Progressive American Insurance Company v. Hillsborough Insurance Recovery Center, LLC, A/ A/ O Joel Wolf
CourtDistrict Court of Appeal of Florida
Date FiledNovember 4, 2022
Docket2D21-0058
StatusPublished
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Full Opinion
DISTRICT COURT OF APPEAL OF FLORIDA
SECOND DISTRICT
PROGRESSIVE AMERICAN INSURANCE COMPANY,
Appellant,
v.
HILLSBOROUGH INSURANCE RECOVERY CENTER, LLC,
a/a/o Joel Wolf, Ernessa Dennis Johnson, and Juan Gil,
Appellee.
PROGRESSIVE AMERICAN INSURANCE COMPANY,
Appellant,
v.
SHAZAM AUTO GLASS, LLC, a/a/o Amanda Stephens, Christopher
Patterson, Gabriel Marchezini, Rolando Rodriguez, and Jerri Lewis,
Appellee.
Nos. 2D21-58, 2D21-85
CONSOLIDATED
November 4, 2022
Appeals pursuant to Fla. R. App. P. 9.130 from the County Court
for Hillsborough County; James S. Moody, III, Judge.
Alexandra Valdes and Kurt T. Koehler of Cole, Scott & Kissane,
P.A., Miami, for Appellant.
Joseph R. Dawson of Law Offices of Joseph R. Dawson, P.A., Fort
Lauderdale, for Appellee Hillsborough Insurance Recovery Center,
LLC.
Earl I. Higgs, Jr., of Higgs Law, P.A., Orlando, for Appellee Shazam
Auto Glass, LLC.
SLEET, Judge.
In these consolidated appeals, which involve several county
court cases, Progressive American Insurance Company challenges
the county court's nonfinal orders denying Progressive's motions to
compel appraisal on windshield damage and replacement claims.1
We have jurisdiction.2 See Fla. R. App. P. 9.130(a)(3)(C)(iv)
(permitting appeal of nonfinal order determining entitlement to
1 We have sua sponte consolidated these appeals for purposes
of opinion only.
2 Progressive originally sought certiorari review of the county
court's orders in the circuit court. However, the cases were
transferred to this court after the change in appellate jurisdiction.
"This court has jurisdiction of this appeal from a nonfinal order that
determined Progressive's entitlement to appraisal under the
insurance policy." See Progressive Am. Ins. Co. v. Glassmetics, LLC,
343 So. 3d 613, 618 (Fla. 2d DCA 2022) (citing art. V, § 4(b)(1), Fla.
Const.; Fla. R. App. P. 9.030(b)(1)(B); Fla. R. App. P.
9.130(a)(3)(C)(iv); Progressive Am. Ins. v. Broward Ins. Recovery Ctr.,
LLC, 322 So. 3d 103, 104 (Fla. 4th DCA 2021)).
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appraisal under insurance policy). We reverse the orders because
the county court erroneously concluded (1) that Progressive failed to
make a good faith attempt to resolve the dispute before invoking
appraisal, (2) that appraisal was economically unrealistic for these
windshield claims due to the de minimis amount at issue, and (3)
that the appraisal provision was against the public policy
underlying section 627.428, Florida Statutes (2020).
I. FACTS AND PROCEDURAL HISTORY
A. 2D21-58
Joel Wolf, Ernessa Dennis Johnson, and Juan Gil (collectively,
insureds) each had a comprehensive automobile policy with
Progressive that provided coverage for windshield damage. After the
insureds' vehicles each sustained windshield damage, they
contracted with Clear Vision Windshield Repair, LLC, to have their
windshields repaired. Upon completion of the repairs, the insureds
assigned their rights and benefits to recover payment under their
policies to Clear Vision. Clear Vision sent its invoices to Progressive
for payment in the amount of $90.95 each. Progressive responded
by sending letters to Clear Vision and each insured stating that
Clear Vision "does not agree with" the amount Progressive had
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determined to be the reasonable amount necessary to repair the
windshield, and it contemporaneously issued checks to Clear Vision
each in the amount it had determined was reasonable for repair.3
The letters further stated that because a dispute existed with
respect to the amount of loss, Progressive was invoking its right to
appraisal under the policies. The policies' appraisal provisions were
all identical and provided:
If we cannot agree with you on the amount of the loss,
then we or you may demand an appraisal of the loss.
