315 So.3d 26
Fla. Dist. Ct. App.2021Background
- Homeowner Jennifer Mezadieu submitted a claim to SafePoint alleging water damage from a one-time second-floor bathroom leak and identified Contender Claims Consultants as her loss consultant.
- SafePoint inspected the house and its building scientist concluded the damage was consistent with chronic moisture over weeks, not a one-time leak; SafePoint denied coverage based on the policy exclusion for constant/repeated seepage.
- Homeowner sued for breach of contract and filed Contender’s detailed estimate seeking $43,181.01 in repairs (including ~$11,107 for kitchen/cabinets); she referenced and adopted that estimate in sworn interrogatory answers and at deposition.
- At deposition Homeowner admitted the kitchen cabinets had been damaged by a prior leak (claimed with a different insurer) and that the current leak did not damage the cabinets; she also acknowledged seeing no damage in some rooms listed in the estimate.
- SafePoint amended its answer asserting the policy’s concealment/fraud provision and moved for summary judgment; Homeowner’s counsel conceded the estimate was adopted and that $11,000 for the kitchen should be removed.
- The trial court granted final summary judgment for SafePoint, finding material false statements in the estimate attributable to Homeowner; the Fourth DCA affirmed, holding an insured is bound by adopted estimates and intent to deceive is not required under the policy clause.
Issues
| Issue | Mezadieu's Argument | SafePoint's Argument | Held |
|---|---|---|---|
| Did the estimate contain false statements? | Contender prepared the estimate; Mezadieu should not be punished for consultant’s errors. | Estimate included items unrelated to the asserted loss (e.g., kitchen cabinets). | Yes; admission and counsel concessions established false statements. |
| Were the false statements material under the policy? | Unstated or disputed materiality. | The $11,000 kitchen line and other claimed repairs were material to the amount claimed. | Yes; the falsely claimed repairs were material. |
| Must the insured have intended to rely on or intentionally made false statements? | Mezadieu: no intent; she relied on an expert estimate and did not prepare it. | SafePoint: intent is not required under the concealment/fraud clause; adoption binds the insured. | Intent not required; insured is bound when she adopts/relies on an estimate containing material false statements. |
| Are statements in a consultant’s estimate attributable to the insured? | Consultant acted independently; insured shouldn’t be bound absent active participation. | An insured is bound by statements she adopts under oath; agency and adoption make them hers. | Yes; by referencing and adopting the estimate in interrogatories and deposition, the insured is bound. |
Key Cases Cited
- Dicus v. Dist. Bd. of Trs. for Valencia, 734 So. 2d 563 (Fla. 5th DCA 1999) (party bound by admissions under oath)
- Ondo v. F. Gary Gieseke, P.A., 697 So. 2d 921 (Fla. 4th DCA 1997) (admissions by deposition/interrogatory are binding)
- Universal Prop. & Cas. Ins. Co. v. Johnson, 114 So. 3d 1031 (Fla. 1st DCA 2013) (concealment/fraud clause does not require intent for a false statement)
- Privilege Underwriters Reciprocal Exch. v. Clark, 174 So. 3d 1028 (Fla. 5th DCA 2015) (agreeing intent not required under similar policy language)
- Oscanyan v. Arms Co., 103 U.S. 261 (U.S. 1880) (court may rely on admissions by counsel)
- Wong Ken v. State Farm Fire & Cas. Co., 685 So. 2d 1002 (Fla. 3d DCA 1997) (affirming summary judgment where uncontested facts showed misrepresentation in claim)