Travis v. American Manufacturers Mutual Insurance Co.

Case Date: 12/24/2002
Court: 5th District Appellate
Docket No: 5-02-0059 Rel

Notice

Decision filed 12/24/02. The text of this decision may be changed or corrected prior to the filing of a Petition for Rehearing or the disposition of the same.

NO. 5-02-0059

IN THE

APPELLATE COURT OF ILLINOIS

FIFTH DISTRICT


JESSIE TRAVIS, Individually and on Behalf ) Appeal from the
of All Others Similarly Situated, ) Circuit Court of
) Madison County.
          Plaintiff-Appellee, )
)
v. ) No. 01-L-290
)
AMERICAN MANUFACTURERS MUTUAL )
INSURANCE COMPANY, )
)
         Defendant-Appellant, )
)
and  )
)
CCC INFORMATION SERVICES, INC., ) Honorable
) Daniel J. Stack,
         Defendant. ) Judge, presiding.

JUSTICE WELCH delivered the opinion of the court:

Jessie Travis (plaintiff), a citizen of Madison County, purchased a policy ofautomobile insurance from American Manufacturers Mutual Insurance Company(defendant). The policy covered her 1992 Dodge Caravan. In November 1999, plaintiff wasinvolved in an automobile accident in Madison County in which her vehicle sustainedsignificant damage. She submitted a claim for her property damage to defendant, whodeclared the vehicle a total loss. Defendant offered plaintiff $4,379 as the actual cash valueof the vehicle, and plaintiff accepted that amount.

On August 24, 2001, plaintiff filed, in the circuit court of Madison County, anamended class action lawsuit against defendant and CCC Information Services, Inc. (CCC).(1)Plaintiff alleges claims of a breach of the insurance contract, statutory fraud, and commonlaw fraud. Plaintiff accuses defendant of engaging in a fraudulent scheme. Plaintiff claimsthat defendant contracted with CCC to provide defendant with biased, below-marketestimates of total-loss-vehicle values. Plaintiff claims that defendant uses these estimates,which are arrived at by using valuation reports generated by a computer software programthat systematically undervalues the actual cash value of total-loss vehicles, to defraud itsinsureds in connection with the insureds' claims for the total loss of their vehicles. Plaintiffcharges defendant with intentionally reducing its overall total-loss claims payout at theexpense of its insureds by using these biased reports, which at first blush appear independentand unbiased. According to plaintiff, defendant relies on these reports to demonstrate thepurported "reasonableness" of what it determines to be the actual cash value of the totaledvehicle so that the insureds either will not challenge the valuation amount or, althoughchallenging the valuation, will settle for an amount greater than the valuation but still lessthan the actual cash value of the vehicle.

Plaintiff further alleges that an integral part of the fraudulent scheme is a provisionof the insurance policy which requires the parties to submit to an appraisal of the loss ifrequested by either the insured or the insurer. The appraisal provision requires the insuredand the insurer to each hire, at their own expense, an appraiser and to bear equally theexpenses of an umpire selected by the two appraisers, as well as any other expenses of theappraisal. Since the amount by which the insureds' total-loss claims are underpaid is lessthan the cost of the appraisal, defendant knows that the insureds will forego the appraisalprocess and accept less than the actual cash value of the vehicle for their total-loss claims. This is precisely what plaintiff alleges she did.

Upon the filing of plaintiff's class action lawsuit, defendant filed a motion to compelan appraisal and to dismiss the lawsuit or to stay the lawsuit pending the appraisal. Bothparties briefed the motion, and oral argument was heard. On January 7, 2002, the circuitcourt of Madison County entered an order denying defendant's motion to compel anappraisal and dismiss or stay the proceedings. The order incorporates by reference thecourt's oral ruling made at the hearing on the motion and cites Lundy v. Farmers Group,Inc., 322 Ill. App. 3d 214 (2001). In its oral ruling, the trial court essentially found thatplaintiff's claims of breach of contract and fraud do not fall within the scope of the appraisalclause and that therefore plaintiff cannot be compelled to submit them to appraisal.

