United States Court of Appeals, Ninth Circuit
United States Court of Appeals, Ninth Circuit
2d 1382
The Fowlers, appellants in the instant case, suffered flood damage on their
property. They had sought flood insurance for the property through appellee
ABF, their insurance company, and ABF had applied for a policy from the
government's National Flood Insurance Program. Although it was determined
that the Fowlers were not eligible for the program, a policy was nevertheless
issued and the government erroneously paid the Fowlers for their loss. Later,
after an audit of the Flood Insurance Program, the erroneous payment was
discovered and the government brought an action against the Fowlers to
recover payment. The Fowlers brought a third-party complaint against ABF
and counterclaimed against the United States on the basis of negligence. The
district court granted summary judgment to ABF because the Fowlers had
signed a liability release. The district court also granted summary judgment to
the United States, finding that the government had not waived its right to
reimbursement and was not estopped. The court dismissed the Fowlers'
counterclaim because it fell within the misrepresentation exception under the
Tort Claims Act. This appeal followed.
James S. Fowler, Sr., Halle W. Fowler, James S. Fowler, Jr., and Robyn Fowler
(the Fowlers) owned adjacent property on the Snake River and Salmon Falls
Creek in Hagerman, Idaho. On April 26, 1984 the Fowlers procured flood
insurance for three buildings on the properties through Anderson-Blake-Fay
Insurance Company (ABF). ABF applied for the policy from the United States'
National Flood Insurance Program (NFIP or United States). Immediately
afterward the Fowlers left for Alaska. Ten days later ABF determined that the
address on the insurance application listed the incorrect county and that, in fact,
the Fowlers' property was in a county that was ineligible for federal flood
insurance. ABF sent three cancellation/nullification request forms to the NFIP
indicating the true property location, explaining the mistake and stating that the
property was not eligible for coverage. The NFIP returned the forms to ABF
because, at the time they were submitted, no policy number had been assigned
yet to the flood insurance applications. ABF did not resubmit the
cancellation/nullification forms. ABF also did not contact the Fowlers on the
phone or through the mail about the cancellation of their insurance.1 The
Fowlers returned from Alaska on May 11 or 12, 1984.
The Salmon Falls Creek flooded on May 16, 1984, damaging the property
owned by James Fowler, Sr. and his wife. On that same day, James Fowler, Jr.
called ABF and was informed that the property was not insured. The Fowlers
retained an attorney who began negotiations with ABF. On May 21, 1984 ABF
submitted two claims to the government. In processing the claims the NFIP
assigned the two claims to separate claim examiners. One examiner correctly
denied the smaller of the two claims because the property was in an ineligible
county. On November 29, 1984 another examiner erroneously issued two
checks totaling $23,237.86 to the Fowlers on the second claim.
4
On May 16, 1985 the Fowlers and ABF began negotiating over the claim
rejected by the NFIP. On February 2, 1986 James Fowler, Sr., signed a release
of all claims arising out of the flood against ABF in return for ABF's payment
of $5,500.
On October 30, 1986 the Fowlers were notified by letter from the NFIP that an
audit had revealed the mistaken payment and that the United States was
demanding repayment of the $23,237.86. The Fowlers filed an action against
ABF in state court alleging negligence, breach of contract, fraud and
misrepresentation. After the Fowlers amended their complaint to add the
Government as a co-defendant, the case was removed to federal court and
consolidated with the Government's collection action against the Fowlers. In
that collection action the Fowlers filed a third-party complaint against ABF
repeating the same claims asserted in the state action. The Fowlers also filed a
counterclaim against the United States seeking damages for negligence in
processing and paying the flood damages. The district court granted summary
judgment to the United States on its claim for reimbursement and on its motion
to dismiss the counterclaim. The district court also granted summary judgment
in favor of ABF on the Fowlers' third-party complaint. The disposition of these
motions resolved all the issues in the case and the Fowlers then timely
appealed to this court.
DISCUSSION
I. Standard of Review
6
A grant of summary judgment is reviewed de novo. Kruso v. Int'l Tel. & Tel.
Corp., 872 F.2d 1416, 1421 (9th Cir.1989), cert. denied, --- U.S. ----, 110 S.Ct.
