Hurricane Ian Shoreline Loss: Four Policies, Oh Joy!
October 19, 2023
State Farm Florida Insurance Company v. Fernandez, No. 3D16—1441, 2017 WL 621247 (Feb. 15, 2017)
The Third DCA held that the insureds must comply with all post-loss obligations before an appraisal may be compelled.
In November 2005, State Farm determined the repair costs for Hurricane Wilma damage to Jose and Sandra Fernandez’s home were below the policy deductible. State Farm did not hear from the insureds again until it received a demand for appraisal in April 2010 along with a claim for $142,733.81 in damages. In response, State Farm requested documentation to support the claim, cause of loss, scope of damages, date and cause of loss and reminded the insureds of their duties after loss to file a sworn statement in proof of loss. State Farm also made a reservation of rights by separate correspondence. A week later, the insureds submitted a proof of loss, but no supporting documentation. State Farm inspected the property and took the examination under oath of the insureds, but still, they produced no documentation in support of their claim. State Farm made two more requests for documentation, then denied the claim in mid-2011. The insureds sued and moved to compel appraisal. After an evidentiary hearing on the insureds’ motion, the trial court granted their motion to compel appraisal and State Farm appealed.
Was it error for the trial court to compel appraisal where the insureds failed to comply with all of their post-loss obligations.
Yes. It is “well-settled” that all post-loss obligations must be satisfied before appraisal is compelled.
The court stated the record on appeal was replete with examples of the insureds’ non-compliance with post-loss obligations. The insureds failed to give immediate notice of alleged additional damage to their property, failed to protect the property from further damage, failed to keep accurate records of repair expenditures, failed to provide the insurer with the requested documents to support their claim, and failed to submit a proof of loss 60 days after the date of loss. Looking to prior Third DCA opinions on motions to compel appraisal, including United States Fidelity & Guaranty Co. v. Romay, 744 So. 2d 467 (Fla. 3d DCA 1999) and State Farm Florida Ins. Co. v. Cardelles, 159 So. 3d 239 (Fla. 3d DCA 2015), the court determined all post-loss obligations must be satisfied in order for appraisal to be compelled. In Cardelles, the court clarified its decision in Citizens Property Insurance Corporation v. Mango Hill Condominium Association 12, Inc., 54 So. 3d 578 (Fla. 3d DCA 2011), to state that “sufficient compliance” with post-loss obligations still requires that all post-loss obligations be satisfied before appraisal can be compelled.
The argument presented by the insureds to the trial court relied upon cases addressing “substantial compliance” with post-loss obligations in the context of the summary judgment standard. The insureds, therefore, argued that a finding of only partial or “less than perfect” compliance with post-loss duties presented a question of fact for a jury, but that nonetheless they fully complied by “reporting timely, mitigating damages, retaining and submitting all documents (including an estimate, roofing proposal, and photographs) in their possession related to the Loss, permitting an inspection of the damaged property and submitting to Examinations Under Oath,” thereby presenting the insurer with “an independent means to determine the amount of the Loss.” While this argument was convincing to the trial court, the Third DCA disagreed and reversed.