Defendant filed a notice of interlocutory appeal on January 9, 2002. We havejurisdiction over this appeal pursuant to Supreme Court Rule 307(a)(1) (188 Ill. 2d R.307(a)(1)).

We begin by pointing out that an appraisal clause is analogous to an arbitration clauseand is enforceable in a court of law in the same manner as an arbitration clause. Beard v.Mount Carroll Mutual Fire Insurance Co., 203 Ill. App. 3d 724, 727 (1990). Accordingly,we will use the two terms interchangeably.

We turn first to a determination of the proper standard of review. Both parties agreethat in an appeal from an interlocutory order granting or denying a motion to compelarbitration, the only issue before the reviewing court is whether there was a showingsufficient to sustain the order of the trial court granting or denying the motion (J&K CementConstruction, Inc. v. Montalbano Builders, Inc., 119 Ill. App. 3d 663, 667 (1983)). Plaintiffargues that this is an abuse-of-discretion standard, while defendant counters that where thetrial court renders its decision without an evidentiary hearing and without findings on anyfactual issues, de novo review is appropriate. We agree with defendant. See AmalgamatedTransit Union, Local 900 v. Suburban Bus Division of Regional Transportation Authority,262 Ill. App. 3d 334, 337 (1994) (where the trial court determines whether or not to compelarbitration without evidentiary hearings and without making any factual findings on anyfactual issues, the finding is made as a matter of law and is reviewable de novo). In theinstant case, the trial court made no findings of fact but took the well-pleaded allegations ofthe complaint as true. The only question before the trial court was whether the insurancecontract contained a mandatory appraisal clause that applied to the controversy at issuebetween the parties. This was a determination made as a matter of law.

A motion to compel arbitration and dismiss the lawsuit is similar to a motion todismiss pursuant to section 2-619(a)(9) of the Illinois Code of Civil Procedure, whichallows a dismissal where the claim asserted is barred by affirmative matter avoiding the legaleffect of or defeating the claim. 735 ILCS 5/2-619(a)(9) (West 2000). The phrase"affirmative matter" encompasses any defense other than a negation of the essentialallegations of the plaintiff's cause of action. Kedzie & 103rd Currency Exchange, Inc. v.Hodge, 156 Ill. 2d 112, 115 (1993). A motion to compel arbitration and dismiss the lawsuitis essentially a motion pursuant to section 2-619(a)(9) to dismiss based on the exclusiveremedy of arbitration. Such a motion admits the legal sufficiency of the plaintiff's complaintbut interposes some affirmative matter that prevents the lawsuit from going forward. Kedzie& 103rd Currency Exchange, Inc., 156 Ill. 2d at 115. On appeal from a ruling on a section2-619(a)(9) motion, the standard of review is de novo. Kedzie & 103rd Currency Exchange,Inc., 156 Ill. 2d at 116-17.

Furthermore, the decision whether to compel arbitration is not discretionary. Wherethere is a valid arbitration agreement and the parties' dispute falls within the scope of thatagreement, arbitration is mandatory and the trial court must compel it. TDE Ltd. v. Israel,185 Ill. App. 3d 1059, 1063 (1989) (parties to an arbitration agreement are irrevocablycommitted to arbitrate all disputes clearly arising under the agreement). On the other hand,where there is no valid arbitration agreement or where the parties' dispute does not fallwithin the scope of that agreement, the trial court may not compel it. Roubik v. MerrillLynch, Pierce, Fenner & Smith, Inc., 181 Ill. 2d 373, 382 (1998) (a party cannot be forcedto arbitrate a dispute that the party has not agreed to submit to arbitration).

Accordingly, we will employ a de novo standard of review, with a view todetermining whether there was a sufficient showing to sustain the trial court's order denyingthe motion to compel appraisal. Nevertheless, even were we to accord the more deferentialreview required by an abuse-of-discretion standard, we would reach the same result.

