Published on:

Insured homeowners often face greater difficulty in receiving payouts from property damage insurance claims where the claims spring out of multiple perils. Situations may arise where homeowners experience damage to property stemming from a peril that is covered under his or her insurance policy, but further examination reveals that there may be more than one peril that caused the loss. The case below illustrates one approach that Florida courts have taken in handling these types of cases.

In American Home Assurance Co v. Sebo, a homeowner purchased a four-year-old house and obtained an all-risks insurance policy. The policy contained an exclusion for inadequate, faulty, or defective planning. Shortly after the owner bought the home, it began showing signs of water leaks during rainstorms and hurricanes. After several months, the homeowner filed an insurance claim for the water damage, and after investigating the claim, the insurer denied coverage for most of the losses. The company tendered $50,000 for mold coverage but indicated that the rest of the damages to the home, including damages to the windows and doors, were excluded.

The house degraded beyond the point of repair and was demolished. The homeowner filed suit against the sellers, the architect, and the construction company that built the house. She alleged that the architect and construction company negligently built and designed the home and that the sellers engaged in material fraud by failing to disclose the property’s defects. Additionally, the homeowner filed suit against the insurance company and sought for the court to declare that the homeowners’ insurance policy covered all the claimed damages. The case against the insurer went to trial, and the jury decided in the homeowner’s favor. The insurance company appealed. Continue reading →

Published on:

 

Florida state courts, over the last several years, have heard numerous cases dealing with the assignment of benefits by homeowners’ insurance policyholders to third-party entities such as home repair companies without the approval of insurance companies. These entities file suit to recover benefits if the insurance companies fail to pay, either in part or wholly, according to the assigned rights. Florida courts seem to favor the assignability of benefits unless the language of the insurance policies prohibit the assignment, and therefore, insurance companies may be revising their policies to include language to that effect.

In One Call Property Services v. Security First Ins. Co., an insured homeowner, assigned insurance benefits to a third-party company that performed emergency services and property restoration work. The owner had experienced severe water damage on her property and asked the company to perform remediation and water removal, which the company completed. The owner executed the assignment of insurance benefits as payment for the company’s services. However, the insurance firm failed to pay the remediation company adequately for its services, and therefore, the company filed a claim for breach of contract. The insurance company requested for the trial court to dismiss the suit contending that the insurance policy in question had a provision prohibiting assignment of benefits. Consequently, the policy prevented the remediation company from filing a lawsuit as an assignee. The trial court ruled in the insurance company’s favor and dismissed the lawsuit, which the company appealed. Continue reading →

Published on:

Timeliness is an important issue when it comes to homeowners’ insurance claims. As with any provision in an insurance policy, parties must ensure that they write timeliness clauses clearly so as to avoid ambiguity, which may lead to litigation. As the case below illustrates, failure to define terms such as what counts as a timely filed claim may be an issue that courts will step in to resolve. In such cases, the court will construe ambiguous provisions against the drafter and make a decision as to timeliness based on a reasonability standard in light of the totality of the circumstances of each case.

In Laquer v. Citizens Property Insurance Corporation, the owner of a condo unit had an insurance policy that provided coverage for damage caused by weather-related events. The policy mandated that the insured provide the insurance company with prompt notice of a claim. A hurricane struck the area where the unit was located and, three years later, the owner notified the insurance company of the growth of mold in the unit. The insurance company denied the claim, citing the owner’s failure to provide prompt notice. The owner sued for breach of the insurance policy. Continue reading →

Published on:

In Florida, weather-related damage to homes is a frequent issue faced by homeowners. Our homeowners’ insurance lawyers find policies often have extensive sections and language devoted to defining what constitutes covered damages, particularly when it comes to those that are weather-related. Therefore, many of the disputes brought in court revolve around whether a particular claimed weather-related damage is a covered loss under a homeowners’ insurance policy. This case illustrates this issue, and why it is important to ensure that an insurance policy has clear language as intended by the parties.