3217, 110 L.Ed.2d 664 (1990). The appellate court must determine, viewing
the evidence in the light most favorable to the nonmoving party, whether there
are any genuine issues of material fact and whether the district court correctly
applied the relevant substantive law. Tzung v. State Farm Fire and Casualty
Co., 873 F.2d 1338, 1339-40 (9th Cir.1989).
It is undisputed that the Fowlers' property was ineligible for NFIP coverage as a
matter of law and that the United States erroneously paid the Fowlers for flood
damage on their property. The Fowlers argue, however, that the United States
is estopped from seeking reimbursement or, alternatively, has waived its right
to reimbursement. We disagree and affirm the district court's order granting the
United States' motion for summary judgment against the Fowlers on its claim
for reimbursement of the flood insurance proceeds.
1. Equitable Estoppel
8
The Ninth Circuit "has held that 'where justice and fair play require it, estoppel
will be applied against the government.' " Watkins v. United States Army, 875
F.2d 699, 706 (9th Cir.1989) (en banc) (quoting Johnson v. Williford, 682 F.2d
868, 871 (9th Cir.1982)). However, "the federal government 'may not be
estopped on the same terms as any other litigant.' " Wagner v. Dir., Fed.
Emergency Management Agency, 847 F.2d 515, 519 (9th Cir.1988) (quoting
Heckler v. Community Health Servs., Inc., 467 U.S. 51, 60, 104 S.Ct. 2218,
2224, 81 L.Ed.2d 42 (1984)). Specifically, "claims for estoppel [against the
government] cannot be entertained where public money is at stake." Office of
Personnel Management v. Richmond, --- U.S. ----, 110 S.Ct. 2465, 2473, 110
L.Ed.2d 387 (1990). Because the Appropriations Clause of the Constitution,
Art. I, Sec. 9, cl. 7, limited the payment of money from the Treasury to that
authorized by statute, the Supreme Court in Richmond held that "judicial use of
the equitable doctrine of estoppel cannot grant respondent a money remedy that
Congress has not authorized." Id., 110 S.Ct. at 2472.
It is undisputed that the Fowlers' property was not eligible for flood insurance
under the National Flood Insurance Act.2 42 U.S.C. Secs. 4001-4128 (1989).
Thus, if we were to permit the Fowlers to estop the United States, we would be
permitting them to retain public funds that Congress had not appropriated. We
have no authority to grant such an expenditure. In this context, the United
States cannot be estopped.
2. Waiver
10
Appellants claim that the United States waived its right to reimbursement by
voluntary payment of the claim.3 They argue that the Court must rely on
standard insurance law and contract principles to determine the waiver issue
and that under this law voluntary payment of an insurance claim waives any
right to reimbursement. The government contends that the general state
doctrines of waiver are not applicable when the insurer is the United States
because the agents in this case were acting outside their scope of authority
The Fowlers are correct that in suits interpreting a federal flood insurance
policy, the appellate court "shall apply the 'traditional common-law technique
of decision' by drawing upon standard insurance law principles." Brazil v.
Giuffrida, 763 F.2d 1072, 1075 (9th Cir.1985) (quoting West v. Harris, 573
F.2d 873, 881 (5th Cir.1978)). However, whether the government has waived
its right to reimbursement by paying the Fowlers is not a question involving
interpretation of the provisions of an insurance policy, for which the court
would look to standard insurance law provisions. Instead, in this case, the court
is determining whether conduct of government agents that is contrary to law
can bind the government; specifically, the court must decide whether agents
can expand the coverage of an insurance program beyond Congress' mandate by
providing benefits to an ineligible party. To determine this question the courts
look to federal law rather than state insurance law. See, e.g., Community Health
Services, 467 U.S. 51, 104 S.Ct. 2218 (applying federal law); Federal Crop Ins.
Corp. v. Merrill, 332 U.S. 380, 383 n. 1, 68 S.Ct. 1, 3 n. 1, 92 L.Ed. 10 (1947)
("[R]ules of law whereby private insurance companies are rendered liable for
the acts of their agents are not bodily applicable to a Government agency....").
12
Under federal law, it is clear that the flood examiner's error did not waive the
United States' right to reimbursement. The Supreme Court has held in a number
of cases that "the United States is neither bound nor estopped by the acts of its
officers or agents in entering into an arrangement or agreement to do or cause to
be done what the law does not sanction or permit." Utah Power & Light Co. v.
