Colony Insurance Company v. Charles Peterson

UNPUBLISHED

UNITED STATES COURT OF APPEALS
FOR THE FOURTH CIRCUIT

No. 13-1033

COLONY INSURANCE COMPANY,

Plaintiff - Appellant,

v.

CHARLES A. PETERSON; EVERGREEN COMPOSITE TECHNOLOGY, LLC;
RANDOLPH BANK AND TRUST COMPANY,

Defendants - Appellees,

v.

EDWARD L. CLAYTON, JR.; HPB INSURANCE GROUP INCORPORATED,

Third Party Defendants - Appellees.

Appeal from the United States District Court for the Middle
District of North Carolina, at Greensboro. William L. Osteen,
Jr., Chief District Judge. (1:10-cv-00581-WO-LPA)

Argued: May 15, 2014 Decided: August 25, 2014

Before KING, WYNN, and FLOYD, Circuit Judges.

Affirmed by unpublished opinion. Judge Wynn wrote the majority
opinion, in which Judge King joined. Judge Floyd wrote a
dissenting opinion.

ARGUED: Reid C. Adams, Jr., WOMBLE CARLYLE SANDRIDGE & RICE,
LLP, Winston-Salem, North Carolina, for Appellant. Patrick
Michael Kane, SMITH MOORE LEATHERWOOD LLP, Greensboro, North
Carolina; James W. Bryan, NEXSEN PRUET, PLLC, Greensboro, North
Carolina; Stephen G. Teague, TEAGUE, ROTENSTREICH, STANALAND,
FOX & HOLT, PLLC, Greensboro, North Carolina, for Appellees. ON
BRIEF: James R. Morgan, Jr., Jonathan R. Reich, WOMBLE CARLYLE
SANDRIDGE & RICE, LLP, Winston-Salem, North Carolina, for
Appellant. M. Jay Devaney, NEXSEN PRUET, PLLC, Greensboro,
North Carolina, for Appellee Randolph Bank and Trust Company.
Manning A. Connors, SMITH MOORE LEATHERWOOD LLP, Greensboro,
North Carolina, for Appellees Evergreen Composite Technology,
LLC and Charles A. Peterson. Lyn K. Broom, TEAGUE,
ROTENSTREICH, STANALAND, FOX & HOLT, PLLC, Greensboro, North
Carolina, for Appellees Edward L. Clayton, Jr. and HPB Insurance
Group, Incorporated.

Unpublished opinions are not binding precedent in this circuit.

2
WYNN, Circuit Judge:

Plaintiff Colony Insurance Company (“Colony”) appeals from

a final judgment entered upon a jury verdict awarding $2,369,000

to Defendants Charles A. Peterson (“Peterson”), Evergreen

Composite Technology, LLC (“Evergreen”), and Randolph Bank and

Trust Company (“Randolph Bank”) (collectively “Defendants”) on

their insurance claim. The jury found that Colony waived its

right to rescind a commercial property policy issued to

Defendants and was estopped from denying coverage for loss after

a fire damaged a building covered by the policy. On appeal,

Colony contends that the district court erred in denying its

motion for judgment as a matter of law. For the reasons below,

we affirm.

I.

In reviewing the denial of a motion for judgment as a

matter of law, we must view and recite the evidence in the light

most favorable to the non-movants. Ocheltree v. Scollon Prods.,

Inc., 335 F.3d 325, 331 (4th Cir. 2003).

Effective March 16, 2010, Colony, a Virginia insurance

company, issued a commercial property policy insuring a 95,000-

square-foot vacant building located at 501 Hamilton Road,

Montezuma, Georgia (“the 501 building”). The policy named

Evergreen, a Georgia corporation headquartered in North

3
Carolina, and its owner, Peterson, a North Carolina resident, as

the insured. The policy also listed Randolph Bank, a community

bank in Randolph County, North Carolina, as a mortgage holder

and loss payee under the policy. The policy provided coverage

limits of up to $1 million for the 501 building and $3.5 million

for the business-related personal property on the site.

Peterson had obtained loans from Randolph Bank to launch

Evergreen, which manufactured composite wood products used in

residential decking, fencing, and railings. As collateral for

its loans, Randolph Bank held a deed of trust on the 501

property and perfected a security interest in the equipment

located there. By late 2009, Evergreen had suspended its

operations and was in default on its loans from Randolph Bank.

In February 2010, a fire, caused by arson, damaged a nearby

building also owned by Evergreen (“the 261 building”).

Thereafter, upon learning that the insurance on both buildings

had lapsed, Randolph Bank engaged third-party defendant Edward

Clayton (“Clayton”), an insurance agent with HPB Insurance

Group, to assist in obtaining insurance coverage for the 501

building. The policy issued by Colony insured the 501 building

against, among other things, risk of loss caused by fire. To

mitigate this risk, the policy contained an endorsement

requiring certain fire protective safeguards.

4
 Specifically, the fire protective safeguards endorsement

required Evergreen and Peterson to maintain an automatic

sprinkler system, fire extinguishers, and functioning utilities

at the 501 building. The fire protective safeguards endorsement

stated that Colony would “not pay for loss or damage caused by

or resulting from fire if, prior to the fire,” the named insured

“[f]ailed to maintain any protective safeguard . . . in complete

working order” or “[k]new of any suspension, malfunction or

impairment in any protective safeguard” and failed to notify

Colony. J.A. 114.

On the same day that Colony issued the policy, it retained

an independent vendor, Safety Resources, to inspect the 501

building. Colony charged Defendants a $250 non-refundable

inspection fee, which was separate from the $18,000 policy

premium. According to the policy, the inspection “relate[d]

only to insurability and the premiums to be charged.” J.A. 75.

The inspection provided Colony “the chance to independently look

at the risk that it [was] insuring.” J.A. 454. By paying the

$250 fee, Defendants expected Colony “to notify [them] if

problems were identified by the inspection” so that they could

remedy them. J.A. 1376.

