YOLANDA VARGAS v. SAFEPOINT INSURANCE COMPANY
19-1656
| Fla. Dist. Ct. App. | Jan 12, 2022Background
- Vargas held a Safepoint homeowners policy and submitted a sworn proof of loss for water damage from a plumbing leak. She did not provide prior repair invoices or pre-loss photos requested by Safepoint.
- In interrogatories and deposition, Vargas denied any prior water-damage claims on the property; she later testified she had simply forgotten a prior claim.
- Safepoint discovered a 2013 Citizens Property Insurance claim for a broken water pipe that listed many of the same damaged areas and added a "Concealment or Fraud" affirmative defense under the policy.
- The policy’s relevant clause disclaims coverage where an insured has: (a) intentionally concealed or misrepresented a material fact; (b) engaged in fraudulent conduct; or (c) made material "false statements relating to this insurance."
- The trial court granted summary judgment for Safepoint on the concealment/fraud defense; Vargas appealed. The appellate court examined whether "false statements" in the post-loss forfeiture context requires intent and whether summary judgment was appropriate.
Issues
| Issue | Plaintiff's Argument (Vargas) | Defendant's Argument (Safepoint) | Held |
|---|---|---|---|
| Whether "false statements" in the post-loss concealment/fraud clause requires intent to deceive or merely incorrectness | "False" can mean an innocent incorrect statement; Vargas argues she forgot the prior claim, so no intent | "False statements" need not be innocent; any false statement defeats coverage (or at least the policy can be read to forfeit coverage) | The court holds that in the post-loss forfeiture context "false statements" includes an intent-to-deceive element; interpretation favors insured and requires intent |
| Whether summary judgment was appropriate given the evidence of a prior similar claim | Vargas: she credibly testified she forgot the prior claim; that creates a genuine issue of material fact regarding intent | Safepoint: similarity of claims makes forgetfulness incredible; facts establish intent so summary judgment should stand | The court reversed and remanded because intent is required and Vargas’s claimed forgetfulness raises a genuine issue of material fact; the appellate court did not resolve the factual credibility dispute |
| Motion to dismiss for fraud on the court based on Vargas’s sworn testimony | Vargas: her sworn testimony that she forgot was truthful as she remembered it then | Safepoint: the sworn omissions/evasions amount to fraud on the court | Trial court denied dismissal for fraud on the court; appellate court affirmed that denial |
Key Cases Cited
- Anchor Property & Casualty Ins. Co. v. Trif, 322 So. 3d 663 (Fla. 4th DCA 2021) (interpreting "false statements" to import knowledge and intent to deceive)
- U.S. Fire Ins. Co. v. Dickerson, 90 So. 613 (Fla. 1921) (similar forfeiture language construed to require element of fraud)
- Johnson v. Life Ins. Co. of Ga., 52 So. 2d 813 (Fla. 1951) (forfeitures under insurance policies are disfavored)
- Universal Prop. & Cas. Ins. Co. v. Johnson, 114 So. 3d 1031 (Fla. 1st DCA 2013) (misrepresentations in applications need not be intentional to affect insurer’s risk or support rescission)
- Volusia Cnty. v. Aberdeen at Ormond Beach, L.P., 760 So. 2d 126 (Fla. 2000) (summary judgment standard)
- American Integrity Ins. Co. v. Estrada, 276 So. 3d 905 (Fla. 3d DCA 2019) (policy provisions limiting liability construed against drafter)
- Kieser v. Old Line Life Ins. Co. of Am., 712 So. 2d 1261 (Fla. 1st DCA 1998) (misstatements in insurance applications need not be intentional for denial of recovery)