The critical importance of homeowners insurance following a serious loss caused by windstorm, fire, or other hazard can hardly be overstated.  While a homeowner's policy provides vital financial protection against a potentially devastating loss, insurance companies deny many legitimate insurance claims.  This tendency of insurers to search for defensible reasons to refuse to pay a claim makes it imperative that homeowners carefully read and understand their policy.  Every homeowners policy imposes certain duties on the insured to undertake post-loss actions.  Failure to comply with these conditions can result in the insurance company having a valid basis to refuse to pay a claim.

The recent Florida Third District case of State Farm Insurance Company v. Xirinachs, et al. provides an example of the fundamental way that non-compliance with the terms of an insurance policy can adversely impact the insured in the claims process.  The insured brought a claim for supplemental benefits under a policy with the insurer after their home was allegedly damaged during Hurricane Wilma.  The insured sought an order compelling appraisal which was granted by the trial court.

In analyzing the insured’s request, the trial court assumed based on the prior 3rd District Court of Appeals case Citizens Property Insurance Corp. v. Mango Hill Condominium Association that an order compelling appraisal could be based on less than full compliance with post-loss duties under a homeowner's policy.  In Mango Hill, the court reversed an order compelling appraisal and remanded the case to the trial court.  The trial court was directed to conduct an evidentiary hearing to evaluate the facts of the case to decide if the insured adequately complied with post-loss obligations.

However, the 3rd DCA in Xirinachs observed that the trial court did not have the benefit of a subsequent 3rd DCA decision in State Farm Insurance Company v. Cardellas.  The court in Cardellas clarified that ALL post-lost conditions must be satisfied before the insured can seek an order compelling appraisal.  The court indicated that when Mango Hill was read in light of Cardellas, the requirement of “sufficient compliance” was to be understood “to require that all post-loss obligations be satisfied before the trial court can properly exercise discretion to compel appraisal.”

The court then applied this clarified standard to the facts of the Xirinachs request for an order compelling appraisal.  The court noted that the homeowners failed to take proper steps to mitigate further damage or to provide documentation to facilitate processing the claim as required by the policy.  Given this failure to comply with post-loss conditions, the court reversed the order requiring appraisal.  Every homeowner's policy contains conditions that must be fulfilled before an insurance company is required to pay a claim.  Failure to satisfy these post-loss conditions can prevent homeowners who have suffered a devastating loss from receiving benefits under a policy.  

You can reach Miami Insurance Claims Lawyer J.P. Gonzalez-Sirgo by dialing his direct number at (786) 272-5841, calling the main office at (305) 461-1095, or Toll Free at 1 (866) 71-CLAIM or email Attorney Gonzalez-Sirgo directly at [email protected].

J.P. Gonzalez-Sirgo
J.P. Gonzalez-Sirgo, P.A.
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