Safety Resources inspected the 501 building on April 13,

2010 and prepared a written report, which noted that the

utilities for the 501 building were off and that there was no

5
heat. This contradicted information provided to Colony during

the insurance application process. Specifically, Clayton had

submitted a “Specialty Property Vacant Supplement” form that

indicated that the power and heat would remain on at the 501

building during vacancy. Colony received the inspection report

on April 21, 2010, but the underwriter at Colony did not review

the report until June 18, 2010. Nevertheless, Colony issued a

mortgagee endorsement on April 22, 2010, and a loss payee

endorsement on May 6, 2010, both with retroactive effect as of

March 16, 2010, and naming Randolph Bank as a mortgagee and loss

payee on the policy.

On May 18, 2010, a fire damaged the 501 building and its

contents. Firefighters discovered that the two valves

controlling the sprinkler system had been turned off. Evidence

at the scene indicated that the valves had likely been “tampered

with and vandalized.” J.A. 761.

Colony subsequently denied coverage for the loss and sought

a declaratory judgment regarding its indemnity obligations under

the policy. Colony argued that material misrepresentations on

the insurance application rendered the policy void and that

breach of the fire protective safeguards endorsement precluded

coverage. Defendants counterclaimed for breach of contract.

Evergreen and Peterson also asserted a cross-claim against

6
Randolph Bank and filed a third-party complaint against Clayton

and HPB Insurance Group.

All parties sought summary judgment, which the district

court denied. Regarding Colony’s claims, the district court

held that genuine issues existed “as to whether the doctrines of

waiver/estoppel prevent Colony from contesting coverage under

the [p]olicy.” J.A. 355. Accordingly, the case proceeded to

trial.

At trial, Defendants introduced deposition testimony by

Roseanne Gauthier, the senior underwriter at Colony responsible

for determining whether the conditions of insurance for the 501

building were met. In her testimony, Gauthier acknowledged that

she received the inspection report from Safety Resources on

April 21, 2010, but that she “just did not get to the inspection

by the time the loss occurred.” J.A. 1051. Gauthier stated

that had she reviewed the inspection report when she received

it, she would have “immediately” taken steps to cancel the

policy. J.A. 1053.

Defendants also presented evidence of other Colony

underwriting files in which discrepancies appeared between some

of the representations made on insurance applications and the

conditions revealed by Colony’s inspections. Regarding those

files, Colony did not seek to rescind, and policyholders

remedied the conditions or paid higher premiums.

7
 At the conclusion of the evidence, Colony moved for

judgment as a matter of law. The district court took the motion

under advisement and allowed the case to go to the jury. The

jury returned a verdict in favor of Defendants, finding that

although a material misrepresentation appeared on the insurance

application and that a condition of the fire protective

safeguards endorsement requiring functioning utilities to remain

on had been breached, Colony had nonetheless waived its right to

rescind the policy and was estopped from denying coverage.

Further, the jury determined that Randolph Bank was not

responsible for the misrepresentation on the application. The

jury awarded Defendants $2,369,000 on their counterclaim for

coverage under the policy, and the court awarded pre-judgment

interest.

On December 3, 2012, the district court denied Colony’s

motion for judgment as a matter of law and subsequently entered

final judgment in favor of Defendants. This appeal followed.

II.

Colony argues that the district court erred in denying its

motion for judgment as a matter of law. “We review de novo the

grant or denial of a motion for judgment as a matter of law[,]”

Anderson v. Russell, 247 F.3d 125, 129 (4th Cir. 2001), to

determine whether “a reasonable jury would not have a legally

8
sufficient evidentiary basis to find for the [non-moving]

party[.]” Fed. R. Civ. P. 50(a)(1). 1 “If, viewing the facts in

the light most favorable to the non-moving party, there is

sufficient evidence for a reasonable jury to have found in [the

non-moving party’s] favor, we are constrained to affirm the jury

verdict.” Lack v. Wal-Mart Stores, Inc., 240 F.3d 255, 259 (4th

Cir. 2001).

We note that North Carolina law governs our analysis of

this diversity case. See Erie R.R. Co. v. Tompkins, 304 U.S.

64, 78 (1938). Thus, we first look to see if the Supreme Court

of North Carolina has spoken on this issue; if not, we must

predict how that court would rule on it. Twin City Fire Ins.

Co. v. Ben Arnold-Sunbelt Beverage Co. of S.C., 433 F.3d 365,

369 (4th Cir. 2005). 2 In forming that prediction, we may

consider opinions from the North Carolina Court of Appeals,

teachings of treatises, and practices of other states. Id.

1
Colony did not pursue any post-verdict motions under Rule
50(b) or Rule 59. As a result, Colony may not challenge the
sufficiency of the evidence supporting the jury’s verdict.
Belk, Inc. v. Meyer Corp., 679 F.3d 146, 154-55 (4th Cir. 2012).
2
Unlike other states within our circuit, there is no
mechanism for certifying questions to the Supreme Court of North
Carolina. See SunTrust Bank, N.A. v. Macky, 669 F.3d 177, 182
n.* (4th Cir. 2012).

9
 A.

Colony contends that the district court should have granted

judgment as a matter of law because the jury determined that

Peterson or Evergreen breached the fire protective safeguards

endorsement. Colony asserts that maintaining functioning

utilities, as required by the fire protective safeguards

endorsement, was a condition of coverage immune to waiver, and

that the district court therefore erred in denying judgment as a

matter of law.

Under North Carolina law, an insurer may waive “a provision

or condition in an insurance policy which is for its own

benefit.” Brandon v. Nationwide Mut. Fire Ins. Co., 271 S.E.2d

380, 383 (N.C. 1980). North Carolina courts have long held that

the breach of any condition in [an insurance] policy,
as against an increase of risk or by keeping of
certain hazardous goods . . . or, indeed, the
violation of any of the conditions of the policy, may
be waived by the insurer; and a waiver may be implied
from the acts and conduct of the insurer after
knowledge that such conditions have been broken.