United States, 243 U.S. 389, 408-09, 37 S.Ct. 387, 391, 61 L.Ed. 791 (1917);
see also Community Health Services, 467 U.S. at 63, 104 S.Ct. at 2225;
Schweiker v. Hansen, 450 U.S. 785, 101 S.Ct. 1468, 67 L.Ed.2d 685 (1981);
Morgan v. Heckler, 779 F.2d 544, 546 (9th Cir.1985). Specifically, in the
insurance context, in Federal Crop Ins. Corp., 332 U.S. 380, 68 S.Ct. 1, the
Supreme Court held that because the limitations on eligibility for government
crop insurance were defined by a government agency under the authority of
Congress, no government agent could create liability on the part of the
Government for a loss that was not covered under the insurance regulations.
See also Wagner, 847 F.2d at 518 ("[T]he conditions of an insurance policy
offered pursuant to a congressionally mandated program, such as the NFIP,
must be strictly observed.").4 Accordingly, the United States cannot be
considered to have waived its right to reimbursement simply because its agents
mailed an unlawful payment to the Fowlers.5
B. Negligence Counterclaim
13
14
28 U.S.C. Sec. 2680(h) prohibits claims against the government arising out of
negligent, as well as intentional, misrepresentation.6 Block v. Neal, 460 U.S.
289, 295, 103 S.Ct. 1089, 1092, 75 L.Ed.2d 67 (1983). The prohibition applies
only to the misrepresentation portion of the lawsuit. If the plaintiff brings both
a misrepresentation and a negligence claim, the government's conduct is
actionable under the negligence claim even if the two claims share certain
factual and legal questions. Id. at 298, 103 S.Ct. at 1094.
15
16
between
the performance of operational tasks and the communication of
information. The Government is liable for injuries resulting from negligence in
performance of operational tasks even though misrepresentations are collaterally
involved. It is not liable, however, for injuries resulting from commercial decisions
made in reliance on government misrepresentations.
17
Id. at 325.
18
Under this definition, we find that the Fowlers' action is one solely for
misrepresentation.7 It is true that the government performed the operational
task of processing an insurance claim negligently, but the injuries claimed by
the Fowlers are not the result of the negligent handling of their claim. The
Fowlers were injured because they relied on the government's representation
that it would pay for the flood damage when, in fact, it would not. The Fowlers
were not damaged by the negligent handling of the claim, which only resulted
in them having the use of $23,237.86 for over four years.
19
After receiving the check for flood damage on one claim from the United
States, the Fowlers negotiated with ABF on the second claim. Pursuant to those
negotiations, James Fowler, Sr. signed a contract releasing ABF from any
further liability resulting from the flooding on May 16 in exchange for a $5,500
check. The district court found that the release applied in the instant negligence
claim and, therefore, granted summary judgment to ABF. For the reasons
which follow, we find that there is a genuine factual issue concerning the
validity of the release and that the district court was incorrect in granting
summary judgment on that basis.
The Fowlers argue that the release is invalid because it was intended to cover
only the claim rejected by the NFIP, not all claims relating to the flood. This
argument is contrary to the clear language in the release.
22
The form letter release signed by Fowler states in pertinent part that James
Fowler, Sr. releases ABF from "any and all claims, actions, causes of action,
demand, rights, damages, costs, loss of service, expenses and compensation"
which he may have "resulting or to result from the accident, casualty or event
which occurred on or about the 16th day of May, 1984 at or near Salmon Falls
Creek near Hagerman, Idaho." The release clearly states that ABF is released
from all damages relating to the flood, even the property damage paid for by
the NFIP. The language of the contract simply does not suggest any limitation
in coverage.
23
Appellants assert, however, that the release should be interpreted as the parties
intended. They allege that because they had no need to relinquish any rights to
ABF resulting from the first claim they could only have meant to include the
second in the release. The Fowlers point to a series of letters leading up to the
release as evidence of intent.
24
Under Idaho law a court can look to extrinsic indicia of the parties' intent only
when a contract is ambiguous on its face. Wood v. Simonson, 108 Idaho 699,
702, 701 P.2d 319, 322 (1985). Thus, this court can consider the letters between
the parties and evidence of Fowler, Sr.'s state of mind only if the contract is
ambiguous.