Defendant argues on appeal that the appraisal provision of the insurance contractunambiguously requires plaintiff to submit to appraisal the "key factual issue underlyingeach of plaintiff's theories of recovery"-the amount of loss. Defendant argues: "The amountof plaintiff's loss must be determined at some point in this case, and the appraisal provisionclearly states how the parties have agreed to make that determination ***. *** [Defendant]seeks to compel appraisal to determine only a single, narrow factual matter: the actual cashvalue of plaintiff's vehicle, which will determine the amount of loss under the Policy." Weunderstand defendant's argument to be that it does not wish to submit the entire lawsuit tothe appraisal process, but only the factual determination of the actual cash value of plaintiff's vehicle, to be used as evidence at the trial of plaintiff's complaint. This argumentmakes no sense in the context of defendant's motion in the trial court, which sought thedismissal of the lawsuit based on the exclusive remedy of an appraisal. Further, a motionto limit the type of evidence to be admitted at the trial was premature here where thecomplaint was not yet at issue, defendant having not yet answered it.

Accordingly, we will address the propriety of the trial court's ruling, on defendant'smotion to compel an appraisal and dismiss or stay the lawsuit, that the dispute at issue didnot fall within the scope of the appraisal clause. At a hearing on a motion to compelarbitration, the only issue before the court is whether an agreement exists to arbitrate thedispute in question. City of Centralia v. Natkin & Co., 257 Ill. App. 3d 993, 995 (1994). If the language of an arbitration agreement is clear and it is obvious that the dispute desiredto be arbitrated falls within the scope of the arbitration clause, the court should compelarbitration. City of Centralia, 257 Ill. App. 3d at 996. Likewise, if it is obvious that theissue sought to be arbitrated is not within the scope of the arbitration clause, the court shoulddecide the arbitrability issue in favor of the opposing party, because no agreement toarbitrate the dispute exists. Caudle v. Sears, Roebuck & Co., 245 Ill. App. 3d 959, 963(1993). The parties are bound to submit to arbitration only those issues that they haveagreed clearly to resolve through the arbitration mechanism, and a court should not extendan agreement by construction or implication. J&K Cement Construction, Inc. v. MontalbanoBuilders, Inc., 119 Ill. App. 3d 663, 669 (1983).

The parties in the case at bar agree that the insurance policy contained an appraisalclause which provided, "If we and you do not agree on the amount of loss, either maydemand an appraisal of the loss." The parties disagree on whether their dispute involves "theamount of loss" and whether it falls within the scope of the appraisal provision. Weconclude, as did the trial court, that plaintiff's complaint raises much more than a disputeover the actual cash value of her vehicle, that is, the amount of loss, and that the issuesraised by the complaint do not fall within the scope of the appraisal clause and could not,in any event, be resolved through the appraisal process.

In Lundy v. Farmers Group, Inc., 322 Ill. App. 3d 214 (2001), the plaintiff filed aclass action lawsuit against her insurer after her car was damaged in a collision. Theplaintiff alleged that the insurer had acted fraudulently in requiring its authorized repairshops to use inferior replacement parts rather than more expensive original equipmentmanufacturer parts on automobiles that were covered under its insurance policies. Theplaintiff's second amended complaint included claims on behalf of herself and the allegedclass members and alleged, inter alia, fraud and breach of contract. Lundy, 322 Ill. App. 3dat 217. The insurance contract in issue had an appraisal clause that was nearly identical tothe one before us. The insurer sought to enforce the clause. Lundy, 322 Ill. App. 3d at 216. In considering the plaintiff's fraud claims and the insurer's appraisal request, the appellatecourt stated:

"[C]ontrary to [the insurer's] assertion, the trial court's analysis does not end withwhether an arbitration or appraisal clause existed. The court must also determinewhether the parties' dispute is covered by the particular clause. [Citation.]

Here, the appraisal process provided for in the policy was designed solely toresolve disputes over the amount of the loss. [The insurer] argues that the amountof the loss is the threshold issue for each of plaintiff's claims, but that argumentoversimplifies the issues raised in plaintiff's second amended complaint. Theresolution of plaintiff's claims will require a determination of whether [the insurer]misrepresented to its policyholders the quality of repair parts that [the insurer] wouldpay for under its policies. This question requires an interpretation of the policylanguage, in particular, the phrase 'like kind and quality.' These issues cannot beresolved through the appraisal process. Consequently, we agree with the trial courtthat the issues plaintiff raised in her second amended complaint were not subject tothe appraisal clause." Lundy, 322 Ill. App. 3d at 219.

