WINSTON DIAS and KATHLEEN DIAS v. UNIVERSAL PROPERTY AND CASUALTY INSURANCE COMPANY, 20-2575

Homeowners Winston and Kathleen Dias suffered water damage on March 16, 2016 and hired emergency mitigators; a public adjuster later notified Universal Property & Casualty of the claim.
Universal acknowledged the claim, requested an inspection, a sworn proof of loss, and supporting documents, and reserved rights for late reporting.
Universal’s field adjuster inspected the property on May 2, 2016 and testified he had the information needed to prepare an estimate.
Universal sent repeated requests; denied the claim on July 12, 2016 for failure to submit the sworn proof of loss and documents; the sworn proof of loss and estimate were submitted about six weeks after denial.
The Diases sued in October 2017; Universal moved for summary judgment arguing the Diases breached post-loss conditions and prejudice to the insurer was presumed; the trial court granted summary judgment.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether failure to timely submit sworn proof of loss/documents bars coverage and suit	Dias: submitted proof and docs (albeit after denial) and substantially complied	Universal: no strict compliance before denial; failure forfeits coverage	Court: strict compliance lacking; presumption of prejudice applies but is rebuttable
Who bears burden to prove prejudice and whether Dias rebutted it	Dias: rebutted presumption via adjuster’s deposition showing insurer had needed info	Universal: presumption stands; Dias did not overcome it	Court: insured may rebut presumption; disputed fact exists whether insurer was prejudiced
Effect of statutory 90-day pay/deny requirement on prejudice	Dias: statutory timing does not automatically establish prejudice; denial can be reopened	Universal: statutorily compelled decision shows prejudice from lack of cooperation	Court: statutory timing is a relevant factor but not dispositive of prejudice

Bankers Ins. Co. v. Macias, 475 So. 2d 1216 (Fla. 1985) (presumption of prejudice when insured breaches notice provisions, but presumption is rebuttable)
Kramer v. State Farm Fla. Ins. Co., 95 So. 3d 303 (Fla. 4th DCA 2012) (untimely sworn proof of loss may give rise to presumed prejudice that insured must rebut)
Hunt v. State Farm Fla. Ins. Co., 145 So. 3d 210 (Fla. 4th DCA 2014) (applies Bankers presumption where insured’s untimely compliance failed to establish lack of prejudice)
State Farm Fla. Ins. Co. v. Figueroa, 218 So. 3d 886 (Fla. 4th DCA 2017) (untimely compliance and prejudice analysis under Bankers framework)
Rodrigo v. State Farm Fla. Ins. Co., 144 So. 3d 690 (Fla. 4th DCA 2014) (distinguishable where insured never provided sworn proof of loss before suit)
Goldman v. State Farm Fire & Cas. Gen. Ins. Co., 660 So. 2d 300 (Fla. 4th DCA 1995) (insurer relieved where insured failed to comply with conditions precedent such as examination under oath)
Chandler v. Geico Indem. Co., 78 So. 3d 1293 (Fla. 2011) (standard of review for summary judgment is de novo)