordinate and commingle financial and other resources by
making financial transactions between each other by issuing consolidated financial
statements, and by other means.
31. Defendants operate and trade under the common name of ACE and use
the same logo to identify and promote their business. Plaintiffs’ policy and the
declarations and signature pages all bear the ACE logo.
32. Defendants maintain a common website, www.acegroup.com/us-en/,
through which ACE insureds can create an online account that, among other things,
allows them to set up bill payments to pay premiums, access policy information, and
check the status of a claim.
2
Defendants’ website provides a toll free number through
which individuals with a homeowners claim can report a claim to ACE.
3
33. Defendants ACE American, ACE Fire Underwriters, ACE Property and
Casualty, Bankers Fire and Marine, Indemnity Insurance Company NA, Insurance
Company NA, Pacific, and Westchester are all listed on the signature page of
Plaintiffs’ policy. Upon information and belief, each of these ACE entities issues
homeowners insurance in Georgia that are the same or substantially similar in all
respects material ways to Plaintiffs’ policy. Upon information and belief, Defendants
engaged in a common course of conduct pursuant to a common corporate policy with
2
See http://www.acegroup.com/us-en/individuals-families/policyholder-center.aspx.
3
See http://www.acegroup.com/us-en/individuals-families/ace-prs-report-a-claim.aspx.
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 9 of 33
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respect to those policies in terms of their failure to assess for and, where found, pay
diminished value to their insureds.
34. Correspondence from ACE following the submission of Plaintiffs’
claim at issue in this action is on “ACE group” letterhead that bears the ACE logo.
35. Upon information and belief, at all relevant times herein, Defendants
acted in all aspects as agent, apparent agent, and alter ego for each other, with respect
to the acts complained of herein.
36. Upon information and belief, at all relevant times herein, Defendants
were engaged in a joint venture with each other.
37. Defendants’ actions are sufficient to find that there is an amalgamation
of the Defendants.
38. Defendants’ actions and relationships are sufficient to find that there is
a juridical link among them.
39. This Court has jurisdiction over this dispute under 28 U.S.C. § 1332(a)
because the parties are completely diverse and the amount in controversy exceeds
$75,000.00. This Court also has subject matter jurisdiction of this action under 28
U.S.C. § 1332(d)(2)(A), which provides for federal jurisdiction in class actions with
minimal diversity when damages exceed five million dollars, exclusive of interest
and costs. Upon information and belief, the aggregate amount at issue in this dispute
exceeds five million dollars. In addition, “minimal diversity” is satisfied because at
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 10 of 33
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least one member of the proposed classes is a citizen of a State different from any
defendant. The Court has supplemental subject matter jurisdiction over the pendent
state law claims pursuant to 28 U.S.C. § 1367.
40. Venue in this Court is proper pursuant to the provisions of 28 U.S.C §§
1391(b)(2) & (d).
ALLEGATIONS SPECIFIC TO THE NAMED PLAINTIFFS
41. Plaintiffs incorporate the foregoing allegations as if fully set forth
herein.
42. At all times pertinent hereto, Plaintiffs maintained an insurance policy
issued by ACE.
43. Specifically, in consideration for Plaintiffs’ payment of premiums,
ACE issued an “ACE Platinum Portfolio Homeowners Policy” to Plaintiffs.
44. The Policy was issued in the State of Georgia.
45. The Policy was drafted by ACE.
46. Plaintiffs performed all contractual conditions required of them under
the Policy, including the timely payment of premiums due under the Policy.
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 11 of 33
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47. Under Georgia law, coverage for diminution in value losses has been,
and is, part of the contracts of homeowners insurance
4
issued by ACE to Plaintiffs
and to other insureds throughout the State of Georgia.
48. Under Georgia law, when insureds present first-party claims under their
homeowners insurance policies for direct physical loss to their covered properties,
the insurers are required not only to pay the costs of repair, but also to assess for,
and where found, pay any diminution in the fair market value of the insured property.
49. Implied in every contract, including the contract of insurance wherein
Defendants agreed to provide coverage to Plaintiffs, is the covenant of good faith
and fair dealing. Defendants had the duty to treat Plaintiffs, as their insureds, with
the utmost good faith.