Blue Bird Cab Co. v. Am. Fid. & Cas. Co., 15 S.E.2d 295, 301

(N.C. 1941) (alteration in original) (quotation marks omitted).

Similarly, an insurer may be estopped from denying coverage

under an insurance policy. Estoppel arises if the insurer’s

“actions or silence when [it] ought to have spoken,

intentionally or through culpable negligence, induce[s] [the

insured] to believe . . . coverage exist[s]” and the insured

10
relies upon such belief to his or her detriment. United States

Fid. & Guar. Co. v. Country Club of Johnston Cnty., Inc., 458

S.E.2d 734, 740 (N.C. App. 1995).

The Supreme Court of North Carolina has not spoken directly

on the precise issue in this matter, but the decisions of that

state’s second highest court, the North Carolina Court of

Appeals, provide us with guidance. See Twin City Fire Ins. Co.,

433 F.3d at 369. In that regard, we find Durham v. Cox

particularly illuminating. 310 S.E.2d 371 (N.C. App. 1984).

In Durham, the North Carolina Court of Appeals determined

that material issues of fact existed as to whether the defendant

insurance company waived its right to deny coverage under a

homeowner’s policy for loss following a fire. 310 S.E.2d at

376-77. The policy stated that “[t]his coverage excludes

structures used in whole or part for business purposes.” Id. at

373. In breach of this provision, the insured plaintiff used

the building, a garage, in connection with his furniture

upholstery business, but asserted that such use was known to the

insurer, resulting in waiver. Id. at 373-74. The insurer

argued that the policy exclusion was a “matter of coverage” that

could not be expanded by waiver or estoppel as a matter of law.

Id. at 374.

On appeal from summary judgment in favor of the insurer,

the North Carolina Court of Appeals reasoned that waiver and

11
estoppel “properly apply” to the business use exclusion “since

the property itself, an appurtenant structure, and the risk,

loss due to fire, [were] already within the coverage of the

policy.” Durham, 310 S.E.2d at 376. Thus, the risk of loss to

the covered property due to fire was an “accepted risk” subject

to forfeiture, rather than an “excepted risk” immune from

waiver:

The distinction between an accepted risk to be
defeated by conditions set forth in the policy and an
excepted risk is clear, and it is logical to hold that
it takes a new contract to cover an excepted risk. By
way of illustration: A. has a plantation on which
there are 10 buildings. All are covered by a policy
of insurance, but the policy provides that, in case A.
shall store certain inflammable materials in any of
the houses, then the insurance on that building shall
instantly cease. That is an assumed risk, which will
be void upon a condition subsequent. B. has a
plantation upon which there are 10 buildings; 9 of
them are covered by a policy of insurance. Building
No. 10 is excluded from the policy. It is entirely
logical to hold that it takes a new contract to
include insurance on B.’s No. 10, but not on A.’s No.
10.

Id. (citation omitted); accord United States Fid. & Guar. Co.,

458 S.E.2d at 739.

Applying this distinction between accepted and excepted

risk, the North Carolina Court of Appeals determined that using

the garage for business purposes did not create an entirely new

risk. Rather, such use “enhance[d] a risk already assumed by

the insurer”—namely, the risk of fire destroying a covered

structure. Durham, 310 S.E.2d at 376. Moreover, observed the

12
court, “conditions regarding permissible or prohibited uses to

which the property may be put are clearly inserted in the policy

for the benefit of the insurer and therefore may properly be

waived by it or its authorized agent.” Id. at 376-77.

Accordingly, the court held that the insurer could waive the

policy provision excluding coverage for business use. Id. at

377.

Turning to the facts at issue here, the relevant part of

the fire protective safeguards endorsement states:

A. The following is added to the COMMERCIAL PROPERTY
CONDITIONS:
PROTECTIVE SAFEGUARDS
1. As a condition of this insurance, you are
required to maintain the protective devices or
services listed in the [s]chedule above.

J.A. 113. The protective safeguards schedule specifies that

“ALL UTILITIES MUST REMAIN ON AND FUNCTIONING.” J.A. 113.

Further, the fire protective safeguards endorsement adds the

following language to the exclusions section of the policy:

We will not pay for loss or damage caused by or
resulting from fire if, prior to the fire, you:

1. Knew of any suspension, malfunction or
impairment in any protective safeguard listed in the
[s]chedule above and failed to notify [Colony] of that
fact;

2. Failed to maintain any protective safeguard
listed in the [s]chedule above in complete working
order[.]

J.A. 114.

13
 There is no dispute that the policy issued by Colony

expressly insured the 501 building against the risk of loss due

to fire. As such, the loss that occurred was contemplated by

the parties and encompassed by the policy. See Durham, 310

S.E.2d at 376 (broadly viewing the risk of loss to property by

fire as covered, notwithstanding a business use exclusion). By

requiring Defendants to maintain functioning utilities, the fire

protective safeguards endorsement limited Colony’s exposure to

risk it had already “accepted”—namely, risk of loss to the 501

building posed by fire. Id.

Consequently, we agree with the district court that

“applying the doctrines of waiver/estoppel to the conditions at

issue in this case would not expand the [p]olicy to cover risks

not currently contemplated by that agreement–i.e., that fire may

destroy the subject property.” J.A. 323. Accordingly, the

district court did not err by submitting the issues of waiver

and estoppel to the jury. And Colony’s arguments to the

contrary are unavailing.

Colony also argues that, under United Capitol Ins. Co. v.

Kapiloff, waiver did not apply as a matter of law because

insufficient time had passed between Colony’s receipt of the

inspection report and the fire. Again, we disagree.