However, mediation, if desired, must be requested prior
to demanding appraisal. Within 30 days of any demand
for an appraisal, each party shall appoint a competent
and impartial appraiser and shall notify the other party
of that appraiser's identity. The appraisers will
determine the amount of the loss. If they fail to agree,
the disagreement will be submitted to an impartial
umpire chosen by the appraisers, who is both competent
and a qualified expert in the subject matter. If the two
appraisers are unable to agree upon an umpire within 15
days, we or you may request that a judge of a court of
record, in the county where you reside, select an umpire.
The appraisers and umpire will determine the amount of
loss. The amount of loss agreed to by both appraisers, or
by one appraiser and the umpire, will be binding. You
3 The letters do not indicate the amount Progressive
determined to be reasonable to repair the windshields. However, at
the June 4, 2020, evidentiary hearing on the applicability of the
prohibitive cost doctrine, the evidence presented indicated that the
amount at issue on each claim was approximately $25. That seems
to suggest that Progressive determined that a reasonable cost to
repair the windshields was around $65.
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will pay your appraiser's fee and expenses. We will pay
our appraiser's fees and expenses. All other expenses of
the appraisal, including payment of the umpire if one is
selected, will be shared equally between us and you.
Neither we nor you waive any rights under this policy by
agreeing to an appraisal.
Clear Vision did not respond to Progressive's invocation of
appraisal or seek to resolve the dispute in accordance with policy
provisions. Instead, it sold the claims and assigned the rights to
collect insurance benefits to Hillsborough Insurance Recovery
Center, LLC (HIRC), whose business practice involves purchasing in
bulk underpaid insurance claims. HIRC similarly did not respond
to Progressive's invocation of appraisal, nor did it demand
mediation or seek further negotiations. Rather, HIRC filed actions
against Progressive for breach of contract and alleged in its
complaints that it and Clear Vision had "performed all conditions
precedent to recover benefits" pursuant to the insurance contracts.
In response to the lawsuits, Progressive filed motions to
compel HIRC to participate in the appraisal process, arguing that
the policies' appraisal provision was a condition precedent to filing a
lawsuit and that HIRC should not be allowed to litigate the matter
because the appraisal process had not occurred. HIRC replied that
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the appraisal was not economically feasible due to the de minimis
amount of the claim ($90.95) and asserted that the prohibitive cost
doctrine rendered the appraisal provisions unenforceable.
The trial court held an evidentiary hearing, denied
Progressive's motions to compel appraisal, and struck the
mandatory component of the appraisal provisions set forth in the
insurance policies. The court found that Progressive failed to
negotiate "in good faith," and it therefore deemed the claims to be
unripe for appraisal. Although HIRC did not raise the issue of bad
faith negotiation, the court concluded that Progressive's use of the
phrase "does not agree" in its letters to Clear Vision implied that
Progressive failed to make a good faith effort to resolve the disputes
but instead unilaterally determined the amount it wanted to pay
and demanded that either Clear Vision accept the amount offered or
be forced into an expensive appraisal process.
The court also found that the "prohibitive cost doctrine does
not apply because the filing fee alone costs more than the appraisal
process." Nonetheless, it struck the mandatory nature of the
appraisal provisions for "small claims" because it determined that
requiring appraisal when the disputed amount is small "makes it
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economically unrealistic for an insured to seek redress." Lastly, the
court found that the mandatory nature of the appraisal provisions
defeated the purpose of section 627.428 by prohibiting a "prevailing
insured from recovering his expended appraisal costs." As such,
the court struck the mandatory component of the appraisal
provisions "on this very small claim" but deemed the provisions
valid for claims "where a larger amount is involved so that the
insured is not economically prohibited from seeking redress."
B. 2D21-85
Like the insureds in the HIRC case, Amanda Stephens,
Christopher Patterson, Gabriel Marchezini, Rolando Rodriguez, and
Jerri Lewis each obtained a comprehensive automobile policy from
Progressive that included coverage for windshield damage. After
their vehicles sustained windshield damage, they contracted with
Shazam to replace their windshields and executed an assignment of
benefits. Shazam sent invoices to Progressive in amounts ranging
from $593.42 to $1,073.42. In response, Progressive sent letters
stating its disagreement with the invoiced amounts and invoking its
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right to appraisal under the policies.4 At the same time, Progressive
tendered payment to Shazam in the amounts Progressive deemed
reasonable for each windshield replacement.
Shazam did not respond to Progressive's appraisal demands
and eventually filed actions against Progressive for breach of
contract, claiming that it had "performed all conditions precedent
and necessary" to recover benefits for the windshield replacements.
