159 So. 3d 239
Fla. Dist. Ct. App.2015Background
- Homeowners Miguel and Graciela Cardelles reported hurricane damage from Katrina (Aug 25, 2005) and Wilma (Oct 24, 2005). State Farm paid partial amounts; plaintiffs contend payments were insufficient.
- Plaintiffs repaired the roof with funds received but claim many original Katrina damages remained unrepaired and sought supplemental recovery years later.
- In 2010 plaintiffs submitted a supplemental claim (date of loss listed as Katrina) and an updated sworn proof of loss; State Farm requested documentation, receipts, photos, and an updated sworn proof within 60 days.
- Plaintiffs did not supply the documentary items State Farm requested because they had not made further repairs and therefore had no new receipts or photos; they permitted and State Farm conducted inspections.
- Plaintiffs sued after State Farm refused additional payment. The trial court found plaintiffs had sufficiently complied with post-loss obligations and ordered a detailed appraisal; State Farm appealed.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether appraisal may be compelled when insurer asserts insured failed to satisfy policy post-loss duties | Cardelles: they complied (initially) and provided an updated sworn proof of loss; no additional documents exist because no further repairs were made; appraisal should proceed | State Farm: plaintiffs failed to provide requested documentation and updated sworn proof, so post-loss conditions not met and appraisal not triggered | Court: affirmed trial court — appraisal may be compelled; plaintiffs had sufficiently complied given facts (initial compliance, updated sworn proof, same claimed damages, inspections) |
| Standard for triggering appraisal clause: full compliance vs. "sufficient" compliance | Cardelles: satisfied requirements here; appraisal appropriate | State Farm: appraisal requires full compliance with all post-loss obligations before appraisal | Court: reiterates binding rule that insured must satisfy post-loss obligations, but on these facts plaintiffs met that requirement; no abuse of discretion in compelling appraisal |
Key Cases Cited
- Citizens Prop. Ins. Corp. v. Mango Hill Condo. Ass’n 12 Inc., 54 So. 3d 578 (discusses requirement that insured comply with post-loss obligations before appraisal)
- Johnson v. Nationwide Mut. Ins. Co., 828 So. 2d 1021 (coverage questions are for courts; appraisal addresses amount of covered loss)
- Sunshine State Ins. Co. v. Rawlins, 34 So. 3d 753 (trial court discretion to compel appraisal before coverage resolution in some cases)
- Paradise Plaza Condo. Assoc. v. Reinsurance Corp. of New York, 685 So. 2d 937 (same)
- U.S. Fid. & Guar. Co. v. Romay, 744 So. 2d 467 (insured must comply with all post-loss obligations before appraisal is triggered)
- First Home Ins. Co. v. Fleurimond, 36 So. 3d 172 (post-loss compliance requirement reaffirmed)
- Citizens Prop. Ins. Corp. v. Galeria Villas Condo. Ass’n, 48 So. 3d 188 (no disagreement for appraisal purposes until insurer had reasonable opportunity to investigate)
- Citizens Prop. Ins. Corp. v. Gutierrez, 59 So. 3d 177 (reiterating post-loss compliance requirement)