Wednesday, February 3, 2010

Order Compelling Appraisal Of Hurricane Damage Reversed As Premature

In Sunshine State Insurance Company v. Corridori (4D09-2502), the Fourth District reversed the trial court's order compelling appraisal of a Hurricane Wilma claim because the court "concluded that the appraisal was premature." 

After an initial claim for damages was paid, the insurer closed the claim.  However, "two years later, appellees submitted a 'supplemental claim' for damages discovered by a public adjuster."  After demanding certain documents (and claiming the insured did not comply, the insurer "denied the claim, concluding that the damages claimed were not in fact 'supplemental' to the original damages. Appellants further claimed that appellees breached the contract by failing to comply with the proof of loss requirement, and appellees materially breached the policy."

Because the insurer denied coverage, appraisal is not yet appropriate.  According to the opinion, "Issues of coverage are 'for judicial determination by a court,' not the appraisal panel. Id. [Johnson v. Nationwide Mutual Insurance Co., 828 So. 2d 1021, 1026 (Fla. 2002)]. Once the court establishes that the losses are covered by a policy, then those losses may be appraised."  The court then stated:
The parties dispute whether the claimed losses are covered by the policy and whether appellees complied with the policy requirements. Specifically, appellees claim that their compliance with the policy requirements was not necessary because appellant previously admitted coverage....By contrast, appellant claims it never admitted coverage and maintains that appellees’ compliance with the policy demands was insufficient....Whether appellees’ compliance with the policy terms was necessary or sufficient is a dispute of fact. The trial court, without taking any evidence, did not resolve this dispute of fact with competent evidence to support its determination of coverage. Because the trial court must resolve all underlying coverage disputes prior to ordering an appraisal, we reverse and remand for further proceedings consistent with this opinion.


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