50. On J anuary 22, 2014, Plaintiffs’ home and property was insured under
the Policy. As of that date, the Policy provided Plaintiffs with several coverages,
including “Home” coverage.
51. On J anuary 22, 2014, Plaintiffs’ home, which was insured under the
Policy, suffered interior water damage as a result of a burst pipe; an event that was
covered under the Policy. Plaintiffs timely reported the direct physical loss to ACE
and otherwise complied with the terms and conditions of the Policy.
4
Plaintiffs use the term “homeowners insurance” to refer to any insurance policy, however titled,
issued by ACE that provides homeowners property coverage.
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 12 of 33
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52. ACE adjusted Plaintiffs’ claim arising out of the loss, authorized
repairs to Plaintiffs’ home, and subsequently paid certain repair costs. Despite those
repairs, as a result of this water damage to Plaintiffs’ property, the fair market value
of Plaintiffs’ property was diminished.
53. At the time ACE authorized the repairs to Plaintiffs’ home and adjusted
the claim, ACE took no action to assess any diminution in the fair market value of
Plaintiffs’ property.
54. ACE failed to assess Plaintiffs’ diminution in value loss.
55. ACE failed to pay Plaintiffs’ diminution in value loss to Plaintiffs.
56. By failing to account and assess for diminution in value as an element
of loss and by failing to pay its insureds the diminution in value of their property,
ACE breached the Policy, including the covenant of good faith and fair dealing
inherent therein.
57. ACE’s breach of contract has injured and harmed Plaintiffs and has
proximately caused Plaintiffs damages for which Plaintiffs seek recovery.
58. Plaintiffs are entitled to recover damages for ACE’s breaches of
contract in (1) failing to assess for diminished value and (2) failing to pay for
diminished value.
59. Plaintiffs, as current policyholders, are also entitled to declaratory
and/or injunctive relief.
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 13 of 33
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CLASS ALLEGATIONS
60. Plaintiffs incorporate the foregoing allegations as if fully set forth
herein.
61. Plaintiffs bring this action on behalf of themselves and other similarly
situated persons who contracted with Defendants for homeowners insurance
5
coverage for property located in the State of Georgia.
62. ACE has issued homeowners insurance policies throughout the State of
Georgia. The Policy issued to Plaintiffs is the same or substantially similar in all
respects material to this action to numerous policies of insurance issued by ACE to
insureds throughout the State of Georgia.
63. Despite the fact that its homeowners policies of insurance provide
coverage for diminution in value, ACE has implemented, and continues to
implement, procedures whereby it systematically fails to assess for and pay
diminution in value in first-party physical damage claims and fails to establish
procedures to handle diminution in value claims.
64. ACE’s failure to assess for and pay diminution in value respecting first-
party physical damage claims and ACE’s failure to establish procedures to handle
such diminution in value claims has resulted in numerous and systematic breaches
of contract by ACE.
5
See supra note 4.
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 14 of 33
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65. Plaintiffs were insured by ACE and had coverage against risks of direct
physical loss to their home under the Policy. At the time Plaintiffs submitted their
claims to ACE and ACE authorized repairs to Plaintiffs’ home and adjusted the
claim, ACE failed to assess for and pay Plaintiffs’ diminution in value loss.
66. Upon information and belief, ACE has treated all of its policyholders
who have presented first-party physical damage claims under their homeowners
insurance policies the same or substantially the same way ACE treated Plaintiffs
when Plaintiffs presented their claim in that ACE has failed to assess for and pay
diminution in value loss.
67. By paying only for repairs and by failing to assess for and pay
diminution in value of its insureds’ properties, ACE’s conduct has been, and is, in
violation of Georgia law and contrary to the terms, conditions, and obligations of its
own contracts of insurance.