First and foremost, Kapiloff, on which Colony’s argument

heavily relies, required us to apply Maryland, not North

14
Carolina, law. 155 F.3d 488 (4th Cir. 1998). “No one doubts

that a federal court called upon to adjudicate a state law claim

in the diversity jurisdiction must apply the relevant state law

in determining the substantive rights and duties of the parties

. . . .” Auer v. Kawasaki Motors Corp., U.S.A., 830 F.2d 535,

537 (4th Cir. 1987) (en banc). Here, that relevant state law is

North Carolina’s. 3

Turning, then, to North Carolina law, “[w]aiver by an

insurer of a forfeiture provision in an insurance policy

requires (1) ‘knowledge on the part of the insurer of the

pertinent facts,’. . . , and (2)‘conduct thereafter inconsistent

with an intention to enforce the condition’. . . .” Mabry v.

Nationwide Mut. Fire Ins. Co., 422 S.E.2d 332, 334 (N.C. App.

1992) (quoting Gouldin v. Inter-Ocean Ins. Co., 102 S.E.2d 846,

849 (N.C. 1958)). “When the evidence is sufficient to justify,

but not require, a finding of waiver on the part of the insurer,

then the issue of waiver is one to be determined by the jury.”

Id. (citing Gouldin, 102 S.E.2d at 851 (because the evidence of

3
The dissenting opinion, too, focuses on Kapiloff.
Undoubtedly, that opinion includes some broad statements and few
citations, as the dissent notes. Those stylistic choices do
not, however, change the fact that “[t]here is no federal
general common law[,]” Erie, 304 U.S. at 78, and that North
Carolina law governs this dispute.

15
waiver was “susceptible of diverse inferences, it is improper

for the presiding judge to give the jury a peremptory

instruction”); and Brandon, 271 S.E.2d at 385 (noting that “the

evidence in this case is sufficient to permit, but not compel, a

jury to find that defendant, by words or conduct, waived the

requirement of proofs of loss [and] [t]he defendant’s evidence

does not, as a matter of law, compel a contrary conclusion” and

thus “hold[ing] that the issue of waiver should have been

submitted to the jury”)).

Here, sufficient evidence existed for a reasonable jury to

determine that Colony had “‘knowledge . . . of the pertinent

facts.’” Mabry, 422 S.E.2d at 334 (quoting Gouldin, 102 S.E.2d

at 849). The inspection paid for by Defendants and conducted by

Colony’s independent vendor revealed that the utilities were off

at the 501 building, in contravention of the fire protective

safeguards endorsement. Colony received this information from

Safety Resources on April 21, 2010, approximately four weeks

before the May 18, 2010 fire. And in North Carolina, “an

insurance company is presumed to be cognizant of data in the

official files of the company[.]” Gouldin, 102 S.E.2d at 849.

Further, sufficient evidence existed for a reasonable jury

to determine that Colony engaged in “‘conduct thereafter

inconsistent with an intention to enforce the condition.’”

Mabry, 422 S.E.2d at 334 (quoting Gouldin, 102 S.E.2d at 849).

16
Although Colony knew for weeks that the utilities were off, it

neither informed Defendants of the violation nor took steps to

cancel the policy. See Faircloth v. Ohio Farmers Ins. Co., 117

S.E.2d 404, 408-09 (N.C. 1960) (“Equitably, if [the insurer] did

not desire to carry the risk longer, because of the [breach of

the policy conditions], it ought, in fair dealing, to have

returned the unearned premium, and rescinded the insurance

contract, so that plaintiff could have known he no longer was

protected thereby and would have been afforded an opportunity to

obtain a new policy from another agent.”). Instead, Colony

confirmed coverage by issuing a mortgagee endorsement on April

22, 2010, and a loss payee endorsement on May 6, 2010, naming

Randolph Bank as a mortgagee and loss payee on the policy. 4

Moreover, testimony by Colony’s underwriter, Roseanne

Gauthier, contradicts Colony’s assertion that the time period

between receipt of the inspection report and the fire was

inadequate to permit a finding of waiver. Gauthier testified

4
The dissent cites Nelson v. Hartford Underwriters Ins.
Co., 630 S.E.2d 221 (N.C. App. 2006), for the notion that “only
a few weeks” provides an insurer with little time to affirm or
deny coverage. Id. at 233. Notably, however, at issue in
Nelson was whether the insurer’s failure to make a coverage
determination within nineteen days of receiving a re-
investigation report of a previously-denied claim constituted an
unfair and deceptive trade practice. Id. The facts and issues
in play in Nelson have little in common with, and shed little
light on, those before us here.

17
that if she had reviewed the inspection report on April 21,

2010, when she received it, she would have “immediately” taken

steps to cancel the policy. J.A. 1053.

North Carolina’s highest court has underscored that

forfeiture “is not imposed as a penalty for making a false

statement, which the insurer may invoke at his pleasure at any

time, regardless of its own antecedent conduct. It is based on

the principle that the insurer has been misled to its damage.”

Hicks v. Home Sec. Life Ins. Co., 39 S.E.2d 914, 916 (N.C.

1946). Crucially, however, an insurer “is not misled when it

knows the facts; and when that knowledge exists or is acquired,

it becomes the right and the duty of the insurer” to act. Id.

at 916-17. And a failure to do so “will operate as a waiver.”

Id. 5

Based on the proffered evidence and the pertinent North

Carolina law, a reasonable jury could determine that Colony was

not misled because it knew the facts, and that Colony had the

right and the duty to act but failed to do so. Accordingly, we

must agree with the district court that we “cannot say that the

5
We concern ourselves neither with homogenizing state laws
for fear that insurance companies will otherwise need to
“operate drastically differently across state lines” nor with
“the day-to-day realities of the business.” Post at 32.
Instead, we stick to our business, which is using North Carolina
substantive law to decide the issues presented by this appeal.

18
27 days between the time Colony received the inspection report

and the fire was insufficient, as a matter of law, for Colony to

take action on the inspection as provided—especially in light of

testimony that had the inspection been reviewed, immediate

action would have occurred.” J.A. 323. The district court

therefore properly submitted the waiver issue to the jury and

did not err in instructing the jury that it could find waiver.

