State Farm v. Cardelles , 159 So. 3d 239 ( 2015 )

Third District Court of Appeal
State of Florida
Opinion filed February 25, 2015.
Not final until disposition of timely filed motion for rehearing.
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No. 3D14-241
Lower Tribunal No. 10-42500
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State Farm Florida Insurance Company,
Appellant,
vs.
Miguel and Graciela Cardelles,
Appellees.
An Appeal from a non-final order from the Circuit Court for Miami-Dade
County, David C. Miller, Judge.
Russo Appellate Firm, P.A., and Christopher D. Bailey and Elizabeth K.
Russo; Ubaldo J. Perez, Jr., for appellant.
Alvarez, Carbonell, Feltman, & DaSilva, PL, and Paul B. Feltman, for
appellees.
Before SHEPHERD, C.J., and ROTHENBERG and LOGUE, JJ.
ROTHENBERG, J.
State Farm Florida Insurance Company (“State Farm”) appeals the trial
court’s order compelling appraisal of Miguel and Graciela Cardelles’ (“the
Plaintiffs”) supplemental Hurricane Katrina claim. Because we find that the
Plaintiffs complied with their post-loss obligations under the policy terms, we
affirm.
Hurricane Katrina and Hurricane Wilma hit South Florida on August 25,
2005, and October 24, 2005, respectively. The Plaintiffs reported home damage to
their homeowners’ insurance carrier, State Farm, following each hurricane. After
obtaining estimates from a contractor and then from public adjuster/attorney
Robert Behar, the Plaintiffs submitted sworn proofs of loss for the damages caused
by each hurricane. State Farm made a net payment (after the Plaintiffs paid a
nearly $10,000 deductible) of approximately $19,000 on the Hurricane Katrina
claim and approximately $13,000 on the Hurricane Wilma claim. The Plaintiffs
repaired their roof and made other minor repairs to their home with State Farm’s
payout, but the Plaintiffs now claim that State Farm’s payment was insufficient to
fully repair the damage from the hurricanes.
Four years later, the Plaintiffs hired another public adjuster, Eduardo
Rodriguez, who submitted a supplemental claim for the Plaintiffs to State Farm on
March 15, 2010, demanding that the Plaintiffs’ claim be reopened and requesting
an additional $127,000 in damages. The date of loss was listed as the date
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Hurricane Katrina hit South Florida: August 25, 2005. State Farm responded to
the request with a letter explaining the Plaintiffs’ post-loss obligations under the
policy. Pursuant to those post-loss obligations, State Farm wrote to the Plaintiffs
on three occasions requesting photographic or video evidence of the damages,
receipts and documentation of purchases and repairs, bank account statements
showing expenditures, and an updated sworn proof of loss from the Plaintiffs to be
made within 60 days of each letter. The record establishes that State Farm
believed the Plaintiffs were requesting reimbursement for newly discovered
damages that had already been repaired, however, the Plaintiffs are in fact claiming
additional payment for the damages initially incurred from the hurricanes that they
allege have not been repaired to this day. The Plaintiffs did not submit any of the
requested documents because they have not yet made any additional repairs, so
there are no documents to be submitted. Moreover, the Plaintiffs have made their
home available to State Farm for inspection of the damages, and State Farm has
inspected the home.
On August 4, 2010, after State Farm refused to pay any additional money for
the supplemental damages claimed by the Plaintiffs, the Plaintiffs filed suit against
State Farm alleging that State Farm had breached the insurance policy by failing to
pay the additional repair costs. After some discovery, State Farm filed a motion
for final summary judgment, arguing that the Plaintiffs had not complied with their
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post-loss obligations to provide requested documentation, including an updated
sworn proof of loss. The Plaintiffs, in turn, filed a Motion to Compel Appraisal
and Abate the Action, to which they attached a joint sworn proof of loss that stated
that they were requesting $117,297.53 in damages incurred as a result of Hurricane
Katrina, but that they were not attaching any receipts, photos, or documentation
with the claim. The sworn proof of loss was notarized and dated April 8, 2010.
The trial court ultimately denied two of State Farm’s motions for summary
judgment.
The parties conducted some additional discovery, and the motion to compel
appraisal was not heard until January 29, 2014, nearly three years after it was filed.
At that hearing, Mr. Cardelles testified that the Plaintiffs had provided sworn
proofs of loss, as well as documentation regarding damages and expenses (receipts,
photos, etc.), to State Farm immediately following the hurricanes in 2005. He also
testified that they replaced the roof with the approximately $32,000 they received
from State Farm but were unable to make other repairs, particularly to the interior
of the home, because State Farm’s payment was insufficient to cover the full cost.