In response to the lawsuits, Progressive filed motions to compel
appraisal and stay discovery based on the same arguments it raised
in the HIRC case. After a nonevidentiary hearing, the trial court,
relying upon the analysis from its order in the HIRC case, rendered
an order denying Progressive's motion to compel appraisal and
striking the mandatory component of the appraisal clause.
II. ANALYSIS
"When reviewing a trial court's ruling on a motion to compel
appraisal, the trial court's factual findings are reviewed for
competent, substantial evidence, while the trial court's application
4 The appraisal provisions in the policies are identical to the
appraisal provisions contained in the policies in the HIRC case
except for one sentence requiring that mediation, if desired, must
be requested prior to demanding appraisal.
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of the law to the facts is reviewed de novo." Heritage Prop. & Cas.
Ins. Co. v. Superior Contracting & Envtl. Specialties, LLC, 314 So. 3d
743, 745 (Fla. 2d DCA 2021) (citing Fla. Ins. Guar. Ass'n v. Waters,
157 So. 3d 437, 439-40 (Fla. 2d DCA 2015)). Because the trial
court's ruling on Progressive's motions to compel appraisal in the
Shazam case effectively hinged on its prior ruling in the HIRC case,
our discussion focuses on the court's findings in that case.
A. Legal Obligations of an Assignee
As an initial matter, we note that HIRC, as a postloss assignee,
has a legal obligation to comply with the contractually mandated
appraisal provisions in the insurance policies. An assignment of an
insured's right to payment by the insured does not eliminate the
duty of compliance with the contract conditions, including
appraisal. See Webb Roofing & Constr., LLC v. FedNat Ins. Co., 320
So. 3d 803, 805 (Fla. 2d DCA 2021) (citing Shaw v. State Farm Fire
& Cas. Co., 37 So. 3d 329, 332 (Fla. 5th DCA 2010), disapproved on
other grounds by Nunez v. Geico Gen. Ins. Co., 117 So. 3d 188 (Fla.
2013)). Thus, because Progressive and Clear Vision had a dispute
over the amount of the loss and Progressive invoked appraisal,
9
HIRC, as the postloss assignee, was contractually obligated to
participate in appraisal.
B. Good Faith Negotiation
The trial court first found that Progressive's demand for
appraisal was not ripe because it failed to negotiate "in good faith."
Progressive argues this was error, and we agree.
Before compelling appraisal, a trial court must determine
whether the demand for appraisal is ripe. Am. Capital Assurance
Corp. v. Leeward Bay at Tarpon Bay Condo. Ass'n, 306 So. 3d 1238,
1240 (Fla. 2d DCA 2020), review granted, SC20-1766, 2021 WL
416684 (Fla. Feb. 8, 2021). "A demand [for appraisal] is ripe where
postloss conditions are met, 'the insurer has a reasonable
opportunity to investigate and adjust the claim,' and there is a
disagreement regarding the value of the property or the amount of
loss." Id. (Citizens Prop. Ins. Corp. v. Admiralty House, Inc., 66 So.
3d 342, 344 (Fla. 2d DCA 2011)). Once the trial court makes the
preliminary ripeness determination, motions to compel appraisal
"should be granted whenever the parties have agreed to [appraisal]
and the court entertains no doubts that such an agreement was
made." People's Tr. Ins. Co. v. Marzouka, 320 So. 3d 945, 947-48
10
(Fla. 3d DCA 2021) (alteration in original) (emphasis omitted)
(quoting Preferred Mut. Ins. Co. v. Martinez, 643 So. 2d 1101, 1103
(Fla. 3d DCA 1994)).
Case law does not require Progressive to engage in good faith
negotiations for its demand for appraisal to be ripe. However, the
trial court determined that the appraisal provision included such a
requirement before Progressive could demand appraisal. We
disagree.
"Under Florida law, insurance contracts are construed
according to their plain meaning." Taurus Holdings, Inc. v. U.S. Fid.
& Guar. Co., 913 So. 2d 528, 532 (Fla. 2005). But "courts may not
'rewrite contracts, add meaning that is not present, or otherwise
reach results contrary to the intentions of the parties.' " Id.
(quoting State Farm Mut. Auto. Ins. Co. v. Pridgen, 498 So. 2d 1245,
1248 (Fla. 1986)). Nor can they "rewrite a contract to relieve a party
from an 'apparent hardship of an improvident bargain' " or "use
equity to remedy a situation the court perceives to be unfair." Oreal
v. Steven Kwartin, P.A., 189 So. 3d 964, 966 (Fla. 4th DCA 2016)
(quoting Dickerson Fla., Inc. v. McPeek, 651 So. 2d 186, 187 (Fla.
