Homeowner can Recover Flood Limits and HO-3 Limit

In Florida Farm Bureau Casualty Insurance v. Mathis, ____ So.3d ____ (Fla. 1st DCA April 20, 2010), a home was significantly damaged as a result of Hurricane Ivan in September 2004.  The homeowners had a $250,000 flood policy and a $295,000 homeowners policy on the home. 

The homeowners submitted claims to both the flood carrier and their homeowners carrier, Florida Family.  The flood carrier paid its limits of $250,000 and Florida Family refused to pay its limits. Suit was filed against Florida Family and a jury found that the home was a total loss as a result of wind - a covered cause of loss under the Florida Family policy.  Pursuant to Florida Statute Section 627.702 - Florida's Valued Policy Law (VPL) - the trial court then entered final summary judgment against Florida Family for the policy limits less prior payments. 

Florida Family argued that the trial court erred in not reducing the judgment by the $250,000 previously paid by the flood insurer.

The appellate court determined that there should be no such offset or reduction in the judgment.  According to the 1st DCA, the juries inquiry was limited "solely to the amount of wind damage legally caused to the Mathises' residence and whether that wind damage caused a total loss either constructively or because of the cost to repair the damage."  Pursuant to the VPL Florida Family was obligated to pay its entire policy limits if the home was a total loss as a result of a covered cause of loss.  Based on the juries determination the home was a total loss as a result of wind - a covered cause of loss - and therefore the homeowner was entitled to the policy limits from Florida Family. 

1st DCA Rules on Valued Policy Law, Debris Removal, Law and Ordinance, and Prejudgment Interest

In Citizens Property Ins. Corp. v. Mallett, 2009 WL 485038 (Fla. 1st DCA Feb. 27, 2009), the First DCA dealt with three issues which are common in homeowners insurance claims: 1) interpreting Florida’s Valued Policy Law (VPL); 2) when payment is due under debris removal, and law and ordinance coverage; and 3) when prejudgment interest begins to running after a loss.

VPL

In Mallett, wind and flood combined to render the home a constructive total loss. Wind damage was a covered cause of loss under the Citizens’ policy, and flood damage was excluded. There was uncontroverted evidence that the wind was a “substantial” cause of the loss to the Mallett’s home. The insureds argued that under Florida Statute Section 627.702(1), Florida’s VPL, Citizens was required to pay its entire policy limits because the home was a constructive total loss, and wind substantially contributed to causing that total loss. The trial court agreed, granting summary judgment to the insured for the entire policy limits.

The 1st DCA reversed, holding that Fla. Farm Bureau Cas. Ins. Co. v. Cox, 967 So. 2d 815 (Fla. 2007) governed:

The summary judgment on appeal is expressly contrary to the holding in Cox, and accordingly, we reverse that part of the summary judgment granting the Malletts additional compensation for the damage sustained to their residence not solely attributable to wind.

However, in my mind, this still leaves open several issues. Who has the burden of proof at the trial level to prove which portion of the loss is due to the uncovered peril of flood?  Typically, if an insurer is claiming that all or a portion of a loss is due to an excluded peril, then the insurer has the burden of proving which portion of the loss is due to the excluded peril. Thus, if these two perils (wind and flood) combined to cause the loss, then does the insurance company need to prove by a preponderance of the evidence which part of the loss was due to flood? Or, does the insured have to prove which portion is due to wind?  There is also an issue raised by the “anti-concurring cause clause” that is typically present in these types of policies.

Debris Removal and Law and Ordinance Coverage

In Mallett, the insured argued that because the home was a total loss, and the insurer owed its entire policy limits under the VPL, then Citizens was required to pay out under the debris removal and the law and ordinance coverage. It is unclear from the opinion if the insureds had actually incurred these expenses, or were seeking these as additional coverages that were simply due because they had recovered the entire policy limits at the trial level.  In any event, the 1st DCA held that summary judgment was improper on the issues of debris removal and law and ordinance, and that there would need to be a trial on the issue of how much was due under these two additional coverages that was attributable to wind alone.

Prejudgment Interest

The insureds argued that they were entitled to prejudgment interest running from the date of the loss.  However, the Citizens’ policy specifically stated that Citizens was not obliged to pay a claim until twenty days after it reached a written agreement with the Malletts, or sixty days after entry of a final judgment on the claim or after the filing of an appraisal award or mediation settlement with Citizens.  Relying on this language, the court sided with Citizens and held that: “It is the terms of a contract for insurance which determine the date from which the coverage payment is due, as well as when interest is due on the amounts payable.”