And “we are constrained to affirm the jury verdict.” Lack, 240

F.3d at 259.

In sum, we conclude, based on North Carolina law, that the

fire protective safeguards endorsement set forth in Colony’s

policy is a provision of forfeiture subject to waiver and

estoppel, that the issue was properly submitted to the jury, and

that there existed “sufficient evidence for a reasonable jury to

have found in [Defendants’] favor, [such that] we are

constrained to affirm the jury verdict.” Lack, 240 F.3d at 259.

B.

Next, Colony contends that it is entitled to judgment as a

matter of law because the jury determined that there was a

material misrepresentation on the insurance application

regarding whether heat and power would be on at the 501

building. Although Colony correctly notes that a material

misrepresentation on an insurance application may forfeit

19
coverage, see Gore v. Assurance Co. of Am., 704 S.E.2d 6, 12

(N.C. App. 2010), waiver and estoppel may overcome a material

misrepresentation, and such a question is for a jury to resolve.

See, e.g., Cullen v. Valley Forge Life Ins. Co., 589 S.E.2d 423,

428 (N.C. App. 2003). Accordingly, the district court did not

err in allowing the jury to decide whether Colony had waived its

right to rescind the policy, notwithstanding the

misrepresentation on the application. 6

III.

We have reviewed and summarily reject all of Colony’s

arguments. The judgment of the district court is therefore

AFFIRMED.

6
Not least given our resolution of the issues above, we
reject Colony’s arguments as regards Randolph Bank, including
Randolph Bank’s status as an innocent mortgagee.

20
FLOYD, Circuit Judge, dissenting:

I agree with the majority that prolonged inaction by an

insurer can amount to a waiver of rights under an insurance

policy if the insurer has received notice of a breach of a

requirement and takes no steps to notify the insured of the

breach within a reasonable time. However, in this case, and as

a matter of law, Colony could not be said to have waived the

endorsement provision of the insurance policy on account of its

inaction during the twenty-seven days between its receipt of the

inspection report on April 21, 2010, and the burning of the

501 building on May 18, 2010. Accordingly, I think that the

district court erred by submitting to the jury Issues 4 and 5

regarding waiver and estoppel in the first instance, and I

therefore would reverse the district court’s denial of Colony’s

Rule 50(a) motion and respectfully dissent to the majority’s

contrary conclusion. I would also remand this case for trial on

the sole issue of whether Randolph Bank had knowledge that the

utilities were off and failed to notify Colony pursuant to the

policy.

I.

It has long been the law in North Carolina that “[u]pon

being informed of [a breach], [an insurer] should within a

reasonable time . . . notif[y] the insured of its determination

21
to cancel the policy[.]” Horton v. Home Ins. Co., 29 S.E. 944,

946 (N.C. 1898) (emphasis added); see also Dailey v. Integon

Gen. Ins. Corp., 331 S.E.2d 148, 154–55 (N.C. Ct. App. 1985)

(insurer’s responsiveness assessed for reasonableness). It is

also well established that “time . . . may be so short or so

long that the court will declare it to be reasonable or

unreasonable as a matter of law.” Claus-Shear Co. v. E. Lee

Hardware House, 53 S.E. 433, 434 (N.C. 1906). Although Claus-

Shear Co. was a contractual dispute pertaining to the delivery

of goods, the principle regarding temporal reasonableness as a

matter of law has been applied widely by North Carolina courts.

See, e.g., Harris v. Lamar Co., 563 S.E.2d 642, 2002 WL 1013571,

at *4 (N.C. Ct. App. May 21, 2002) (unpublished table decision)

(opinion by Wynn, J.) (quoting the above text from Claus-Shear

Co. in a property case presenting the question of whether a

billboard should be considered “abandoned”). Thus, I see no

reason to limit its import in this case.

The North Carolina Supreme Court has not spoken regarding

what time period is reasonable for an insurer to receive an

inspection report and to process that report and notify the

insured of any deficient conditions or breaches. Therefore, we

must look to secondary indicia to try to predict how the North

Carolina Supreme Court would rule in such a case, including,

inter alia, opinions from the North Carolina Court of Appeals

22
and the practices of other states. Twin City Fire Ins. Co. v.

Ben Arnold-Sunbelt Beverage Co. of S.C., 433 F.3d 365, 369 (4th

Cir. 2005). As between these two secondary sources, North

Carolina’s “intermediate appellate court decisions constitute

the next best indicia of what state law is, although such

decisions may be disregarded if the federal court is convinced

by other persuasive data that the highest court of the state

would decide otherwise.” Liberty Mut. Ins. Co. v. Triangle

Indus., Inc., 957 F.2d 1153, 1156 (4th Cir. 1992) (citation

omitted) (internal quotation marks omitted). For the reasons

that follow, both North Carolina appellate decisions and the

practices of other states, together and separately, yield the

conclusion that, as a matter of law, Colony could not have

waived the endorsement provision of the insurance policy.

A. North Carolina Law

As the majority notes, waiver requires “(1) knowledge on

the part of the insurer of the pertinent facts” and “(2) conduct

thereafter inconsistent with an intention to enforce the

condition which leads the insured to believe that he is still

protected by the policy.” Mabry v. Nationwide Mut. Fire Ins.

Co., 422 S.E.2d 332, 334 (N.C. Ct. App. 1992) (citation omitted)

(internal quotation marks omitted). As to the first criterion,

the majority claims that Colony had knowledge of the utilities

23
being off at the 501 building simply by virtue of Colony’s

receipt of the inspection report on April 21, 2010. See ante

at 17 (citing Gouldin v. Inter-Ocean Ins. Co., 102 S.E.2d 846,

849 (N.C. 1958) (“[A]n insurance company is presumed to be

cognizant of data in the official files of the company, received

in formal dealing with the insured.” 1)). But surely, the

majority does not mean to extract from Gouldin the notion that

an insurer has no time whatsoever after receiving an inspection

report to process that report and run it up the corporate

flagpole to be reviewed by the appropriate personnel and

decision-makers. Indeed, North Carolina’s appellate courts

appear to recognize that some time period is necessary between

receipt of information and action on that information.

