84 So. 3d 390
Fla. Dist. Ct. App.2012Background
- State Farm seeks certiorari review of a circuit court decision affirming denial of a motion to compel appraisal for a covered loss.
- Hinchman, insured under a State Farm homeowner’s policy, suffered water damage from a plumbing leak and received coverage.
- Unlimited Restoration assigned Hinchman’s rights, performed services, and billed approximately $1,827; State Farm estimated $800 and sent a lower check that was refused.
- State Farm informed Hinchman of a mediation option under Florida’s mediation program, noting it did not request mediation.
- Mediation failed; State Farm then demanded appraisal under the policy, and Unlimited Restoration filed suit.
- Lower courts relied on an administrative rule (Rule 69B-166.031/its successor) to expand the statute’s effect, which the court found improper.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the appraisal waiver under §627.7015(7) applies here | State Farm argues waiver only when insurer fails to notify or mediation is requested and impasse occurs. | Unlimited Restoration contends mediation participation by insurer/assignor triggers waiver via the rule. | Waiver not triggered; statute does not cover insured-initiated mediation; appraisal rights remain enforceable. |
| Whether the administrative rule improperly enlarges the statute | State Farm asserts the rule cannot expand the statutory scope. | Unlimited Restoration relies on the rule to allow direct litigation after unsuccessful mediation. | Rule expanded the statute; improper, administrative rule cannot contravene or enlarge statute. |
| Whether the circuit court properly applied §627.7015 and related rule to determine the process after mediation | State Farm argues statute allows mediation as optional and then appraisal if impasse, not insured-initiated path. | Unlimited Restoration argues the rule permits insured-initiated path after unsuccessful mediation. | Statute contemplates mediation as a pre-appraisal step only under specific conditions; insured-initiated post-mediation path was not authorized. |
| Whether the proper remedy is to enforce appraisal per the contract rather than allowing litigation | State Farm seeks dismissal or compel appraisal per contract terms. | Unlimited Restoration argues litigation permissible due to mediation participation. | Proceedings should enforce appraisal rights under the insurance contract; litigation unnecessary. |
Key Cases Cited
- Florida Hosp. v. Agency for Health Care Admin., 823 So.2d 844 (Fla.1st DCA 2002) (courts do not defer to agency construction when it conflicts with plain statute)
- Willette v. Air Products, 700 So.2d 397 (Fla.1st DCA 1997) (administrative rule cannot enlarge statutory provisions)
- Florida Ins. Guar. Ass’n, Inc. v. Devon Neighborhood Ass’n, Inc., 33 So.3d 48 (Fla.4th DCA 2009) (mediation can reduce costs; statute does not unduly interfere with private contract)
- United Auto. Ins. Co. v. Santa Fe Medical Center, 21 So.3d 60 (Fla.3d DCA 2009) (certiorari discussion on circuit court misapplication of statutes)
- Broward County v. G.B.V. Intern., Ltd., 787 So.2d 838 (Fla.2001) (certiorari standards for reviewing circuit-county decisions)
- Wekiva Springs Reserve Homeowners v. Binns, 61 So.3d 1190 (Fla.5th DCA 2011) (second-tier certiorari standards; clearly established law)
- Custer Med. Ctr. v. United Auto. Ins. Co., 62 So.3d 1086 (Fla.2010) (circuit court’s legal error; general applicability concern)