Obviously, this ruling allows an insurance company to breach the insurance contract, force the insured to file suit, retain the use of the money while the case is litigated, and not be liable for interest on the money they illegally retained.

One way to possibly avoid this result is to file a Civil Remedy Notice pursuant to Florida Statute 624.155, and then seek the prejudgment interest as damages in a subsequent bad faith case.

Supreme Court Quashes 3 More Mierzwa Cases in the Wake of Cox

On March 27, 2008 the Florida Supreme Court quashed three more First DCA "Valued Policy Law" cases which had been decided pursuant to Mierzwa v. Florida Windstorm Underwriting Ass'n, 877 So. 2d 774 (Fla. 4th DCA 2004).  The Mierzwa court had interpreted the VPL in such a way that a total loss required payment of the policy's face amount, regardless of liability and causation: "[T]he VPL provides that any liability of a casualty insurer where a covered peril is involved in a total loss must be for the face amount rather than pro rata with other coverages." Id. at 776.  

Soon after, a legislative fix followed.  Then, 2007, the Florida Supreme Court stepped in and expressly disapproved of Mierzwa's interpretation of the VPL.  In Fla. Farm Bureau Cas. Ins. Co. v. Cox, 967 So. 2d 815 (Fla. 2007), the supreme court held the prior version of the VPL was intended only to set the valuation of the insured property.  The court also determined that the VPL did not intend for an insurer to pay for the total loss if a covered peril caused part of the total loss. 

In Citizens Property Insurance Corp. v. Dancy, Citizens Property Insurance Corp. v. Ueberschaer, and State Farm Florida Insurance Company v. Ondis, the First DCA had determined the VPL required a carrier to pay the face amount of the policy when the structure was deemed a total loss, but the damage was caused in part by a covered peril and in part by an excluded peril.  The supreme court referenced its recent decision in Cox, and quashed the First Districts opinions and remanded the cases for reconsideration in light of Cox. 

Another Post-Cox blow to the Valued Policy Law

Citizens Property Insurance Corporation v. Manning, 32 FLW D2458c (Fla. 1st DCA October 15, 2007)

In this newly decided case, the insured homeowners sought to recover from their homeowner's insurer for the total loss of their home as a result of Hurricane Ivan which devestated the north-west coast of Florida on September 16, 2004. 

The trial court granted summary judgment in favor of the homeowner, and against Citizens Insurance Company.  The homeowner presented evidence at the summary judgment hearing that the total loss of their home was due, at least in part, by wind - a covered cause of loss.  The trial court held that under Florida Statute Section 627.702 the Valued Policy Law, the insured was owed the total policy limits under their homeowners insurance because the total loss was due "in part" to the wind damage. 

However, the trial court made this ruling before the Florida Supreme Court had ruled on the VPL in Florida Farm Bureau Casualty Insurance Co., v. Cox,  32 FLW S564 (Fla. Sept. 20 2007).  In Cox, the Supreme Court ruled that the VPL "does not establish any requirement for an insurer to pay for excluded or noncovered perils" identified by a windstorm policy as such.  Thus, the policy controls, not the VPL.  In this case, the Citizens' policy excludes coverage for loss caused directly or indireectly by "water damage," which includes "flood, surface water, waves, tidal water, storm surge, wave wash, or total wave overflow of a body of water, or spray from any of these, whether or not driven by wind," and, except in certain circumstances, even wind-driven rain.  The policy also contains an anti-concurrent cause clause, providing that losses to which excluded perils contribute are "excluded regardless of any other cause or event contributing concurrently or in any sequence."  The First DCA then noted that the record before it did not identify which damage to the house was done by wind alone, or the amount of any such damage. 

Thus, the parties were sent back down to the trial court level to determine which portion of the loss was due to wind - a covered cause of loss, and which portion was due to items that were not covered.  Obviously, the insured will argue that the burden of proof is on the insurance company to prove what portion is of the loss is excluded.  Given the "anti-concurring cause clause," the insurance company will probably argue that they do not owe any of the loss as long as the loss is caused in part by a covered cause of loss, and in part by an excluded cause of loss.  I expect to see this case back up on appeal regardless of what happens.