PEOPLE'S TRUST INSURANCE COMPANY v. GLADYS A. FRANCO, Etc.
CourtDistrict Court of Appeal of Florida
Date FiledApril 15, 2020
Docket3D18-2178
StatusPublished
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Full Opinion
Third District Court of Appeal
State of Florida
Opinion filed April 15, 2020.
Not final until disposition of timely filed motion for rehearing.
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No. 3D18-2178
Lower Tribunal No. 17-22975
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People’s Trust Insurance Company,
Appellant,
vs.
Gladys A. Franco, etc., et al.,
Appellees.
An Appeal from the Circuit Court for Miami-Dade County, Barbara Areces,
Judge.
Cole, Scott & Kissane, P.A., and David C. Borucke and Mark D. Tinker
(Tampa); Brett Frankel and Jonathan Sabghir (Deerfield Beach), for appellant.
Mintz Truppman, P.A., and Timothy H. Crutchfield, for appellee Gladys A.
Franco.
Before SALTER, HENDON and LOBREE, JJ.
SALTER, J.
People’s Trust Insurance Company (“PTIC”) appeals a final circuit court
order dismissing with prejudice PTIC’s complaint against its insureds, Gladys
Franco and Maximiliano Quesada (together, the “Insureds”), under a homeowner’s
insurance policy. The underlying case tests the right of PTIC to enforce an “election
to repair” provision in its policy of insurance and the remedies that may be pursued
when the Insureds repudiate that election or otherwise fail to comply with the
policy’s requirements.
We reverse the order and remand the case to the trial court for further
proceedings. Although many of the facts detailed below regarding the background
of the case are uncontroverted, the procedural status of the dismissal and our
standard of review require us to consider the factual allegations of PTIC’s complaint,
including facts gleaned from the attachments to the complaint, as true.
Background and Procedural History
PTIC offered, and the Insureds chose, a homeowner’s insurance policy
(“Policy”) with a premium discount and an endorsement allowing PTIC the right to
have a designated contractor, Rapid Response Team, LLC™ (the “Contractor”),
repair covered damages to an insured’s home. The “direct repair” concept seems
straightforward, and the form of endorsement has been approved by Florida’s
Department of Insurance. Apparently the devil, in the present case, is in the details.
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The Policy was in effect on January 30, 2017, when the Insureds’ home
suffered water damage. Five days later, the Insureds entered into a one-page
agreement with “911Claims,” a Miami-based licensed public adjuster, whereby the
Insureds retained 911Claims to “adjust, appraise, advise and assist in the settlement”
of the water damage at the Insureds’ home. The agreement included an assignment
by the Insureds of “20% of the whole amount recovered (including recoverable
depreciation and overhead & profit and any extra-contractual or bad faith damages
less deductible).” (Original emphasis). The agreement defined “recovered” as “any
amount that is actually paid by the insurance carrier or other applicable party/non-
party (collectively ‘carrier’) OR any amount which is offered by the carrier.” The
agreement also specified “NO recovery, NO fee to policy holder.” (Original
emphasis). It followed that if the Contractor designated by PTIC performed the
repairs caused by the water damage, 911Claims would not be entitled to a payment
by the Insureds.
On March 3, 2017, 911Claims notified PTIC that it represented the Insureds
and that the loss had occurred. PTIC responded by email that very day, assigned a
claim number, and provided a one-page explanation form, captioned “What to
Expect During Your Claim.” On March 9, PTIC’s inspector visited the property to
investigate the claim. On March 20, PTIC sent two separate letters to the Insureds,
with a copy of each also sent to 911Claims. The first letter, two pages and an
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attachment, notified the Insureds that they needed to complete and execute a sworn
proof of loss for return to PTIC within 60 days, as required by the Policy. PTIC’s
letter also requested “estimates, invoices, photographs and documentation related to
this claim,” and informed the Insureds that the failure to comply with the requests
“may prejudice [PTIC’s] claim investigation and ultimately jeopardize coverage to
the extent that coverage exists for this claim.” The letter provided the name, phone
number, address, and email address of a senior claims adjuster at PTIC and attached
the form of proof of loss to be completed by the Insureds.