4th DCA 1995)).
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The appraisal provision at issue in the underlying cases, as
written, does not require good faith negotiation, as the trial court
suggests. In fact, nowhere in the three insurance policies is there a
provision concerning the nature of negotiations between the parties
before either the insured or the insurer invokes appraisal based
upon a dispute as to the amount of the loss. Rather, the appraisal
provisions simply state that "[i]f we cannot agree with you on the
amount of a loss, then we or you may demand an appraisal of the
loss." Once Progressive disagreed with Clear Vision on the amount
of loss, it could demand appraisal. And HIRC took the assignment
with the full knowledge of the terms of the appraisal process.
However, in making its ruling, the trial court impermissibly rewrote
the policies' appraisal provision to require Progressive to
demonstrate a good faith negotiation before the invocation of
appraisal.
Furthermore, to conclude that Progressive's notice of a
disagreement between it and Clear Vision is indicative of bad faith
is wholly without support in the record. Progressive investigated
the claim, acknowledged coverage, reviewed Clear Vision's invoice,
and tendered an offer to settle pursuant to its contractual duties.
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The record clearly demonstrates a disagreement between Clear
Vision and Progressive over the value of the claim. Once appraisal
was properly invoked, this dispute was ripe for appraisal—a process
wherein any errors in valuation of the loss which the trial court
mistook for bad faith would be resolved by selected appraisers.
While the insurance contracts do not include a requirement to
negotiate in good faith, Progressive does "have a statutory duty to
act reasonably and in good faith in evaluating the claim." Williams
v. State Farm Fla. Ins. Co., 47 Fla. L. Weekly D633, D634 (Fla. 2d
DCA Mar. 16, 2022); see also § 624.155(1)(b)1, Fla. Stat. (2020).
However, this statutory duty is entirely distinct from Progressive's
contractual duty to "timely evaluate and pay benefits owed on the
insurance policy." See Williams, 47 Fla. L. Weekly at D634 (quoting
Vest v. Travelers Ins. Co., 753 So. 2d 1270, 1275 (Fla. 2000)). And
when an insurer violates that statutory duty and fails to attempt to
negotiate or settle claims in good faith, an appropriate course of
action is to file a bad faith lawsuit against the insurer pursuant to
section 624.155.
13
The record before us, however, is devoid of any allegation of,
let alone a cause of action for, bad faith against Progressive.5 Yet
the trial court sua sponte raised the issue and, based on the
testimony of Steven Schaet, HIRC's owner, concluded that
Progressive, as a matter of course, failed to engage in good faith
negotiations. However, Schaet's speculation that "Progressive will
more than likely invoke their appraisal provision" with windshield
claims is insufficient to demonstrate bad faith on the part of
Progressive, especially given the absence of any cause of action for
bad faith. Thus, to conclude that Progressive acted in bad faith
because it tends to invoke appraisal in windshield claims ignores
both parties' contractual right to invoke appraisal.
Accordingly, the trial court erred when it intervened to rescue
HIRC from the burden of its calculated financial risk of buying in
5 Section 624.155(3) sets forth the procedural requirements for
bringing a civil action for bad faith against an insurer. See
Williams, 47 Fla. L. Weekly at D634 (detailing the procedure for
bringing a statutory bad faith claim). However, there is nothing in
this record to demonstrate that HIRC followed such procedures and
sought a bad faith action against Progressive, and this court
expresses no opinion concerning the prospect or viability of a bad
faith action in this matter.
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bulk the rights to claims to insurance benefits payments for
windshield claims.
C. "Economically Unreasonable" Doctrine
Although the trial court correctly rejected HIRC's argument
that the prohibitive cost doctrine barred appraisal, by striking the
appraisal provision as "economically unreasonable" the trial court
erroneously created a similarly inapplicable doctrine.
