**Author's Note: If you have reached this blog through a list that carries advertising, your computer may or may not be put at risk either through the list or through the advertising. I do not accept or authorize any commercial advertising of any kind on any list or post. Placing commercial advertisements with or near any of my web log posts is prohibited. Further, I do not recommend any products or services advertised with or near any of my posts or any list of my posts.**
Policyholders' alleged breach of Proof of Loss requirements in their Homeowner's Insurance Policy resulted in reversal of an Order to Appraise their Hurricane Wilma Damage Claims, until the Coverage Issue of Proof of Loss compliance was determined, in Download Sunshine State Insurance Co. v. Corridori (Fla. 4th DCA Case No. 4D09.2502, Opinion Filed February 3, 2010), attached Official Slipsheet Opinion at 1, also reported as Sunshine State Insurance Co. v. Corridori, 2010 WL 366599 *1 (Fla. 4th DCA February 3, 2010)(subscription required to access Westlaw).
The Policyholders in that case had previously presented a Hurricane Wilma Damage Claim under their same Homeowner's Insurance Policy, which the Homeowner's Insurance Company paid and resolved. "Two years later," they filed what was denominated "a supplemental claim" for additional Damages. In response to the supplemental claim, the Homeowner's Insurance Company requested a Proof of Loss as required by the Policy and also requested Examinations Under Oath. The Policyholders returned an allegedly "incomplete and inaccurate" Proof of Loss after the time for doing so had passed, and apparently their EUOs were not scheduled although this is not clear from the Court's opinion.
The Homeowner's Insurance Company denied the supplemental claim. The Policyholders filed a petition to compel Appraisal of their supplemental claim. The Trial Court ordered Appraisal, concluding "[w]ithout taking any evidence," that the original claim and the supplemental claim were different and that the Policyholders had not breached their Homeowner's Policy. Download Sunshine State Insurance Co. v. Corridori (Fla. 4th DCA Case No. 4D09.2502, Opinion Filed February 3, 2010), at 1; Sunshine State Insurance Co. v. Corridori, 2010 WL 366599 *1 (Fla. 4th DCA February 3, 2010).
The Florida Appellate Court reversed. In Florida as in most if not all jurisdictions, it is generally held that Insurance Coverage issues must be resolved before there can be an Appraisal of the amount of a loss. Insurance Coverage issues, moreover, must be determined by a Court in Florida, not by a panel of Appraisers. Since the Policyholders argued that they complied with Policy conditions including for Proof of Loss and that their breach, if any, of the Insurance Policy was not material, the case presented a Question of Fact as to the degree of the Policyholders' compliance with the Policy requirements. "The trial court, without taking any evidence, did not resolve this dispute of fact with competent evidence to support its determination of coverage." Download Sunshine State Insurance Co. v. Corridori (Fla. 4th DCA Case No. 4D09.2502, Opinion Filed February 3, 2010), at 1-2; Sunshine State Insurance Co. v. Corridori, 2010 WL 366599 *1-*2 (Fla. 4th DCA February 3, 2010).
Various Cases dealing with Appraisals under First-Party Policies, as in Corridori, are examined in Dennis J. Wall, "Litigation and Prevention of Insurer Bad Faith" § 11:2 (Second Edition, Shepard's/McGraw-Hill; 2009 Supplement West Publishing Company). Examinations Under Oath are the subject of discussion in id. § 11:8, and Proofs of Loss are mainly addressed in id. § 11:9, among other Sections.
Please Read The Disclaimer.