McInnis v. Liberty Mut. Fire Ins. 2022 WL4594609 (5th Cir. Sept.30, 2022)
Sep 30, 2022OUTCOME: Summary Judgment granted.
The U.S. Fifth Circuit examined the time-bar issue following 2016 flooding within the Middle District of Louisiana. In McInnis, the WYO Program carrier, Liberty Mutual, issued two letters to the plain ... tiffs. The first letter, dated November 16, 2016, partially denied plaintiffs’ contents claim. Plaintiffs appealed the denial to FEMA with FEMA concurring with the denial. Id. On December 26, 2017, plaintiffs submitted a proof of loss to Liberty Mutual. Liberty Mutual sent a second letter to the plaintiffs, dated January 8, 2018. Exactly one year later, on January 8, 2019, McInnis sued Liberty Mutual for breaching the SFIP. The Court concluded that the November 16, 2016 denial letter plainly put McInnis on notice that a part of her claim had been disallowed.” Plaintiffs argued that the first letter was not a denial because it did not deny a "proof of loss." Court held that "Section 4072 does not mention a proof of loss, much less requires the disallowance of one. Instead, it refers to the “disallowance ... of any such claim.” 42 U.S.C. § 4072). Therefore, a claim and a proof of loss are distinct. As FEMA explains in its NFIP Claims Manual, ‘[t]he proof of loss is not the claim. The claim is the policyholder’s assertion that they [sic] are entitled to payment for a Insured [sic] loss under the terms of the SFIP. A policy holder has only one claim from a flood event regardless of the number of proofs of loss and amount of documentation the policyholder may submit in support of that claim.”
