Policyholders and Public Adjusters Beware of Claims Notice Deadlines! Florida Supplemental and Reopened Claims Statute Causes Potential Claims Denials For Otherwise Covered Claims

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Florida is the one state to handle and supply a statutory definition for a “re-opened claim” or a “supplemental claim.” Florida’s regulation isn’t a client safety regulation. Instead, it’s an insurance coverage firm safety regulation. The present wording of Florida’s statute on Supplemental and Reopened claims reads as follows:

627.70132 Notice of property insurance coverage declare.—

(1) As used on this part, the time period:

(a) “Reopened claim” means a declare that an insurer has beforehand closed, however that has been reopened upon an insured’s request for extra prices for loss or injury beforehand disclosed to the insurer.

(b) “Supplemental claim” means a declare for extra loss or injury from the identical peril which the insurer has beforehand adjusted or for which prices have been incurred whereas finishing repairs or alternative pursuant to an open declare for which well timed discover was beforehand supplied to the insurer.

(2) A declare or reopened declare, however not a supplemental declare, underneath an insurance coverage coverage that gives property insurance coverage, as outlined in s. 624.604, together with a property insurance coverage coverage issued by an eligible surplus strains insurer, for loss or injury brought on by any peril is barred until discover of the declare was given to the insurer in accordance with the phrases of the coverage inside 1 yr after the date of loss. A supplemental declare is barred until discover of the supplemental declare was given to the insurer in accordance with the phrases of the coverage inside 18 months after the date of loss. The time limitations of this subsection are tolled throughout any time period of deployment to a fight zone or fight assist posting which materially impacts the flexibility of a named insured who’s a servicemember as outlined in s. 250.01 to file a declare, supplemental declare, or reopened declare.

(3) For claims ensuing from hurricanes, tornadoes, windstorms, extreme rain, or different weather-related occasions, the date of loss is the date that the hurricane made landfall or the twister, windstorm, extreme rain, or different weather-related occasion is verified by the National Oceanic and Atmospheric Administration.

(4) This part doesn’t have an effect on any relevant limitation on civil actions supplied in s. 95.11 for claims, supplemental claims, or reopened claims well timed filed underneath this part.

One problem is whether or not these notices have to offer estimates of harm, as I famous in Supplemental or Reopened Claims—Does the Notice Have to Include Some Type of Estimate:

What is the lesson from this holding, and does this imply that the discover doesn’t have to incorporate an estimate of harm? ‘Better safe than sorry’ is the lesson. Estimates and full descriptions of loss needs to be supplied. The courtroom famous that its holding is opposite to a different appellate courtroom, which raises the chance that the problem could possibly be resolved by the Florida Supreme Court. Other appellate courts might discover by hook or by crook till this authorized tie is damaged.”

A federal appellate courtroom simply determined that an estimate isn’t required. 1 It first famous that Florida courts are break up on the problem and that the Florida Supreme Court has not weighed in:

In this case, there aren’t any related selections from the Florida Supreme Court decoding § 627.70132. Two Florida appellate courts, nevertheless, have weighed in. The first is Goldberg v. Universal Property & Casualty Insurance Co., from Florida’s Fourth District Court of Appeal. In Goldberg, the courtroom examined whether or not an insured get together ‘was required to submit a supplemental claim before filing suit for additional payment for’ its loss…Finding that the insured’s try to say further fee for an already adjusted loss certified as a supplemental declare underneath § 627.70132, the courtroom concluded that the insured ‘was required to file a supplemental claim setting forth those damages he sought in excess of what the insurance company had already paid.’…The courtroom said {that a} ‘competing estimate by an insured’s unbiased adjuster, or by a potential contractor’ would suffice….

The second state appellate courtroom resolution on level was issued after the district courtroom granted abstract judgment to Great Lakes under. In Patios West One Condominium Association, Inc. v. American Coastal Insurance Co., Florida’s Third District Court of Appeal held that § 627.70132 doesn’t require a discover of a supplemental declare to include an estimate of further damages…Instead, the statute requires solely that ‘the notice of a supplemental or reopened claim (1) be ‘given to the insurer in accordance with the terms of the policy’ and (2) represent an ‘additional claim for recovery’ for losses from ‘the same hurricane.’ ‘ Id. (quoting Fla. Stat. § 627.70132).

The Patios courtroom explicitly rejected Goldberg’s assertion that § 627.70132 required a damages estimate, reasoning that the statute’s plain textual content didn’t include any such requirement and that the statute was not a ‘supplemental claim statute’ however a ‘notice of supplemental claim statute,’ delineating solely the time interval by which an insured should give discover to its insurer of the existence (however not the exact quantity) of a supplemental declare. Id. It additionally dismissed this portion of Goldberg as nonbinding dicta.”

The appellate courtroom adopted the Patios case discovering as follows:

Concourse Plaza urges this Court to observe Patios, arguing that Goldberg is each factually distinguishable and wrongly determined. We needn’t decide whether or not Goldberg would apply to this case, nevertheless, as a result of as a federal courtroom making use of state regulation, we’re sure to use Patios in any occasion. This lawsuit originated within the Miami Division of the United States District Court for the Southern District of Florida. ‘State courts located there are within the territory of, and are bound to follow decisions issued by, the Third District Court of Appeal.’…. Therefore, as a result of that is an enchantment of a case arising out of the Miami Division, we apply the Third District Court of Appeal’s Patios resolution.

No one disputes that Concourse Plaza’s September 2020 letter sought further restoration for losses from the identical hurricane—Hurricane Irma—as the unique declare. And Great Lakes concedes that the insurance coverage coverage by itself ‘does not impose a requirement to provide an estimate of damages.’ Concourse Plaza’s September 2020 letter due to this fact qualifies as a discover of a supplemental declare underneath Fla. Stat. § 627.70132. Because it was despatched inside three years of the date Hurricane Irma made landfall, the provisions of Fla. Stat. § 627.70132 had been happy.

Policyholders and public adjusters needs to be conscious that this resolution adopted the regulation when it was first made in 2011. As Ashley Harris famous in September 10, 2020 is Not the Statute of Limitations for Hurricane Irma Claims, the older Supplemental and Reopened claims statute allowed for 3 years to offer discover.

Now, the newer statute has a one-year time restrict for a reopened declare and 18 months for a supplemental declare. While not a statute of limitation, failure to adjust to the discover provisions successfully bars additional restoration. This statute is essential as a result of insurers will use it to restrict the quantity owed whatever the declare’s benefit.

Thought For The Day

Procrastination is sort of a bank card: it’s plenty of enjoyable till you get the invoice.
—Christopher Parker


1 Great Lakes Ins. SE v. Concourse Plaza A Conominium Assoc., No 22-13141 (eleventh Cir. Apr. 15, 2024).

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