Time Bar Defeats Suits Against Insurer
Post 5247
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In Kevin J. Labudde v. The Phoenix Insurance Company, No. 7:21-CV-197-BO-BM, United States District Court, E.D. North Carolina, Southern Division (December 12, 2025) Defendant The Phoenix Insurance Company (Phoenix) moved for summary judgment, moved to exclude the testimony of Donald Dinsmore and Jerome Redmond, and moved to seal certain documents.
FACTS
Kevin J. Labudde’s home was damaged by Hurricane Matthew on October 8, 2016. He discovered additional mold damage in January 2017 and hired a contractor, who filed an insurance claim with Phoenix Insurance Company. Phoenix found hail damage (covered by the policy) but determined the cost was below the deductible and denied coverage for water intrusion and mold, citing policy exclusions for seepage.
Second Claim:
On December 13, 2019, water again intruded into the property. Labudde filed a second claim. Phoenix’s adjuster, Erin Crane, could not determine the water’s source and hired Vertex Engineering. Vertex concluded that the damage was due to construction defects, not a covered peril. Phoenix denied coverage for water intrusion but paid for mold remediation (up to the policy limit) and roof replacement due to hail.
Lawsuit:
Labudde sued Phoenix on September 9, 2021, alleging breach of contract, unfair claims settlement practices under North Carolina’s Unfair and Deceptive Trade Practices Act (UDTPA), and common law bad faith.
LAW – STATUTE OF LIMITATIONS
Breach of Contract & Bad Faith:
Both claims have a three-year statute of limitations, starting from the date of loss. Since the initial damage occurred in 2016 and the lawsuit was filed in 2021, these claims are time-barred.
Unfair Claims Settlement Practices (UDTPA):
This claim has a four-year statute of limitations, starting when the insurer denies coverage. The court found the claim time-barred as to the 2017 claim, but not clearly time-barred for the 2019 claim, so it allowed the 2019-related UDTPA claim to proceed.
Unfair and Deceptive Trade Practices (UDTPA)
To prove a UDTPA violation, a plaintiff must show:
1. An unfair or deceptive act or practice
2. In or affecting commerce
3. That proximately caused injury.
A practice is unfair when it offends established public policy as well as when the practice is immoral, unethical, oppressive, unscrupulous, or substantially injurious to consumers. A practice is deceptive if it has the capacity or tendency to deceive; proof of actual deception is not required.
If substantial aggravating circumstances accompany a breach of contract, then those circumstances can create a UDTPA claim.
The court found that Phoenix’s investigation and communication regarding the 2019 claim were adequate. Phoenix hired an outside expert, considered Labudde’s input, and communicated its decision. There was no evidence that Phoenix misled the engineer, withheld information, or failed to respond in a timely manner.
Expert Testimony
The court excluded portions of the plaintiff’s expert testimony on the UDTPA claim, finding it amounted to legal conclusions rather than helpful expert opinion.
Motion to Seal
The court granted Phoenix’s motion to seal certain documents containing proprietary business information, finding the need for confidentiality outweighed the public’s right of access.
CONCLUSION
The court granted summary judgment for Phoenix on all claims except the UDTPA claim related to the 2019 insurance claim, which was not clearly time-barred but ultimately failed on the merits. The court also granted the motion to seal certain documents and excluded some expert testimony.
ZALMA OPINION
Insurance claims created by a contractor rather than an insurance professional like a Public Insurance Adjuster or a lawyer, are often questionable. By the time Phoenix was sued the statute of limitations of the first claim had run and the second claim was not due to an insured against peril. When an insured is upset with the result of a claim he or she should consult with either a public insurance adjuster or an attorney. If the insurance professional suggests the claim denial was wrong then, before the running of the statute of limitations or a private limitation of action provision and then retain counsel to sue promptly. The summary judgment was granted because the insured did not follow that advice.
(c) 2025 Barry Zalma & ClaimSchool, Inc.
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Insured Must Give Prompt Notice of Loss
Post 5256
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Once The Insured Knows There is Damage It is Obligated to Report the Loss to the Insurer
In Greater St. Stephen Ministries, Inc. v. Mt. Hawley Insurance Company, No. 24-cv-3130 (AS), United States District Court, S.D. New York (January 2, 2026) resolved a case brought by a church against an insurance company for denying coverage after Hurricane Ida. After discovery, the insurance company moved for summary judgment because it claimed the insured breached a material condition of the policy.