Likewise, we find that the instant case presents much more than a disagreement between theparties concerning the actual cash value of plaintiff's vehicle.

Here, plaintiff contends that defendant is engaged in a fraudulent scheme toundervalue insureds' vehicles that are declared a total loss, in order to increase its ownprofits. Plaintiff's claims focus upon whether defendant defrauded her and thereby breachedthe terms of the policy. Plaintiff's amended complaint specifically focuses upon theappraisal provision and claims that defendant inserts the appraisal provision into its policyas one way to effectuate its wrongful scheme, because insureds will forego their unpaidclaims rather than pursue the expensive appraisal process, especially because the disputedamount is virtually always worth less than the cost of pursing an appraisal. The amendedcomplaint further alleges, "As designed, the appraisal clause prevents plaintiff and the classfrom effectively vindicating their statutory and common law causes of action." Thislanguage establishes that plaintiff's amended complaint presents much more than adisagreement between the parties concerning the actual cash value of the vehicle. Accordingly, the dispute is not covered by the appraisal clause, and the trial court did noterr in denying defendant's motion to compel an appraisal.

Finally, we reject defendant's argument that the trial court erroneously considered themerits of plaintiff's claims and the cost of an appraisal when it denied the motion to compelan appraisal. Defendant correctly asserts that when a trial court rules on a motion to compelan appraisal, any venture into the merits of the claim underlying the dispute is improper. TDE Ltd., 185 Ill. App. 3d at 1064. Defendant asserts that, in ruling on the motion tocompel appraisal, the trial court erroneously considered whether plaintiff might ultimatelyprove her claims and the cost of an appraisal. We have reviewed the trial court's oralpronouncements at the hearing, as well as its written order denying the motion, and we donot agree with defendant that the trial court erroneously considered these matters in decidingthe motion. The trial court properly ruled on defendant's motion to compel an appraisal.

For the foregoing reasons, the judgment of the circuit court of Madison County ishereby affirmed. The cause is remanded for further proceedings consistent with thisopinion.

Affirmed; cause remanded.

HOPKINS, P.J., and GOLDENHERSH, J., concur.

NO. 5-02-0059

IN THE

APPELLATE COURT OF ILLINOIS

FIFTH DISTRICT


JESSIE TRAVIS, Individually and on Behalf ) Appeal from the
of All Others Similarly Situated, ) Circuit Court of
) Madison County.
          Plaintiff-Appellee, )
)
v. ) No. 01-L-290
)
AMERICAN MANUFACTURERS MUTUAL )
INSURANCE COMPANY, )
)
         Defendant-Appellant, )
)
and  )
)
CCC INFORMATION SERVICES, INC., ) Honorable
) Daniel J. Stack,
         Defendant. ) Judge, presiding.

Opinion Filed December 24, 2002


Justices: Honorable Thomas M. Welch, J.

Honorable Terrence J. Hopkins, P.J., and

Honorable Richard P. Goldenhersh, J.,

Concur


Attorneys Michael L. McCluggage, Michael R. Blankshain, Derek C. Smith,Wildman,

for Harrold, Allen & Dixon, 225 West Wacker Drive, Suite 3000, Chicago, IL 60606-

Appellant 1229; Gordon R. Broom, Troy Bozarth, Burroughs, Hepler, Broom, MacDonald,

Hebrank & True, 103 W. Vandalia Street, Suite 300, P.O. Box 510, Edwardsville,

IL 62025


Attorneys Gail G. Renshaw, The Lakin Law Firm, P.C., 301 Evans Avenue, P.O. Box 229,

for Wood River, IL 62095-0229; Paul M. Weiss, Freed & Weiss, LLC, 111 West

Appellee Washington Street, Suite 1331, Chicago, IL 60602


1. CCC is not a party to this appeal but was named as a codefendant in the suit.