On January 16th, 2019, the Third District Court of Appeals for the State of Florida ruled in favor of a homeowner in a property insurance dispute. In the case of Safepoint Insurance Company vs. Eduardo Gomez, et al., the court affirmed the decision of a lower court — determining that the insurance company improperly denied a claim based on a homeowner’s supposed failure to comply with post-loss obligations. In this article, our Fort Lauderdale property insurance attorneys provide an overview of the key facts of this case and explain the implications for policyholders.
Case Analysis: Safepoint Insurance Company vs. Eduardo Gomez, et al.
The Facts
Eduardo Gomez filed a property damage insurance after a toilet overflow caused substantial damage at his home. Safepoint Insurance Company investigated his claim, acknowledged that he suffered a covered loss, and sent him an initial payment for the damages. However, Mr. Gomez disputed the amount of the payment. Soon after, Safepoint Insurance invoked its appraisal rights.
The Issue
After initial negotiations, no agreement could be reached. The appraiser for each side selected a neutral umpire in order to help bring a resolution to the case. The neutral umpire was scheduled to conduct his own investigation of the home to help assess the true value of the damage. However, Safepoint Insurance then sent Mr. Gomez a letter — demanding that he and other individuals submit to an examination under oath and demanding the production of at least 24 different types of documents. Mr. Gomez did not respond to the requests as to not interfere with the appraisal that was invoked by the insurance company. The insurance company denied his claim for failure to comply with “poss-loss obligations”. Mr. Gomez then filed a breach of contract claim against Safepoint Insurance.
The Decision
After reviewing the case, Florida’s Third District Court of Appeals determined that Safepoint Insurance improperly put additional, unreasonable post-loss obligations on its policyholder. The company had already previously acknowledged that the loss was covered. In addition, the appraisal process was nearing its completion and Safepoint Insurance failed to produce evidence that indicated that the neutral umpire needed any more documents or information to determine the value of the loss. By previously invoking its appraisal rights, Safepoint had already waived other post-loss requirements.
The Implications
As a policyholder, you have a duty to comply with the post-loss obligations contained in your insurance agreement. That being said, the insurance company must apply those obligations in a reasonable and fair manner. Insurers do not have the right to make burdensome document requests very late in the claims process.
Contact Our Fort Lauderdale Property Insurance Lawyers Today
At Geyer Fuxa Tyler, our legal team is made up of a diverse combination of attorneys who are well-positioned to protect the legal rights and financial interests of policyholders, just as they did for Mr. and Mrs. Gomez. If your property insurance claim was denied, we can help. For a free consultation, please call us today at (954) 990-5251. With an office in Sunrise, we represent policyholders in Broward County and throughout the state of Florida.
Resource:3dca.flcourts.org/opinions/3D18-1366.co.pdf