BACKGROUND
Greater St. Stephen Ministries, Inc., a church located in Louisiana, owned property that suffered damage from Hurricane Ida on August 29, 2021. The property was insured under a policy with Mt. Hawley Insurance Company, which required the insured to provide “prompt notice” of any loss or damage, ...
Insured Must Give Prompt Notice of Loss
Post 5256
Read the full article at https://lnkd.in/gBXRbKXD, see the video at https://lnkd.in/g4DKfUDz and at https://lnkd.in/g65V_RQ7 and at https://zalma.com/blog plus more than 5250 posts.
Once The Insured Knows There is Damage It is Obligated to Report the Loss to the Insurer
In Greater St. Stephen Ministries, Inc. v. Mt. Hawley Insurance Company, No. 24-cv-3130 (AS), United States District Court, S.D. New York (January 2, 2026) resolved a case brought by a church against an insurance company for denying coverage after Hurricane Ida. After discovery, the insurance company moved for summary judgment because it claimed the insured breached a material condition of the policy.
BACKGROUND
Greater St. Stephen Ministries, Inc., a church located in Louisiana, owned property that suffered damage from Hurricane Ida on August 29, 2021. The property was insured under a policy with Mt. Hawley Insurance Company, which required the insured to provide “prompt notice” of any loss or damage, ...
New Trial Because Jury Used Policy That Provides No Coverage to Assess Damages
Post 5255
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In Brown & Brown of Florida, Inc. v. Houligan’s Pub & Club, Inc., and Ormond Wine Company, LLC, Nos. 5D2024-2352, 5D2024-2458, Florida Court of Appeals (January 2, 2026) the Court of Appeals was faced with a case of first impression that involved damages from a hurricane that hit the East Coast of Florida almost a decade ago and the extent to which an insurance broker is responsible for paying for such damages.
The jury entered a verdict in favor of the insurance broker on the insured’s claim that it was negligent in failing to procure insurance, but it found in favor of the insured on claims of breach of fiduciary duty and negligent misrepresentation.
The insurance broker does not contest it breached its duties on these two claims, only ...
Court Must Follow Judicial Precedent
Post 5252
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Insurance Policy Interpretation Requires Application of the Judicial Construction Doctrine
In Montrose Chemical Corporation Of California v. The Superior Court Of Los Angeles County, Canadian Universal Insurance Company, Inc., et al., B335073, Court of Appeal, 337 Cal.Rptr.3d 222 (9/30/2025) the Court of Appeal refused to allow extrinsic evidence to interpret the word “sudden” in qualified pollution exclusions (QPEs) as including gradual but unexpected pollution. The court held that, under controlling California appellate precedent, the term “sudden” in these standard-form exclusions unambiguously includes a temporal element (abruptness) and cannot reasonably be construed to mean ...
Lack of Jurisdiction Defeats Suit for Defamation
Post 5250
Posted on December 29, 2025 by Barry Zalma
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He Who Represents Himself in a Lawsuit has a Fool for a Client
In Pankaj Merchia v. United Healthcare Services, Inc., Civil Action No. 24-2700 (RC), United States District Court, District of Columbia (December 22, 2025)
FACTUAL BACKGROUND
Parties & Claims:
The plaintiff, Pankaj Merchia, is a physician, scientist, engineer, and entrepreneur, proceeding pro se. Merchia sued United Healthcare Services, Inc., a Minnesota-based medical insurance company, for defamation and related claims. The core allegation is that United Healthcare falsely accused Merchia of healthcare fraud, which led to his indictment and arrest in Massachusetts, causing reputational and business harm in the District of Columbia and nationwide.
Underlying Events:
The alleged defamation occurred when United ...
Zalma’s Insurance Fraud Letter
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ZIFL Volume 29, Issue 24
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Zalma’s Insurance Fraud Letter (ZIFL) continues its 29th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma. It is provided FREE to anyone who visits the site at http://zalma.com/zalmas-insurance-fraud-letter-2/
Zalma’s Insurance Fraud Letter
Merry Christmas & Happy Hannukah
Read the following Articles from the December 15, 2025 issue:
Read the full 19 page issue of ZIFL at ...