An appraisal provision that requires the insurer and the
insured to equally bear the costs of appraisal is "a cost of doing
business." Progressive Am. Ins. Co. v. Glassmetics, LLC, 343 So. 3d
613, 620 (Fla. 2d DCA 2022) ("The cost of appraisal is 'a cost of
doing business, i.e., a fee paid to a neutral third party who is hired
to help resolve a dispute about the amount of the total loss.' "
(quoting Progressive Am. Ins. v. SHL Enters., LLC, 264 So. 3d 1013,
1017-18 (Fla. 2d DCA 2018))). Insurance companies are heavily
regulated by Florida statutes, and unless the legislature intercedes
to place the financial burden solely upon the insurers for the total
cost of appraisal, the insurance policies dictate each party's liability
for the costs. See SHL Enters., 264 So. 3d at 1018; Glassmetics,
343 So. 3d at 621 ("We recognize the concern that the cost of the
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appraisal process appears to far exceed the [amount] at issue, and
no economical solution exists for windshield shops if insurance
companies underpay claims. But as noted in SHL Enterprises, '[i]f
the legislature intends for insurers to solely bear the costs of
appraisal in windshield damage claims, it knows how to express
that intention.' " (alteration in original) (quoting SHL Enters., 264
So. 3d at 1018)). As such, the prohibitive cost doctrine and any
other judicially created doctrine that deem sharing the costs of
contractually mandated appraisals to be economically unreasonable
do not apply to relieve an insured and his or her assignee from
liability for their share of the cost of appraisal. And "[a]bsent a
directive from the Florida Supreme Court, this [c]ourt should not
rewrite the contract by imposing a judge-crafted doctrine to bypass
the contractual remedy." Progressive Am. Ins. Co. v. Broward Ins.
Recovery Ctr., LLC, 322 So. 3d 103, 105 (Fla. 4th DCA 2021).
The plain language of Progressive's appraisal provisions
indicates that all claims for damages shall be subject to appraisal if
there is a dispute between the insurer and insured over the amount
of the loss and either party properly invokes appraisal. The policies
do not carve out any exceptions or exemptions to appraisal for
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windshield damage or loss, and courts do not have authority to
excise contractually mandated policy provisions from an insurance
policy. The legislature is well-versed in insurance law, and we defer
to the legislature to decide whether windshield claims will continue
to be subject to appraisal.
Accordingly, the trial court had no authority to deny the
motions to compel appraisal because the expense to participate in
the appraisal may have equaled or exceeded the amount in dispute.
D. Public Policy and Section 627.428
Lastly, Progressive argues that the trial court erred in
concluding that the appraisal provisions were void against public
policy in section 627.428, which provides insureds with an award of
attorney fees when they obtain a judgment against an insurance
company that underpaid a claim. We agree.
In Glassmetics, LLC, 343 So. 3d 613, this court addressed the
same issue and squarely rejected the arguments HIRC now makes.
This court explained that Progressive's appraisal provision, the
identical provision at issue in this case, did not contain language
concerning attorney fees. And "because there are no attorneys
involved in appraisal and there is no final judgment or its
17
equivalent in the appraisal process," there is no right to attorney
fees in appraisal under section 627.428. Id. at 620. It further
stated that "section 627.428 'contains no express prohibition
against requiring an insured to pay his or her own appraisal costs
where there is a dispute over windshield repair/replacement
costs.' " Id. (quoting SHL Enters., 264 So. 3d at 1018). Accordingly,
it found no merit in the argument that Progressive's appraisal
provision violated the public policy of section 627.428.
Furthermore, while the appraisal provisions provide that the
determination of the amount of loss will be binding, it also allows
the parties to enforce other rights they may have under the policy.
"For example, to the extent the appraisal process results in a
determination that Progressive underpaid [HIRC], [HIRC] would be
entitled to pursue any rights it may have against Progressive due to
the underpayment in accordance with the provisions of the
polic[ies] and the applicable law." See id. at 626.
As this court did in Glassmetics, "we conclude that the
appraisal provision[s] do[] not violate the public policy behind the
attorney[] fee statute in section 627.428." Id. at 620.
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E. The Shazam Case
In its order denying Progressive's motion to compel appraisal
in the Shazam case, the trial court made the following findings:
The Court adopts the analysis in its Order on
Defendant's Motion to Compel Appraisal and Motion to
Abate or Stay in Hillsborough Insurance Recovery Center,
LLC a/a/o Juan Gil vs. Progressive American Insurance
Company 19-CC-047706 (Aug. 24, 2020), including the
finding that the prohibitive cost doctrine does not apply
in the appraisal context.
In this matter, given the amount in dispute, the
Court finds that the mandatory component of the
appraisal provision must be stricken to resolve the
conflict between the appraisal provision and the public
policy underlying Florida Statutes section 627.428.
Because the denial of the motion to compel was based on the trial
court's adoption of the analysis from its order in the HIRC case, the
deficiencies explained above similarly afflict the court's ruling in the
Shazam case.
III. CONCLUSION
For the foregoing reasons, we conclude that the county court
erred in denying Progressive's motions to compel and reverse the
orders.
Reversed and remanded for further proceedings.
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ATKINSON and STARGEL, JJ., Concur.
Opinion subject to revision prior to official publication.
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