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How can a policyholder report a loss that the policyholder doesn’t know of? Do any property insurance coverage insurance policies require the policyholder to examine the insured property on a day by day or routine foundation, on the lookout for proof of a loss? Do any property insurance coverage executives climb on their very own roofs and search for injury following a thunderstorm or hailstorm?
Yet, the insurance coverage firm claims executives will deny claims after a loss and have their insurance coverage firm attorneys argue to judges that policyholders have an obligation to report losses—even when they have no idea of the loss. How can a policyholder do this?
This was the state of affairs in a case determined this week1 the place a policyholder notified the provider as soon as the policyholder knew of the loss. The construction was leased, and the policyholder didn’t know of or discover the loss till the tenant left the construction.
Here is the courtroom’s evaluation:
Castro contends that the trial courtroom erred in figuring out that, as a matter of regulation, offering discover to Citizens greater than two years after the loss couldn’t represent immediate discover. Castro posits that the related focus ought to have been on when Castro grew to become conscious of the loss and whether or not her actions have been affordable in mild of that consciousness. Castro argues that as a result of she offered an affidavit explaining the delay in reporting the loss, and establishing that she reported it promptly upon discovering it, there stays a real situation whether or not she complied together with her responsibility underneath the coverage to promptly report the loss.
…
It is undisputed that Castro didn’t present discover of the loss till almost two-and-a-half years after Hurricane Irma.
The courtroom famous the related coverage language:
In case of a loss to coated property, we have now no responsibility to supply protection underneath this Policy if the failure to adjust to the next duties is prejudicial to us. These duties should be carried out both by you, an insured searching for protection, or a consultant of both:
1. Give immediate discover to us or your insurance coverage agent.
The courtroom then defined the regulation underneath Florida precedent if discover is late:
[T]he phrase ‘prompt,’ when it comes to discover, ‘is synonymous with ‘forthwith,’ ‘immediate,’ and ‘as soon as practicable.’ Stated in another way, to fulfill the duty to supply immediate discover, such ‘notice should be provided ‘with reasonable dispatch and within a reasonable time in view of all the facts and circumstances of the particular case.’ The obligation to supply discover arises ‘when there has been an occurrence that should lead a reasonable and prudent man to believe that a claim for damages would arise’ ’ ….Whether discover was offered in a immediate method is ordinarily a query for the factfinder…however ‘if the undisputed evidence will not support a finding that the insured gave notice to the insurer as soon as practicable, then a finding that notice was timely given is unsupportable.’…
Our resolution in Navarro—additionally arising out of a Hurricane Irma declare– is instructive. In Navarro, the insured filed go well with in opposition to Citizens for breach of contract, asserting the house by which he was residing was broken by Hurricane Irma on September 10, 2017. Citizens denied the declare as a result of, inter alia, Navarro didn’t present discover of the loss till May 5, 2020. The trial courtroom granted abstract judgment in favor of Citizens, upon a dedication that the insured’s discover to the insurer was not immediate, elevating a presumption of prejudice which Navarro did not rebut. We affirmed, noting the insured’s personal deposition testimony by which Navarro acknowledged that he observed leaks all through his residence the day after Irma struck; he noticed roof leaks in his home and tried to make repairs roughly a month after the hurricane; he made much more roof repairs, together with changing roof tiles, the next yr; however waited greater than two and a half years to report the declare. Navarro conceded that ‘his only explanation for failing to report the damages to Citizens was a lack of fluency with the terms of the policy.’ We affirmed the ultimate abstract judgment, holding there was no real situation of reality in dispute whether or not Navarro acted ‘with reasonable dispatch and within a reasonable time.’…
In Laquer….this courtroom held that regardless of an almost three-year delay in offering discover to Citizens, ‘issues of fact exist[ed] concerning when a reasonable and prudent person would believe that a potential claim for damages might exist,’ precluding abstract judgment. Specifically, the proof established that ‘damage to Laquer’s unit or the inside of the wall was not obvious till a number of years after Hurricane Wilma: nobody, together with Laquer, her tenant, her housekeeper, and the condominium supervisor and his brokers who frequently visited Laquer’s unit, was in a position to observe any injury to the wooden flooring or partitions of the unit previous to [the notice date] or was in any other case placed on discover to additional examine for injury.’….The Laquer courtroom did observe, nonetheless, that the date the insured found the complete extent of the injury was not essentially the triggering date both.
Under this regulation, the Florida courts appear to search for a prudent individual commonplace about when a policyholder would know {that a} potential declare for damages may exist.
Based on that authorized view, the appellate courtroom reversed the trial courtroom and held for the policyholder, making the next conclusion:
In this case, the injury to Castro’s property is alleged to have been brought on in September 2017, however was not reported till February 2020. This passage of time was defined by Castro, who averred that the property was occupied by a tenant throughout that point interval, that the tenant by no means suggested Castro of any injury, and that Castro herself was unaware of any injury to her property till the tenant moved out of the property in February 2020. Castro offered Citizens with discover of the loss lower than three weeks after turning into conscious of harm to her property. Given the proof submitted by Castro in opposition to the movement for abstract judgment, and in view of all of the details and circumstances of the actual case, a real situation of disputed reality stays as as to whether Castro gave immediate discover of the loss….
The jury should make that dedication.
Thought For The Day
There’s a distinction between magnificence and attraction. A fantastic lady is one I discover. A captivating lady is one who notices me.
—John Erskine
1 Castro v. Citizens Prop. Ins. Corp., No. 3D21-1847 (Fla. 3d DCA June 21, 2023).