Elderly Phila. homeowner sues insurance carrier for failure to pay out claim stemming from damaged residence

Jon Campisi May 17, 2012, 8:21am

A man who claims the carrier holding his homeowner’s insurance policy breached its contract with the plaintiff after it failed to fully pay out a claim stemming from damages resulting from a busted sewer pipe has filed a civil action against the company in state court.

Philadelphia attorney Predrag Filipovic filed the complaint May 9 at Philadelphia’s Common Pleas Court on behalf of city resident George Ivkovic.

The defendant named in the lawsuit is Delaware-based Keystone Insurance, also known as AAA Insurance.

According to the lawsuit, Ivkovic’s residence suffered damage on Sept. 30, 2011 after a sewage pipe burst in several places.

A claims adjuster for the defendant subsequently came out to the residence to assess the damage, but Ivkovic claims in his lawsuit that the adjuster informed the plaintiff that the damages resulting from the busted cast iron pipe were not covered under the homeowner’s insurance policy.

The plaintiff claims that the wording of the insurance policy is ambiguous, and he argues that the provisions of the contract that the company cited in refusing coverage could be interpreted various ways.

“Defendants solely and exclusively relied on this ambiguous language to refuse the payment of the invoice …,” the lawsuit states.

The lawsuit claims that despite repeated attempts to try and get the defendant to pay the insurance claim, it has failed to do so, causing financial hardship to the plaintiff.

The complaint further alleges that the entire dispute began only after the plaintiff decided to ignore the findings of an initial claims adjuster who came out to the residence, and actually agreed with the repair estimates by Ivkovic’s contractor, and decided to send for a second adjuster, whose assessment was “unreasonably premised on the notion that the repairs could somehow be completed without tearing down the second floor bathroom floors and walls through which the faulty sewer pipe ran and had fractured and leaked in more than three different places.”

It was only after the second adjuster came out that the defendant stated it would not be paying out the claim.

The lawsuit states that finally, on Dec. 23 of last year, the defendants issued a payment under the policy in the amount of $20,382.82, only after the plaintiff retained legal counsel to handle the matter.

However, that amount was “significantly less” than the cost of repairs incurred and submitted by the plaintiff’s contractor, which came out to be $29,538.

The lawsuit also claims that while repairs to the home were taking place in December 2011, the defendant “unreasonably” denied the plaintiff’s request for alternative living accommodations available under the homeowner’s policy because the defendant considered the residence to be livable under the contract.

The plaintiff is an 81-year-old who requires the assistance of an electric stair climber, the suit states.

The lawsuit contains counts of breach of contract and bad faith.

Ivkovic demands judgment against the defendant for $50,000 in punitive damages plus the interest on the plaintiff’s claim in an amount equal to prime rate of interest plus three percent.

An arbitration hearing has been scheduled for early next year.


The case ID number is 120500483.


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