For example, in Nelson v. Hartford Underwriters Insurance

Co., an insurer received an inspection report regarding the

condition of the insured property on July 17, 2002, but on

August 5, 2002—nineteen days later and “before [the insurer] had

made its determination of whether the . . . claim was covered by

the policy”—“plaintiffs’ counsel sent [to the insurer] a letter

directing it to have no further contact with plaintiffs[.]” 630

1
I note that Colony did not receive the inspection report
from Peterson and Evergreen (the insured), but rather from an
independent third party (Safety Resources). Nonetheless, I
assume, argudendo, that this difference is immaterial here.

24
S.E.2d 221, 233 (N.C. Ct. App. 2006). Plaintiffs then sued the

insurer for failing to affirm or deny coverage “within a

reasonable time.” Id. In holding that the insurer did not act

unreasonably for not having responded to plaintiffs on or before

August 5, the court noted that “[t]he report . . . was provided

to [the insurer] only a few weeks before [the insurer] was

warned not to have any contact with plaintiffs, providing little

time for [the insurer] to determine whether it should cover a

claim it had previously denied.” Id. Although nineteen days is

fewer than twenty-seven days, the court’s use of “only a few

weeks” (emphasis added), and the description of nineteen days as

“little time,” certainly indicates that the insurer would have

been allowed additional time to respond. 2 See also Meadlock v.

Am. Family Life Assurance Co., 729 S.E.2d 127, 2012 WL 2891079,

at *7 (N.C. Ct. App. July 17, 2012) (unpublished table decision)

(in light of a lack of evidence or authority to the contrary,

2
The majority attempts to discount Nelson by splitting the
finest of hairs based on the facts, see ante at 18 n.4, but
provides no case-to-case analyses of its own for its cited
cases. Rather, the majority opinion is long on statements of
law and instances in which waiver was found, see id. at 16, but
devoid of application of that law and the facts of the cited
cases to the facts here. Absent guidance from the North
Carolina Supreme Court as to what time period is “reasonable”
for an insurer to respond under these circumstances, and absent
a case with more similar facts and arriving at an alternative
outcome, Nelson actually provides an excellent analogy from
which much can be gleaned. Any other characterization of Nelson
is, quite simply, disingenuous.

25
insurer’s delay of four months was not unreasonable); cf. N.C.

Gen. Stat. § 20-279.21(b)(3)(a.) (“Suit may not be instituted

against the insurer in less than 60 days from the posting of the

first notice of the injury or accident to the insurer[.]”).

As to the second waiver criterion, the majority asserts

that Colony’s inaction during the twenty-seven days after

receiving the inspection report provides the requisite evidence

of conduct that is “inconsistent with an intention to enforce

the condition,” Mabry, 422 S.E.2d at 334. But this argument is

built upon the false premise that Colony had “knowledge” of the

condition in the first instance. Neither the majority nor

Peterson and Evergreen dispute the accuracy or execution of

Colony’s internal review procedure upon receipt of an inspection

report. Specifically, Colony describes, at pages 18–19 of its

brief, its internal review procedure as follows:

The initial review [by an assistant underwriter] is
simply to determine if the inspector has made any
recommendations, and to direct the underwriter’s
attention to those recommendations. It [is] not the
underwriting assistant’s responsibility to compare the
inspection results against the conditions of coverage,
or to confirm that all conditions of coverage had been
met. . . . [T]he underwriting assistant . . . reviewed
the ‘recommendations’ portion of the Inspection report
on April 21, 2010, and then passed them on to the
underwriter . . . . The ‘Recommendations Section’ of
the report . . . said nothing about the utilities in
the 501 building.

(Paragraph break omitted.)

26
 In view of the above-described (and uncontested) practice

at Colony, the majority’s argument that waiver must be found

because Colony’s underwriter testified that she would have

“immediately” taken steps to cancel the policy had she reviewed

the pertinent part of the inspection report is a red herring.

In essence, the relevant portion of the inspection report had

not been reviewed, and thus, Colony cannot be imputed with

knowledge of the information contained in the “recommendations”

section of the report until the appropriate personnel—Colony’s

underwriter—had reviewed that section. Moreover, neither the

majority nor Peterson and Evergreen argue that the internal

review procedures at Colony are unreasonable and/or out of the

ordinary for the insurance business, and to hold that knowledge

was imputed on April 21, 2010, simply because Colony’s assistant

underwriter reviewed the inspection report would be to impute

knowledge on any individual at Colony who handled the report.

In sum, notwithstanding the majority’s statements of pure

law, when North Carolina law—most pertinently Nelson—is applied

to the facts of this case, it is unquestionable that North

Carolina’s appellate decisions counsel in favor of providing to

insurance companies a grace period for processing documents

during which waiver cannot be found as a matter of law.

27
 B. Practices of Other States

When looking to the practices of other states, my principal

reason for positing that Colony could not have waived the

endorsement provision is this Court’s ruling in United Capitol

Insurance Co. v. Kapiloff, 155 F.3d 488 (4th Cir. 1998). In

Kapiloff, this Court held that an insurer was not considered to

have waived a condition/requirement of building occupancy that

the insured failed to meet prior to a fire destroying the

subject property, even though the insurer had knowledge of the

insured’s noncompliance via a property inspection and did not

inform the insured about the inspection results. Id. at 497.