68. Plaintiffs seek certification of two or more classes of similarly situated
persons or entities in order to: (a) obtain a declaration that ACE is obligated under
the homeowners insurance policies to assess insured properties for and pay
diminished value when policyholders present first-party physical damage claims
arising from direct physical losses to their insured properties, which are covered
events; (b) prohibit ACE from failing to assess for and pay diminution in value, to
require ACE to establish procedures to handle such claims and notify its
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 15 of 33
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policyholders of such coverage, and to require ACE in the future to honor and abide
by its contractual obligations and the law of the State of Georgia to assess for and
pay diminution in value when policyholders present first-party physical damage
claims arising from direct physical losses to their insured properties, which are
covered events; (c) to require ACE to pay damages equal to the cost of performing
diminished value assessments to those insureds who, under their homeowners
insurance policies, have within the period of six years preceding the filing of this
civil action, presented first-party physical damage claims arising from direct
physical losses to their insured properties caused by water damage, which are
covered events, but for which ACE failed to assess for diminished value; and (d) to
require ACE to pay damages for diminution in the fair market value of their
properties to those insureds who, under their homeowners insurance policies, have
within the period of six years preceding the filing of this action, presented first-party
physical damage claims arising from direct physical losses to their insured properties
caused by water damage, which are covered events, but for which such insureds were
not paid such diminished values.
69. Specifically, pursuant to Rule 23 of the Federal Rules of Civil
Procedure, Plaintiffs bring this action on behalf of themselves and all others
similarly situated, as a representative of the following classes:
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 16 of 33
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A.
All persons currently insured under homeowners
insurance policies issued by ACE that provide coverage
for property located in the State of Georgia (hereinafter the
“Policyholder Class”).
B.
All persons formerly or currently insured under
homeowners insurance policies issued by ACE that
provide coverage for property located in the State of
Georgia who, within the period of six years preceding the
commencement of the instant civil action, presented first-
party claims arising from direct physical losses to their
properties as a result of water damage to their homes,
which are events covered by the policy, wherein
diminution of value was not assessed for or paid in
connection with said claims (hereinafter the “Covered
Loss Class”).
70. Excluded from the Policyholder Class and the Covered Loss Class are
Defendants, the officers and directors of the Defendants at all relevant times,
members of their immediate families and their legal representatives, heirs,
successors or assigns, and any entity in which Defendants have or had a controlling
interest.
FEDERAL RULE OF CIVIL PROCEDURE 23(a)
71. Plaintiffs incorporate the foregoing allegations as if fully set forth
herein.
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 17 of 33
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72. The Policyholder Class and the Covered Loss Class (collectively, the
“Classes”) are properly brought and should be maintained as a class action under
Rule 23(a) of the Federal Rules of Civil Procedure because they satisfy the
prerequisites of numerosity, commonality, typicality, and adequacy.
73. Specifically, the members of the Classes are so numerous that joinder
of all members is impracticable. While the exact number of Class members is
unknown to Plaintiffs at this time and can only be ascertained through appropriate
discovery, Plaintiffs believes that ACE insures hundreds, if not thousands, of home
owners in the State of Georgia who are members of the proposed Policyholder Class
and/or Covered Loss Class.
74. The claims of Plaintiffs and the members of the Policyholder Class
involve common questions of law and fact, including, inter alia, the following: (1)
whether, under Georgia law and pursuant to ACE’s homeowners insurance policies,
ACE is required to assess for, and pay to, its first-party physical damage claimants,
any diminution in value to their real property, where such damage is a covered event
under the applicable insurance policy; (2) whether ACE, once an insured reports a
loss, must evaluate the claims to determine whether the insured’s real property
sustained a diminution in value; (3) whether ACE, pursuant to its insureds’
homeowners insurance policies, at the conclusion of the adjustment and repair
process, must pay for any diminished value; (4) whether Plaintiffs and members of
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 18 of 33
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the Policyholder Class are entitled to declaratory relief; and (5) whether Plaintiffs
and members of the Policyholder Class are entitled to an injunction.
