In a latest determination that explains what policyholders should show to prevail on a statutory dangerous religion declare in Colorado, the Tenth Circuit Courtroom of Appeals affirmed abstract judgment in favor of Mid-Century Insurance coverage Firm in El Dueno, LLC v. Mid-Century Insurance coverage Firm. 1 The ruling is a transparent reminder that below Colorado legislation, an insurer’s reliance on a professional, impartial skilled, absent opposite proof, can function an inexpensive foundation for a declare determination and defeat allegations of dangerous religion.
The dispute started when El Dueno, the proprietor of a business property in Greeley, Colorado, submitted a hail injury declare following a July 2018 storm. Initially, Mid-Century’s adjuster, Maggie Fields, inspected the property and located indicators of hail injury, main the insurer to challenge a fee. Nevertheless, El Dueno later submitted a revised estimate exceeding $340,000. This was considerably greater than the preliminary scope of harm by Mid-Century.
Mid-Century reassigned the file to a large-loss adjuster, who in flip retained Rimkus Engineering to evaluate the roof. Rimkus engineer William Templeton performed an inspection and concluded that the roof injury was not attributable to hail however somewhat on account of put on, tear, and different non-covered causes. Mid-Century relied on this report in denying additional fee on the roof portion of the declare, whereas nonetheless issuing an extra fee for hail injury to HVAC models as recognized by a separate vendor.
El Dueno filed swimsuit alleging dangerous religion below Colorado Revised Statutes Sections 10-3-1115 and 10-3-1116. Mid-Century moved for abstract judgment. The federal district courtroom granted the movement, holding that the insurer’s reliance on a professional engineering report, unrebutted by any proof of industry-standard violations, was affordable as a matter of legislation. On enchantment, the Tenth Circuit agreed.
The appellate courtroom emphasised that below Colorado legislation, an insurer’s conduct have to be evaluated primarily based on whether or not it had an inexpensive foundation for its declare determination and whether or not it violated any relevant {industry} requirements. Importantly, the courtroom famous that El Dueno didn’t present a competing engineering opinion on the time of Mid-Century’s protection determination. It by no means took the deposition of Mr. Templeton, the insurer’s roofing skilled, and did not submit any skilled testimony that Mid-Century’s claims dealing with fell under {industry} requirements. Whereas El Dueno finally, throughout litigation, retained former adjuster Kerry Freeman as an skilled, Freeman was not an engineer, didn’t deal with whether or not Templeton’s report violated any engineering requirements, and supplied no opinion on whether or not Mid-Century acted in dangerous religion.
In affirming abstract judgment, the Tenth Circuit reiterated that mere disagreement with an insurer’s conclusions or skilled opinions is inadequate to show dangerous religion. With out proof that Mid-Century ignored related information, failed to research totally, or acted opposite to established norms, the courtroom discovered no triable challenge of fabric truth. The courtroom underscored that policyholders bear the burden of articulating and proving how an insurer’s conduct deviated from acceptable requirements, particularly when counting on the findings of impartial professionals.
The ruling sends a transparent sign to policyholders and their counsel that difficult an insurer’s denial primarily based on a third-party skilled report requires greater than merely disputing the result. To succeed on a foul religion declare in Colorado, claimants have to be ready to supply well timed, substantive proof, which is ideally within the type of skilled testimony demonstrating that the insurer’s reliance on its skilled was not solely incorrect, however unreasonable below relevant requirements. With out such a exhibiting, courts are more likely to proceed rejecting dangerous religion allegations on the abstract judgment stage.
Thought For The Day
“Get your information first, then you possibly can distort them as you please.”
—Mark Twain
1 El Dueno v. Mid-Century Ins. Co., No. 24-1110, 2025 WL 1540329 (10th Cir. Could 30, 2025) (The appellate briefs by El Dueno and Mid-Century submitted to the Tenth Circuit are additionally hooked up)