In Advance Cable Company v. Cincinnati Insurance Company, a building was hit by a severe hailstorm and suffered roof damage. The building owners filed a claim with their insurance provider for a new roof, but the company denied the claim stating that the damage to the structure from the hailstorm was cosmetic in nature and specifically excluded from coverage. The insurance company argued that only damages that were substantial or structural in nature would fall within the meaning of direct physical loss that would be covered by the policy. The building owners filed suit in federal district court. The federal district court issued a decision in the case, holding that the insurance policy covered the damage from the hailstorm, and entered judgment for the building owners. The insurance company appealed. Continue reading →

Published on:

Insurance companies in Florida have a duty under state law to try to settle insurance claims in good faith, which encourages such companies to act honestly towards its insured parties. When they fail to do so, insured homeowners are permitted to bring separate civil actions for bad faith against the insurance company once the questions of liability and damages have been determined. This principle is illustrated in the case below.

In Cammarata v. State Farm Florida Insurance Company, the plaintiffs were Florida homeowners whose home sustained damage stemming from a hurricane. Nearly two years after the event, the homeowners filed a claim with their homeowners’ insurance company, State Farm Florida. A month after filing their homeowners insurance claim, the plaintiffs met with a representative of the insurance company who inspected the damage to the home to provide an estimate. The estimate amounted to be less than the deductible under the insurance policy and, therefore, the insurance company informed the homeowners that it will not be paying out on their claim. Approximately six months later, the plaintiffs asked the insurance company to participate in an appraisal process as provided for by their policy, and the company willingly participated. Both parties hired appraisers. The appraiser for the plaintiffs provided a damage estimate which was higher than the deductible amount and the damage estimate provided by the insurance company was lower than the deductible. The insurance company then requested a state court to appoint a neutral party to settle the parties’ dispute, which the court did. The neutral party appointed by the court found the damage to the home to have a higher value than the deductible and, therefore, the insurance company paid out the claim to the homeowners. Continue reading →

Published on:

Homeowners’ insurance policies are typically lengthy documents that contain many provisions most homeowners would find surprising. However, many homeowners fail to perform their due diligence and adequately examine the provisions of an insurance policy before signing. As a result, disputes often arise between insurance companies and insured individuals over the meaning of particular language in the policy. These disputes frequently occur when dealing with exclusions from coverage outlined in the policy. As the case below illustrates, parties should ensure that terms are well-defined in a policy and that the parties agree to the definitions before executing a policy.

In Bottee v. Southern Fidelity Ins. Co., an arsonist intentionally caused a fire that destroyed the plaintiff’s home. The plaintiff’s home was vacant for more than a month when the arsonist caused the fire. The plaintiff filed an property insurance claim with her homeowners’ insurance company, which denied the claim because the insurance policy in question excluded losses caused by malicious mischief and vandalism if it had been unoccupied for greater than thirty days before the loss occurred. The plaintiff then filed an action in state court against the insurance company. The court granted the insurance company’s request for summary judgment in its favor, and the plaintiff appealed. Continue reading →

Published on:

Our water damage attorneys find that water damage is still one of the reasons most commonly stated in home insurance claims, particularly in Florida. Water damage may stem from a wide range of reasons – severe weather events, bursting pipes, overflowing tubs or sinks, etc. Consequently, many homeowner’s insurance cases that policyholders file in court raise issues regarding the denial of claims involving water damage. The case below shows how one homeowner prevailed against an insurance company that denied a claim arising from water damage.

In Cheetham v. Southern Oak Insurance Company, the plaintiff filed an insurance claim with Southern Oak Insurance Company, their insurer. The plaintiff’s home had sustained some water damage, but Southern Oak denied the claim, stating that the insurance policy had a water damage exclusion statement that applied to the claim and supported its denial. Specifically, the damage exclusion provided that the policy excluded losses caused by water that backs up in the drains or sewers or overflows or discharged from a sump pump or other equipment. However, the policy also states that the policy covers accidental release or overflow of water from a sewer pipe in the premises or plumbing system on the premises. Continue reading →

Published on:

Litigation regarding homeowner’s insurance almost always stems from an insurance company’s denial of a claim. These disputes arise due to disagreements over the scope of coverage, and one of those disagreements are over personal liability coverage under the policy. Our homeowners insurance lawyers often see insurance companies trying to limit their responsibility to cover injuries under the policy, and as the case below illustrates, courts will interpret any ambiguities in coverage arising from language in the policy against the insurance company and likely rule for broader coverage.