The Plaintiffs also testified that they did not submit any of the documentation State
Farm had requested because they “didn’t have anything else to send.”
The trial court found that the supplemental claim was based on the original
damages from the 2005 claim rather than additional repairs that had been made,
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and that the Plaintiffs had no additional documents to provide. The trial court
ultimately ruled that the Plaintiffs had sufficiently complied with their post-loss
obligations in the insurance policy and ordered a detailed appraisal to determine
the amount of damages and the cause of each item of damage within ninety days.
State Farm timely appealed the trial court’s order compelling appraisal.
“A challenge to coverage is, as the Florida Supreme Court has confirmed, a
matter for determination by a court; whereas, a challenge to the amount of a
covered loss is for determination by an appraisal panel.” Citizens Prop. Ins. Corp.
v. Mango Hill Condo. Ass’n 12 Inc., 54 So. 3d 578, 581 (Fla. 3d DCA 2011)
(citing Johnson v. Nationwide Mut. Ins. Co., 828 So. 2d 1021, 1022 (Fla. 2002)).
This Court has held on several occasions that the trial court may exercise its
discretion when determining whether to compel appraisal of an insurance claim
before determining whether the policy covers the claimed loss. See, e.g., id.;
Sunshine State Ins. Co. v. Rawlins, 34 So. 3d 753, 754 (Fla. 3d DCA 2010) (citing
Paradise Plaza Condo. Assoc. v. Reinsurance Corp. of New York, 685 So. 2d 937
(Fla. 3d DCA 1996) (en banc)). However, we have also held that “an ‘insured
must comply with all of the policy’s post-loss obligations before the appraisal
clause is triggered.’” Mango Hill 12, 54 So. 3d at 581 (quoting U.S. Fid. & Guar.
Co. v. Romay, 744 So. 2d 467, 471 (Fla. 3d DCA 1999) (en banc)); see also First
Home Ins. Co. v Fleurimond, 36 So. 3d 172, 174 (Fla. 3d DCA 2010). “Until
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these [post-loss obligation] conditions are met and the insurer has a reasonable
opportunity to investigate and adjust the claim, there is no ‘disagreement’ (for
purposes of the appraisal provision in the policy) regarding the value of the
property or the amount of loss.” Citizens Prop. Ins. Corp. v. Galeria Villas Condo.
Ass’n, 48 So. 3d 188, 191 (Fla. 3d DCA 2010).
The trial court in this case found that the Plaintiffs had “sufficiently
complied” with the policy’s post-loss obligations, citing this Court’s opinion in
Mango Hill 12. See 54 So. 3d at 582 (“Because [the trial court compelled
appraisal without holding an evidentiary hearing to determine whether the insured
had complied with his post-loss obligations], we reverse the order compelling
appraisal and remand for an evidentiary hearing on whether [the insured] Mango
Hill sufficiently complied with the policy’s post-loss requirements.” (emphasis
added) (citing Corridori, 28 So. 3d at 131)). The trial court’s order seems to
suggest that our Mango Hill 12 decision substantially changed the requisite
standard to obtain appraisal to require something less than full compliance with all
post-loss obligations, as had been mandated by our numerous past holdings.
However, a full reading of Mango Hill 12, along with a litany of our other cases on
this subject, confirms that “sufficient compliance” still requires that all post-loss
obligations be satisfied before the trial court can properly exercise its discretion to
compel appraisal. Id. (holding that “an ‘insured must comply with all of the
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policy’s post-loss obligations before the appraisal clause is triggered.”’ (quoting
Romay, 744 So. 2d at 471)); see also Citizens Prop. Ins. Corp. v. Gutierrez, 59 So.
3d 177, 179 (Fla. 3d DCA 2011) (citing Romay for that same proposition after
Mango Hill 12 was issued).
Despite the confusion on which standard to apply, we cannot say that the
trial court abused its discretion by compelling appraisal of the Plaintiffs’ claimed
damages on these particular facts. State Farm admits that the Plaintiffs complied
with all post-loss obligations immediately following the hurricanes in 2005, and
the Plaintiffs have provided State Farm with an updated sworn proof of loss
detailing all of the damages they are claiming. Moreover, because these damages
are the same as those claimed from the original hurricane damage, State Farm
already has all the required documentation of the damages, and the Plaintiffs have
also agreed on many occasions to open their home to State Farm for further
inspection of the damages. Thus, the trial court did not abuse its discretion by
granting the Plaintiffs’ motion to compel appraisal.
Affirmed.
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