75. The claims of Plaintiffs and the members of the Covered Loss Class
involve common questions of law and fact, which predominate over questions
affecting only individual members of the Class, including, inter alia, the following:
(1) whether, under Georgia law and pursuant to ACE’s homeowners insurance
policies, ACE is required to assess for, and pay to its first-party physical damage
claimants, any diminution in value to their real property sustained as the result of
water damage to such property, where such damage is a covered event under the
applicable insurance policy; (2) whether ACE failed to assess and/or pay for any
diminution in value when its policyholders presented first-party physical damage
claims arising from direct physical losses to their insured properties caused by water
damage to their insureds’ properties, which are covered events under the policies;
(3) whether ACE breached the terms of the homeowners insurance policies by
refusing to assess and, where found, pay for diminished value; (4) whether the claims
of the Covered Loss Class arise from the same conduct constituting ACE’s breach
of the homeowners insurance policies; (5) whether ACE’s practices complained of
herein should be enjoined; (6) whether Plaintiffs and members of the Covered Loss
Class are entitled to monetary damages as a result of ACE’s failure to assess for
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 19 of 33
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diminished value; and (7) whether Plaintiffs and members of the Covered Loss Class
are entitled to damages as a result of ACE’s failure to pay for diminished value.
76. Plaintiffs’ claims are typical of those of the members of the
Policyholder Class because their claims have the same essential characteristics as
the claims of the Class members, and their claims arise from the same course of
conduct by ACE. In particular, Plaintiffs and all of the members of the Policyholder
Class maintain physical damage insurance coverage pursuant to homeowners
insurance policies issued by ACE containing identical, or substantially similar,
language respecting risks of direct physical losses to their properties and provisions
respecting settlement of such losses. Plaintiffs’ claims arise out of contracts of
insurance that have not been performed due to the uniform policies, practices, and
procedures of ACE that omit or conceal reference to, consideration of, and payment
for diminution in value. ACE has developed policies, practices, and procedures for
the repair of properties and the adjustment and settlement of claims that omit or
conceal reference to, consideration of, and payment for diminution in value. ACE
applies these policies, practices, and procedures in a similar fashion to Plaintiffs and
all other members of the Policyholder Class. Plaintiffs and the members of the
Policyholder Class all have an interest in ensuring that ACE adjusts claims in the
future in a manner that is consistent with Georgia law.
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 20 of 33
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77. The claims of Plaintiffs are typical of those of the members of the
Covered Loss Class because their claims have the same essential characteristics as
the claims of the class members, and their claims arise from the same course of
conduct by Defendants. Plaintiffs and all of the members of the Covered Loss Class
maintain, or have maintained, physical damage insurance coverage pursuant to
homeowners insurance policies issued by ACE, containing identical, or substantially
similar, language respecting risks of direct physical losses to their properties and
provisions respecting settlement of such losses. Plaintiffs and the members of the
Covered Loss Class all made claims upon ACE for adjustment of first-party physical
damage claims as a result of water damage to their properties, which are events
covered under ACE’s insurance policies. When adjusting such claims, ACE failed
to assess for and pay diminution in value losses to Plaintiffs and the members of the
Covered Loss Class. Each Covered Loss Class member’s contract of insurance was
breached by ACE in a substantially similar manner, i.e., by ACE’s failure to assess
for and pay diminution in value.
78. Plaintiffs will fairly and adequately represent the interests of all
members of the Policyholder Class and the Covered Loss Class. Plaintiffs’ claims
are common to all members of the Classes and Plaintiffs have strong interests in
vindicating their rights. Plaintiffs are represented by counsel experienced in
complex and class action litigation.
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 21 of 33
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THE POLICYHOLDER CLASS MEETS THE REQUIREMENTS OF RULE
23(b)
79. Plaintiffs incorporate the foregoing allegations as if fully set forth
herein.
80. Certification of the Policyholder Class is appropriate under Rule
23(b)(2) of the Federal Rules of Civil Procedure.
81. ACE has acted or refused to act on grounds that apply generally to the
members of the Policyholder Class, so that final injunctive relief and corresponding
declaratory relief is appropriate respecting the class as a whole. ACE has failed to
assess and pay diminution-in-value losses to its insureds in a manner which is
generally applicable to the members of the Policyholder Class, thereby making
appropriate final injunctive relief with respect to the Policyholder Class as a whole.