In Maddox v. Florida Farm Bureau General Insurance Company, the plaintiff, and her two children lived with her boyfriend and his two dogs. The boyfriend had a homeowner’s insurance policy with Florida Farm Bureau. The policy provided the homeowner with personal liability insurance coverage up to $100,000 for each occurrence of harm. The insurance policy defines a single occurrence as an accident that results in bodily injury or property damage. One day, one of the homeowner’s dogs bit the plaintiff and one of her children, causing serious injuries. The plaintiff filed a complaint against the homeowner seeking damages. Florida Farm Bureau then asked the court to enter declaratory judgment stating that the whole dog attack on both the plaintiff and her child counted as a single occurrence under the insurance policy. Therefore, Florida Farm Bureau asked the court to rule that it was not liable to pay any damages to the plaintiff. The company argued that the damages the plaintiff claimed for her injuries were part of the same occurrence as the damages suffered by her child. Furthermore, the insurance company already paid the amount limit – $100,000 – to the child. The trial court granted the insurance company’s request and held that both injuries were subject to the single occurrence limit in the policy. The plaintiff appealed. Continue reading →

Published on:

Insurance companies may not be entitled to direct how an insured individual performs sinkhole repairs as long as he or she has consulted with a qualified engineer. In the case of Roker v. Tower Hill Preferred Insurance Co., a homeowner, and her servicing homeowner’s insurance company agreed that a sinkhole damaged the insured home.  Tower Hill’s engineer recommended that the homeowner gets subsurface remediation that necessarily includes chemical grouting and compaction.  Tower Hill told Roker, the homeowner, that it would only reimburse sinkhole remediation if Roker contracted for subsurface work in according to its engineering recommendation. Subsequently, Roker obtained a second opinion on the sufficiency of Tower Hill’s proposed remediation plan.  That second opinion by another engineer found the original plan to be deficient and proposed an alternate plan that included chemical grouting, compaction, and underpinning.

Consequently, Roker contracted for repairs according to the second opinion.  Roker sent the signed repair contract to Tower Hill.  In response, Tower Hill refused to honor the contract for remediation because it did not implement the remediation plan the company initially proposed. Florida statute states in relevant part that if an insurer verifies damages stemming from a sinkhole, then the insurer must compensate the cost of stabilizing the land and repairing the foundation according to a remediation plan recommended by an engineer in consultation with the policyholder. The insurer must pay for other repairs as outlined in the policy. Continue reading →

Published on:

Our homeowners insurance claims lawyers know the assignment of benefits by an insured person to a third-party contractor remains one of the most litigated homeowner’s insurance issues in Florida. In these cases, the typical scenario usually begins with an insured homeowner suffering damage to her home. That homeowner then contacts a third-party contractor, such as a plumber or water mitigation firm (for water damage), who asks that she assign insurance benefits to them before they begin any repairs. Such an assignment of benefit may come with unintended consequences that are detrimental for a homeowner. This case illustrates one of those consequences.

In Damage Control, Inc. v. State Farm Florida Insurance Company, a homeowner who experienced water damage hired Damage Control, Inc., a contractor, to perform remediation of the home. At the contractor’s request, the homeowner executed an assignment of benefits, which assigned the homeowner’s insurance benefits with State Farm Florida Insurance Company to Damage Control. After completing its work on the home, Damage Control provided an invoice to State Farm for the amount of the repairs. However, State Farm issued a check for less than half of the sum due on the bill. State Farm notified the homeowner that it wanted to dispute the amount of the repairs and invoked a clause in the insurance policy stating that if the parties failed to agree on the amount of the loss, either can make a written demand for an appraisal of the amount of the loss. Under this clause, both parties must each select a competent appraiser and notify the other party of that appraiser’s identity. Both appraisers will then choose an impartial umpire, and if any two of them agree in writing, that agreement will set the amount of the loss. Continue reading →

Contact Information