25
26
B. Validity of Release
27
The Fowlers also assert that the release is invalid because either there was a
mutual mistake in its formation or ABF misrepresented the true situation to
them. We find that there is a question of fact as to whether there was a mutual
mistake, which under Idaho law would invalidate the release.8
28
29
There is substantial evidence in the instant case that both parties mistakenly
assumed that the government was paying approximately $23,000 worth of the
damages. The Fowlers have sworn that they never imagined the United States
would demand repayment and evidence indicates that ABF too assumed that
the government was paying.9 It appears that both ABF and the Fowlers thought
that $5,000 was adequate consideration for the release simply because the
government had already paid a portion of the claim. Thus, the assumption that
the government had paid for some of the damages appears to be a "vital fact
upon which they base[d] their bargain." Id. At the very least, it is a question of
fact.10 Summary judgment is not appropriate when there is a genuine issue of
material fact. Tzung, 873 F.2d at 1340. We, therefore, reverse the summary
judgment order in favor of ABF and recommend that the district court remand
the case to Idaho state court where the validity of the release can properly be
determined under Idaho law.11
CONCLUSION
30
For the foregoing reasons, we affirm the district court's grant of summary
judgment in favor of the United States. We reverse, however, the district court's
grant of summary judgment in favor of ABF.
31
There is a factual dispute over whether ABF even attempted to reach the
Fowlers by phone
Under the National Flood Insurance Act, Congress provided flood insurance
coverage to eligible properties. 42 U.S.C. Secs. 4001-4128 (1989). What
constitutes an eligible property is determined by the Director of the Federal
Emergency Management Agency. 42 U.S.C. Sec. 4013(a)(1). In the instant
case, the Director had determined that property located in Twin Falls County
was not eligible for the National Flood Insurance Program. The Fowlers'
property was in Twin Falls
The district court did not decide the waiver issue separately, holding instead
that "[u]nder the circumstances of this case, the defenses of waiver and
estoppel dovetail.... [I]f estoppel falls, waiver follows."
The mere existence of common elements in the defenses of waiver and estoppel
does not permit the district court to dismiss the waiver defense without separate
consideration. The Supreme Court in Lyng v. Payne, 476 U.S. 926, 936, 106
S.Ct. 2333, 2340, 90 L.Ed.2d 921 (1986), held that while
[i]t may well be that some of the same concerns that limit the application of
equitable estoppel against the Government bear on the appropriateness of
awarding other remedies that have a close substantive resemblance to an
estoppel[, w]e reject ... petitioners' suggestion that any remedy that can be
analogized to an equitable estoppel is necessarily invalid, regardless of the
source of the cause of action, unless the plaintiff succeeds in proving all the
In the district court the Fowlers also asserted an accord and satisfaction
defense. They did not argue that defense in either of their appellate briefs and
we assume that they have waived it
28 U.S.C. Sec. 2680(h) provides, in pertinent part, that "[t]he provisions of this
chapter and section 1346(b) of this title shall not apply to ... (h) Any claim
arising out of ... misrepresentation, deceit, or interference with contract rights."
(emphasis added)
Cline v. Hoyle & Associates Ins., Inc., 108 Idaho 162, 164, 697 P.2d 1176,
1178 (1985). Because we find a question of fact as to mutual mistake, we need
not reach this issue
9
The district court disbelieved the Fowlers assertion that they did not suspect
that the government would seek reimbursement. This is a credibility
determination that is inappropriate at the summary judgment stage
10
The release does not cover this possibility. The language in the release refers to
unknown and unforeseen bodily and personal injuries and property damages
resulting from the accident. The obvious meaning of this language in the
release is that if the Fowlers discovered additional damage to their property
caused by the flood that they were not aware of when they signed the release
they could not seek damages from ABF. A mistaken belief that the government
would pay is not unknown or unforeseen property damage resulting from the
accident and is not covered by the release
11
Because the district court determined that the release was valid, it never
decided whether summary judgment was appropriate on the merits. Both sides
argue the merits on appeal. The merits of the Fowlers' negligence claim against
ABF rest on whether alternative flood insurance was available and whether
proof of alternative insurance is a prerequisite to a negligence claim in Idaho.
The former is a hotly disputed factual question and the latter is an undecided
issue in Idaho tort jurisprudence. As such, both issues are better decided at the
trial level in state court than in federal court on appeal. We, therefore, will not
consider the merit arguments