In particular, any final injunctive or declaratory relief would apply to the entire
Policyholder Class as the rights of all Class members under the terms of the
homeowners insurance policies can be addressed in one declaratory order and/or
ACE would be ordered to assess for and pay diminution in value when policyholders
present first-party physical damage claims arising from direct physical losses to their
insured properties, which are covered events.
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 22 of 33
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THE COVERED LOSS CLASS MEETS THE REQUIREMENTS OF RULE
23(b)
82. Plaintiffs incorporate the foregoing allegations as if fully set forth
herein.
83. The Covered Loss Class may be maintained pursuant to Rule 23(b)(1),
(b)(2), (b)(3), and/or (c)(4).
84. Certification of the Covered Loss Class is appropriate pursuant to Rule
23(b)(1)(A) because the prosecution of separate actions by individual class members
would create a risk of inconsistent or varying adjudications with respect to individual
class members which would establish incompatible standards of conduct for ACE.
Certification of the Covered Loss Class is likewise appropriate pursuant to Rule
23(b)(1)(B) because the prosecution of separate actions by individual class members
would create a risk of adjudications with respect to individual class members which
would, as a practical matter, be dispositive of the interests of the other members not
parties to the adjudications or substantially impair or impede their ability to protect
their interests.
85. Certification of the Covered Loss Class is also appropriate pursuant to
Rule 23(b)(2). ACE has acted or refused to act on grounds that apply generally to
the members of the Covered Loss Class, so that final injunctive relief and
corresponding declaratory relief is appropriate respecting the Class as a whole.
ACE has systematically breached the contracts of insurance by failing to assess for
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 23 of 33
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and pay diminution-in-value to its insureds in a manner which is generally applicable
to the members of the Covered Loss Class, thereby making appropriate final
injunctive relief with respect to the Covered Loss Class as a whole. In particular,
any final injunctive or declaratory relief would apply to the entire Covered Loss
Class as the rights of all Class members under the terms of the homeowners
insurance policies can be addressed in one declaratory order and/or ACE would be
ordered to assess for and pay diminution in value when policyholders present first-
party physical damage claims arising from direct physical losses to their insured
properties caused by water damage, which are covered events.
86. Certification of the Covered Loss Class is also appropriate pursuant to
Rule 23(b)(3) because common questions of law and fact that exist as to all members
of the Class are central to the adjudication of this action and predominate over any
questions solely affecting individual members of the Covered Loss Class.
87. Moreover, a class action is superior to other available methods for the
fair and efficient adjudication of this controversy in that, among other factors:
(a) The interests of the Plaintiffs and members of the Covered Loss Class
in individually controlling the prosecution of separate actions are outweighed by the
advantages of adjudicating the common issues of fact and law by means of a class
action;
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 24 of 33
25
(b) The expense of prosecuting Plaintiffs’ and Class members’ claims
individually would significantly exceed any economic benefit Plaintiffs or Class
members could realize individually, and individual litigation would overload court
dockets and magnify the delay and expense to all parties making individual litigation
of liability and damages claims economically impractical and infeasible;
(c) It is desirable that litigation of the claims occur for the Class in this
forum to preserve the resources of both the Courts and the litigants, and to reduce
the risk of varying and inconsistent adjudications that could occur in individual
adjudications; and
(d) Little, if any, difficulty is likely to be encountered in management of
this class action because applicable law will uniformly apply to the claims of the
Covered Loss Class.
88. In the alternative, or in addition to certification under Rule 23(b),
Plaintiffs seek certification of the Covered Loss Class under Rule 23(c)(4), which
provides that an action may be brought or maintained as a class action with respect
to particular issues. Under Rule 23(c)(4), certification is appropriate when a Plaintiff
establishes a class under Rule 23(a), and when a common issue threads through the
case.
89. In particular, Plaintiffs seek certification of the liability aspects of the
claims asserted by the Covered Loss Class, including but not limited to whether
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 25 of 33
26
ACE’s homeowners insurance policies provide coverage for diminished value and
whether ACEbreached the homeowners insurance contractsby failing to assess and,
where found, pay for diminished value. Specifically, the liability issues applicable
to the breach of contract claim suffered by the Covered Loss Class arise from the
following question: whether the Defendants breached the homeowners insurance
policies by failing to assess for and pay diminution in value when its policyholders
presented first-party physical damage claims arising from direct physical losses to
their insured properties caused by water damage, which are coveredevents. Because
ACE’s conduct was uniform with respect to all members of the Covered Loss Class
in that it failed to assess for and pay diminution of value, this issue is suited for class-
wide issue resolution under Rule 23(c)(4).