Specifically, the building inspection took place in January and

the losses occurred in February and March of the same year. The

insurer, however, did not deny coverage to the insured until

December of that year. Id. at 491. In holding that the

occupancy requirement was not waived, this Court stated the

following:

[T]he amount of time it took for [the insurer] to
determine that the [insured’s] properties were not in
compliance with the policy would not, as a matter of
law, be long enough in any event to constitute a
waiver of any right under the policy. . . . In making
coverage decisions, an insurance company must be
entitled to a sufficient time to collect the facts,
evaluate them, and make legal determinations with
respect to those facts. These activities require not
only field work but also an internal evaluation with a
review by appropriate personnel. The one or two months
urged by the [the insured] as supporting the finding
of waiver or estoppel would hardly provide an

28
 insurance company with adequate time to make this kind
of a decision, particularly when its liability for a
wrongful decision could expose it to the risk of bad
faith.

Id. at 497.

As noted above, the fire at the 501 building occurred just

twenty-seven days after Colony received the inspection report.

That amount of time is shorter than the lower end of the at

least “one or two months” contemplated in Kapiloff, during which

an insurer is permitted to timely process information regarding

the conditions of an insured property. Nonetheless, Peterson,

Evergreen, and the majority assert that such a grace period does

not apply to Colony merely because Kapiloff is a Maryland case.

In the absence of more on-point case law from North Carolina,

however, Kapiloff provides strong and logical guidance, given

its factual similarity to this case.

Kapiloff was indeed a case arising out of the District of

Maryland and applying Maryland law based upon jurisdiction

pursuant to 28 U.S.C. § 1332(a), but the relevant portion of the

opinion is in no way Maryland-specific. In the entirety of

Part V of the Kapiloff opinion, which discusses the grace period

before waiver occurs, this Court cited to Maryland law in three

different instances. First, this Court cited A/C Electric Co.

v. Aetna Insurance Co., 247 A.2d 708, 713 (Md. Ct. App. 1968),

and McFarland v. Farm Bureau Mutual Automobile Insurance Co., 93

29
A.2d 551, 554 (Md. 1953), for the proposition that “an insurance

company may waive a condition of its policy by its conduct when

it induces an honest belief that the condition is not required,

when the insured is duly misled, and when no extension of

coverage results from the waiver.” Kapiloff, 155 F.3d at 497.

North Carolina follows a similar scheme. See Brendle v.

Shenandoah Life Ins. Co., 332 S.E.2d 515, 518 (N.C. Ct. App.

1985) (“An insurer may be found to have waived a provision or

condition in an insurance policy which is for its own benefit.

Implied waiver occurs when the insurer acts in a manner

inconsistent with an intention to enforce strict compliance of

the contested provision, and the insured is naturally led to

believe that the right has been intentionally given up.”

(citations omitted)). Second, this Court cited Prudential

Insurance Co. v. Brookman, 175 A. 838, 840 (Md. Ct. App. 1934),

for the proposition that “waiver or estoppel may occur only when

it does not create new coverage; an extension of coverage may

only be created by a new contract.” Kapiloff, 155 F.3d at 497.

Again, North Carolina follows the same rule. See Gore v.

Assurance Co. of Am., 704 S.E.2d 6, 10 (N.C. Ct. App. 2010) (“In

North Carolina, the doctrines of waiver and estoppel are not

available to broaden the coverage of a policy so as to protect

the insured against risks not included therein or expressly

30
excluded from coverage.” (citation omitted) (internal quotation

marks omitted)).

Finally—and most relevant here, as it immediately precedes

the above block quote from Kapiloff—this Court cited Monumental

Life Insurance Co. v. U.S. Fidelity & Guaranty Co., 617 A.2d

1163, 1181 (Md. Ct. Spec. App. 1993), for the proposition that

“an insurance company that denies coverage or rescinds the

policy in bad faith risks liability for that action.” Kapiloff,

155 F.3d at 497. Once again, North Carolina adheres to a nearly

identical rule. See Robinson v. N.C. Farm Bureau Ins. Co., 356

S.E.2d 392, 395 (N.C. Ct. App. 1987) (vacating summary judgment

for the defendant insurer and stating, “An insurance company is

expected to deal fairly and in good faith with its

policyholders. . . . Th[e] evidence is sufficient to establish a

tortious bad faith refusal to settle in a timely manner.”

(paragraph break omitted)); see also Thomas v. Ray, 317 S.E.2d

53, 57 (N.C. Ct. App. 1984) (“We are aware that insurance

companies have wrongfully denied coverage in some cases in which

bad faith or careless business practices might reasonably be

imputed to them.”). In sum, nothing about the relevant portion

of our decision in Kapiloff is unique to Maryland law; quite the

opposite, North Carolina has the same guidelines to resolve the

same types of issues, and thus this Court should ipso facto

reach the same result.

31
 Kapiloff, rather than announcing a Maryland-specific rule,

provides a much-needed yardstick for assessing reasonableness in

a factual scenario identical to the one at play here. It is

curious, given their rejection of Kapiloff’s at least “one or

two months” time period, that Peterson and Evergreen do not

advocate for any standard of their own regarding what amount of

time would have been reasonable for Colony to respond; on the

contrary, they simply contend that North Carolina does not have

a hard-and-fast sixty-day rule. Similarly, while not disputing

that reasonableness is the sine qua non of whether Colony waived

the endorsement provision, the majority does not put forth any

amount of time that it believes would be reasonable for Colony

to process the information and send notice to Peterson and

Evergreen, nor does the majority cite any authority for the idea

that twenty-seven days is, as a matter of law, unreasonable and

that an insurer should necessarily process information in a more

timely fashion.

By casting aside the rule from Kapiloff—and thus ignoring

one of the two criteria that we should consider when trying to

predict how the North Carolina Supreme court would rule in this

case—the majority appears to think that insurance companies

operate drastically differently across state lines, thus

ignoring the day-to-day realities of the business and the fact

that North Carolina, like Maryland, also holds insurers liable

32
for wrongfully denying coverage or rescinding a policy in bad

faith. Compare Monumental Life Ins. Co., 617 A.2d at 1181, with

Robinson, 356 S.E.2d at 395, and Thomas, 317 S.E.2d at 57.

