Mejia v. Citizens Property Insurance Corp.
161 So. 3d 576
| Fla. Dist. Ct. App. | 2014Background
- Mejia owned a home insured by Citizens under an HO-3 policy and purchased a paid sinkhole-loss endorsement that purported to remove the sinkhole/earth-movement exclusion for sinkhole losses.
- Mejia claimed his home sustained structural damage from sinkhole activity during the policy period; Citizens hired BCI, which concluded there was no sinkhole activity and denied the claim.
- At trial, the court pretrial-allocated the burden to Mejia to prove the damage was caused by a sinkhole, and the jury found Mejia failed to meet that burden; final judgment entered for Citizens.
- Mejia appealed, arguing the court misallocated the burden of proof and improperly excluded evidence of payments Citizens made to BCI that could show bias of Citizens’ expert witnesses.
- The appellate court held the policy must be treated as an all-risks policy for burden purposes and that Citizens bore the burden to prove an exclusion applied after Mejia proved covered damage; it also held the trial court abused its discretion by excluding evidence of the $9.5 million paid to BCI over three years.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Proper allocation of burden of proof under the sinkhole endorsement | Mejia: as insured under an all-risks policy with a sinkhole endorsement, he need only prove damage during the policy term; insurer must then prove the damage is excluded | Citizens: plaintiff must prove the damage was caused by sinkhole activity (i.e., cause-of-loss) | Reversed: court holds HO-3 with sinkhole endorsement is treated as an all-risks policy; insured proves loss during policy term, then insurer must prove an exclusion applies (Hudson controlling) |
| Admissibility of payments from insurer to expert’s firm to show bias | Mejia: evidence Citizens paid BCI ~$9.5M over 3 years is relevant to demonstrate expert bias and credibility impeachment | Citizens: payment history is irrelevant and prejudicial | Reversed: trial court abused discretion; such payment history is relevant and admissible impeachment evidence (following Allstate v. Boecher rationale) |
| Characterization of the policy form (all-risks vs. special/named-peril issues) | Mejia: endorsement does not change all-risks nature; sinkhole endorsement narrows exclusion | Citizens: (implicit) characterization affects burden allocation | Court: treats the policy as all-risks for burden purposes; concurrence notes HO-3 is complex but still places practical burden on insurer once insured shows damage |
Key Cases Cited
- Hudson v. Prudential Prop. & Cas. Ins. Co., 450 So.2d 565 (Fla. 2d DCA 1984) (endorsement did not change all-risks nature; insurer bears burden to prove exclusion)
- Allstate Ins. Co. v. Boecher, 733 So.2d 993 (Fla. 1999) (expert fee/financial relationship over prior three years is discoverable and relevant to show bias)
- Milligan v. State, 177 So.2d 75 (Fla. 2d DCA 1965) (dictum from the state supreme court carries persuasive weight)
- Carnival Corp. v. Jimenez, 112 So.3d 513 (Fla. 2d DCA 2013) (financial interest evidence admissible to attack expert credibility)
- Herrera v. Moustafa, 96 So.3d 1020 (Fla. 4th DCA 2012) (permits inquiry into sums paid by insurer to defense experts over prior three years)
- Flores v. Miami-Dade Cnty., 787 So.2d 955 (Fla. 3d DCA 2001) (inquiry extends to expert's work in other cases for bias assessment)