COUNT 1 – BREACH OF CONTRACT
90. Plaintiffs incorporate the foregoing allegations as if fully set forth
herein.
91. During the relevant class period, Plaintiffs and all members of the
Covered Loss Class maintained coverage against risks of direct physical loss to their
properties under policies of homeowners insurance issued by ACE. These policies
of homeowners insurance were drafted by the insurer and are accordingly construed
against the insurer.
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 26 of 33
27
92. Implied in every contract, including the contracts of insurance wherein
ACE agreed to provide homeowners insurance coverage to Plaintiffs and the
members of the Covered Loss Class, is the covenant of good faith and fair dealing.
ACE had a duty to treat Plaintiffs and the members of the Covered Loss Class with
the utmost good faith.
93. During the relevant class period, Plaintiffs and the other members of
the Covered Loss Class all made first-party claims against ACE for water damage
to dwellings, which were covered under the homeowners insurance policies issued
by ACE.
94. Despite being required to do so by its policies of homeowners insurance
and Georgia law, ACE failed to assess the diminution in value losses of Plaintiffs
and the other Covered Loss Class members and failed to pay these losses to Plaintiffs
and the other Covered Loss Class members.
95. By failing to assess for diminution in value as an element of loss, ACE
breached the homeowners insurance contracts, including the covenant of good faith
and fair dealing inherent therein.
96. By failing to pay Plaintiffs and the Covered Loss Class members the
diminution in value of their properties, ACE breached the homeowners insurance
contracts, including the covenant of good faith and fair dealing inherent therein
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 27 of 33
28
97. The breaches of contract by ACE have injured and harmed Plaintiffs
and the Covered Loss Class members and have proximately caused them damages.
98. Plaintiffs and the members of the Covered Loss Class are entitled to
recover damages from ACE for breach of contract arising from ACE’s failure to
assess for diminished value. Plaintiffsand the members of the Covered Loss Class
also are entitled to recover damages from ACE for breach of contract arising from
ACE’s failure to pay for diminished value. Accordingly, Plaintiffssue on behalf of
themselves and the other Covered Loss Class members in order to recover for
amounts due to members of that class based upon ACE’s failure to assess and pay
diminution of value in the aforesaid first-party claims of Plaintiffs and the other
Covered Loss Class members.
99. Because monetary relief is not adequate to remedy the harm caused by
ACE’s ongoing and/or future breaches of the homeowners insurance contracts,
Plaintiffs also seek specific performance and/or an order enjoining Defendants’
ongoing and/or future nonperformance to prevent irreparable harm to Plaintiffsand
members of the Class.
COUNT 2 – DECLARATORY JUDGMENT
28 U.S.C § 2201
100. Plaintiffs incorporate the foregoing allegations as if fully set forth
herein.
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 28 of 33
29
101. There exists an actual controversy as to the responsibilities of the
parties under the homeowners insurance policies issued by ACE to Plaintiffs and the
members of the Policyholder and Covered Loss Classes.
102. Section 2201 of Title 28 of the United States Code authorizes this Court
to declare the rights and other legal relations of the parties where such a controversy
exists.
103. Specifically, Plaintiffs and the members of the Policyholder and
Covered Loss Classes contend the homeowners insurance policies issued by ACE
require ACE to assess and pay for the diminution in value to insured properties
resulting from covered losses to insured properties as more completely set forth in
the preceding allegations.
104. Furthermore, the risk that Plaintiffs or the class members will sustain
another covered loss in the future, and that ACE will continue to improperly fail to
assess and pay for diminished value to their insured properties, is real and immediate.
COUNT 3 – ATTORNEYS’ FEES AND COSTS
105. Plaintiffs incorporate the foregoing allegations as if fully set forth
herein.
