Defining Occurrence – When Policy Definitions Do Not Apply To All Coverages
September 24, 2020
Florida courts continue to refine the roles and limitations of appraisers in Florida property claims. Florida’s Fifth District Court of Appeal recently held that a public adjuster cannot serve as a disinterested appraiser where the public adjuster is retained on a contingency fee basis. State Farm Florida Ins. Co. v. Crispin, No. 5D19-249 (Fla. 5th DCA February 7, 2020).
In Crispin, the insured submitted a claim to her insurer and retained a public adjuster to assist with her claim. The public adjuster was retained under a contingency fee agreement. The insurer issued payment to the insured. Thereafter, the public adjuster advised the insurer that the insured was invoking the insurance policy’s appraisal provision. In pertinent part, this provision says: “[i]f you and we fail to agree on the amount of loss, either party can demand that the amount of the loss be set by appraisal…Each party will select a qualified, disinterested appraiser and notify the other of the appraiser’s identity within 20 days of receipt of the written demand.”
The insured selected her public adjuster as her appraiser. The insurer objected, asserting that the insured’s public adjuster was not disinterested with respect to the subject claim. The insured filed a petition for declaratory relief asking the trial court to declare that the public adjuster could serve as her appraiser under the terms of the policy. The trial court granted this petition.
On appeal, Florida’s Fifth District Court of Appeal looked to the meaning of the word “disinterested” as contemplated under the insurance policy. The Court noted that its sister Court recently considered this precise issue and evaluated “the same contractual provision and nearly identical facts” in State Farm Florida Ins. Co. v. Valenti (285 So. 3d 958 (Fla. 4th DCA 2019). The Court in Crispin reversed the trial court’s final decree and held that the insured’s public adjuster was not a disinterest person under the terms of the insurance policy.
Moreover, the Court cited to the concurrence opinion in Valenti, which explains that “an appraiser is not disinterested in an insurance claim if the appraiser is entitled to a percentage of the recovery from the same claim.” The Court also relied on its reasoning in Fla. Ins. Guaranty Ass’n v. Branco, 148 So. 3d 488, 390 (Fla. 5th DCA 2014) where it addressed whether an insured’s attorney could serve as an appraiser and held in the negative with respect to that issue.
The insured’s argument relied on Rios v. Tri-State Ins. Co., 714 So. 2d 547 (Fla. 3d DCA 1998) and argued that her contingent fee appraiser qualified as a “competent, independent appraiser.” However, the Court reasoned that Rios was not instructive as there is a legally significant distinction between the terms “independent” and “disinterested.”
The Crispin opinion is but the most recent example of Florida’s courts continuing to develop the law governing the roles and limitations of appraisers, public adjusters, and persons involved in property claims. Accordingly, insurers should continue to monitor the evolution of this topic as Florida’s courts continue to clarify and expound upon it.