Given that Kapiloff is directly on point and is a published

decision of this Court, and that there is not any North Carolina

authority to the contrary to even suggest that twenty-seven days

is an unreasonable time to respond (but there is authority to

suggest that twenty-seven days is not unreasonable, see Nelson,

630 S.E.2d at 233), I would follow Kapiloff’s guidance and logic

in this case. Accordingly, I do not think that Colony was

required to have notified Peterson and Evergreen that the

utilities were off at the time that the 501 building burned.

C.

Peterson and Evergreen also contend that Colony should not

be permitted to avail itself to a grace period because, at other

times, Colony acted more quickly—at times on the same day—to

contact policyholders after receiving inspection reports.

Specifically, Peterson and Evergreen included in their brief a

table showing that Colony had, at other times, responded in a

more timely fashion following receipt of an inspection report.

Among these examples is an instance from 2009 in which Colony’s

underwriter reviewed an inspection report and took action

twenty-two days after the assistant underwriter received the

33
report. Based on Peterson and Evergreen’s implication that this

time period was reasonable, Peterson and Evergreen would

apparently draw the reasonableness line somewhere between day

twenty-two and day twenty-seven. Perhaps at day twenty-four.

Or maybe day twenty-six, thus leaving Colony on the outside

looking in by just twenty-four hours.

The problem with this approach is readily evident: if we

were to use a company’s own prior response times as the

benchmark for what is reasonable, companies might begin dragging

their feet in responding to reports to establish a record of

slower response times, thus creating an environment in which

prolonged delays become the new business norm—and are even

encouraged—due to the fear of future litigation. This would

have the opposite effect of ensuring that insurance companies

provide timely notice to policyholders of defects or breaches.

II.

The majority did not reach the issue of whether Randolph

Bank can recover from Colony because it held that Colony’s

purported waiver trumps any alleged knowledge of a material

misrepresentation. But because I do not think that Colony

waived its rights, as explained above, I would reach the merits

of Colony’s defenses to Randolph Bank’s counterclaims.

34
 There are two possible ways for Randolph Bank to recover

payments/benefits under the policy: as Peterson and Evergreen’s

loss payee or as mortgagee of the 501 building. As a loss

payee, however, Randolph Bank stands in the same shoes as

Peterson and Evergreen and its rights are coterminous with those

of Peterson and Evergreen; thus any successful defense by Colony

against Peterson and Evergreen also works as against Randolph

Bank. See Wells Fargo Equip. & Fin., Inc. v. State Farm Fire &

Cas. Co., 805 F. Supp. 2d 213, 218–19 (E.D. Va. 2011) (citing

Sydincate Ins. Co. v. Bohn, 65 F. 165, 173 (8th Cir. 1894)),

aff’d, 494 F. App’x 394 (4th Cir. 2012). Because Colony has a

successful defense against Peterson and Evergreen pursuant to

Kapiloff, Randolph Bank is precluded from recovery under the

loss-payee theory.

Colony further argues that Randolph Bank cannot recover as

an innocent mortgagee of the 501 building because Randolph Bank

is responsible for, and/or had knowledge of, Peterson and

Evergreen’s noncompliance with the endorsement provision.

Colony advances two theories. First, Colony claims that

Clayton—whom Randolph Bank engaged to procure the policy—was

Randolph Bank’s agent. Colony reasons that because Clayton

filled out the insurance application containing the material

misrepresentations regarding the status of the utilities, those

misrepresentations can be imputed to Randolph Bank and the

35
policy is void as to Randolph Bank. See In re McCrary, 435

S.E.2d 359, 364 (N.C. Ct. App. 1993) (“Under [the relevant state

statute], an insurer may avoid the policy if the insured makes a

representation which is both (1) false and (2) material; the

misrepresentation need not be fraudulent.” (emphasis deleted)).

Although sound in principle, this argument by Colony fails in

light of the jury’s finding that Randolph Bank was not

responsible for the representations made in the application for

insurance. Insofar as Colony failed to file a Rule 50(b) motion

after trial, it cannot now challenge the sufficiency of the

evidence and the jury’s findings; thus, the agency theory fails.

Second, Colony argues that Randolph Bank itself had actual

knowledge of the misrepresentations in the application for

insurance that substantially increased the risk of loss but

never informed Colony of that knowledge. The jury passed on the

question of whether Randolph had actual knowledge based on its

conclusion that Colony had waived and/or was estopped from

rescinding the endorsement provision. The policy states, in

relevant part, as follows:

If we [Colony] deny your [Peterson and Evergreen]
claim because of your acts or because you have failed
to comply with the terms of this Coverage Part, the
mortgageholder [Randolph Bank] will still have the
right to receive loss payment if the mortgageholder:
. . . (3) has notified us of any change in ownership,
occupancy or substantial change in risk known to the
mortgageholder.

36
Randolph Bank and Colony have a material factual dispute

regarding communications between Peterson and representatives of

Randolph Bank as to whether Randolph Bank had knowledge that the

utilities at the 501 building were off. 3 In particular, Colony

claims that Randolph Bank was told, via telephone, that the

utilities were off at the 501 building; Randolph Bank, on the

other hand, claims that it specifically required that a letter

be sent to it confirming the state of the utilities at the 501

building and that it never received such letter. Because the

jury did not reach this issue, and because this issue is

determinative of whether Colony must pay benefits to Randolph

Bank, I would remand the case for trial on the sole issue of

whether Randolph Bank had knowledge that the utilities were off

and failed to notify Colony pursuant to the policy.

III.

For the reasons set forth above, I would reverse the

district court’s denial of Colony’s Rule 50(a) motion as to

waiver of the endorsement provision and remand the case for

trial as to whether Randolph Bank had knowledge that utilities

3
Randolph Bank does not appear to contend that the
utilities being off constitutes a “substantial change in risk”
for purposes of the policy, but argues only that it did not have
any such knowledge.

37
at the 501 building were off. Therefore, I very respectfully

dissent.

38