106. Throughout the course of events described in this Complaint,
Defendants have acted in bad faith, been stubbornly litigious, and/or have caused
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 29 of 33
30
Plaintiffs and members of the Policyholder and Covered Loss Classes undue trouble
and expense.
107. As a result, Plaintiffs and members of the Policyholder and Covered
Loss Classes are entitled to recover attorneys’ fees, costs, and the expenses of
litigation pursuant to O.C.G.A. § 13-6-11.
WHEREFORE, the Plaintiffs pray:
(a) that summons and process issue to the Defendants as required by law;
(b) that Plaintiffs, individually, recover compensatory damages for the
injuries and damages they have incurred in an amount proven at trial;
(c) that this Court certify the Policyholder Class and the Covered Loss
Class requested herein, and that the Court find and conclude that
Plaintiffs are an appropriate representative of these classes;
(d) that this Court find and conclude that the undersigned counsel fairly
and adequately represent and protect the interests of the Policyholder
Class and the Covered Loss Class requested herein, and certify the
undersigned counsel to act as counsel for these classes;
(e) that this Court issue a declaratory judgment that Defendants are
obligated under the homeowners insurance policies to assess insured
properties for and pay diminished value when policyholders present
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 30 of 33
31
first-party physical damage claims arising from direct physical losses
to their insured properties, which are covered events;
(f) that judgment be entered against Defendants finding that Defendants
breached the homeowners insurance contracts by (1) failing to assess
for diminished value and (2) failing to pay for diminished value;
(g) that judgment be entered against Defendants in such amount as will
fully and adequately compensate Plaintiffs and the other members of
the Covered Loss Class;
(h) that this Court issue an order requiring that Defendants specifically
perform their obligations under the homeowners insurance contracts in
effect and enjoining any future non-performance by Defendants under
the homeowners insurance contracts;
(i) that this Court enter a permanent injunction requiring Defendants to
establish procedures to handle diminution in value claims and evaluate
for and, if found, pay diminution in value when policyholders present
first-party physical damage claims arising from covered losses;
(j) that this Court enter a permanent injunction requiring Defendants to
make clear and obvious to policyholders their contractual right to be
compensated for diminution in value losses and requiring Defendants
to establish procedures to handle such diminution in value losses;
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 31 of 33
32
(k) that this Court award Plaintiffs and members of the Policyholder and
Covered Loss Classes their costs and attorney’s fees pursuant to
O.C.G.A. § 13-6-11;
(l) that Plaintiffs have a trial by jury with respect to the legal claims; and
(m) that this Court grant such other and further relief as it deems just and
proper.
[REMAINDER OF PAGE INTENTIONALLY BLANK]
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 32 of 33
33
Respectfully submittedthis 15
th
day of J anuary, 2016,
/s/ Richard Kopelman
Richard Kopelman(GA Bar No. 428115)
Clint W. Sitton(GA Bar No. 649420)
KOPELMAN SITTON LAW GROUP, LLC
3405 Piedmont Road, N.E., Suite 500
Atlanta, Georgia 30305
clint@kopelmansitton.com
richard@kopelmansitton.com
Adam P. Princenthal (GA Bar No. 588219)
PRINCENTHAL & MAY, LLC.
5901 Peachtree Dunwoody Road
Building A, Suite 525
Sandy Springs, Georgia 30328
adam@princemay.com
C. Cooper Knowles(GA Bar No. 426699)
LAW OFFICES OF C. COOPER KNOWLES
3405 Piedmont Road, N.E.
Suite 500
Atlanta, Georgia 30305
cknowles@cckfirm.com
J ames C. Bradley(SC Bar No. 16611)
Michael J . Brickman(SC Bar No. 874)
Nina Fields Britt (SC Bar No. 68294)
RICHARDSON, PATRICK, WESTBROOK &
BRICKMAN, LLC
1017 Chuck Dawley Blvd. (29464)
Post Office Box 1007
Mount Pleasant, South Carolina 29465
jbradley@rpwb.com
mbrickman@rpwb.com
nfields@rpwb.com
Attorneys for Plaintiff
Case 5:16-cv-00021-MTT Document 1 Filed 01/15/16 Page 33 of 33

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