On March 20, 2017, the same senior claims adjuster also sent a longer, six-
page letter to the Insureds reflecting PTIC’s decisions after the March 9 inspection
of the damage at the Insureds’ residence. This letter acknowledged that the claim
was covered for damage that was caused by a pipe leak and “damage associated with
tearing out parts of the building as necessary to access the broken pipe which needs
repair,” but damage to the pipe itself was not covered. The letter identified the
applicable policy provisions and notified the Insureds that PTIC elected to use the
Contractor to repair the Insureds’ property to its pre-loss condition by making repairs
to the covered damages, as determined “by agreement or submitting the matter to an
appraisal panel as set forth in the policy.”
PTIC included with its March 20 notice of electing its right to repair an
“Estimate and Scope of Repairs” pursuant to the “Preferred Contractor
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Endorsement,” and a copy of the endorsement was attached to the notice. PTIC
followed up the March 20 correspondence with requests for compliance by the
Insureds and 911Claims in May and June of 2017, but the completed “Sworn
Statement in Proof of Loss” and other requested information were not forthcoming.
On September 27, 2017, over six months after the Insureds’ claim was
reported to PTIC, the property damage had been inspected by PTIC’s claims
adjuster, and PTIC had elected to have the Contractor repair the damage (all of which
were accomplished in March 2017), PTIC filed its complaint in the circuit court.
Alleging in detail the sequence of events and policy provisions, the Insureds’
“obstinate and unjustified refusal and repudiation of [PTIC’s] election-to-repair,”
and the resulting prejudice to PTIC as a result, PTIC sought (1) declaratory relief as
to the parties’ rights and obligations under the Policy, and (2) a judgment for
anticipatory repudiation and breach of the Policy terms “permanently voiding any
further coverage obligations, and for an award of all reasonable costs incurred in
prosecuting this action,” and any further relief deemed just and proper.
In response, the Insureds moved to dismiss the complaint as legally
insufficient and improper. The trial court heard and granted the motion to dismiss
in April 2018, initially granting leave to amend. PTIC’s counsel waived amendment
so that the legal sufficiency of the complaint and its attachments could be tested
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here. The resulting final order was a dismissal with prejudice, and PTIC’s timely
appeal followed.
Analysis
“When ruling on a motion to dismiss for failure to state a cause of action, the
trial court must ‘treat as true all of the . . . complaint’s well-pleaded allegations,
including those that incorporate attachments, and to look no further than the . . .
complaint and its attachments.’” Romo v. Amedex Ins. Co., 930 So. 2d 643, 648
(Fla. 3d DCA 2006) (quoting City of Gainesville v. State, Dep’t of Transp., 778 So.
2d 519, 522 (Fla. 1st DCA 2001)). Our standard of review is de novo. Romo, 930
So. 2d at 647.
Count I plainly states a cause of action for declaratory relief. The election-to-
repair endorsement has been an established option for various Florida residential
insurance policy forms for several years. The legal features of the endorsement have
been analyzed repeatedly by Florida’s appellate courts. The new contract formed
between the insurer’s preferred and designated contractor under such an
endorsement and the insured has been termed a “Drew agreement,” a reference to
Drew v. Mobile USA Ins. Co., 920 So. 2d 832 (Fla. 4th DCA 2006).
“A declaratory judgment is a statutorily created remedy.” Martinez v.
Scanlan, 582 So. 2d 1167, 1170 (Fla. 1991). Florida Statute section 86.011, entitled
“Jurisdiction of trial court,” states:
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The court may render declaratory judgments on the existence, or
nonexistence: (1) Of any immunity, power, privilege, or right; or (2) Of
any fact upon which the existence or nonexistence of such immunity,
power, privilege, or right does or may depend, whether such immunity,
power, privilege, or right now exists or will arise in the future. Any
person seeking a declaratory judgment may also demand additional,
alternative, coercive, subsequent, or supplemental relief in the same
action.
“Put another way, ‘the courts have the general power to issue declaratory
judgments . . . in suits solely seeking a determination of any fact affecting the
applicability of an “immunity, power, privilege, or rights.”’” Heritage Prop. & Cas.
Ins. Co. v. Romanach, 224 So. 3d 262, 265 (Fla. 3d DCA 2017) (quoting Higgins v.
State Farm Fire & Cas. Co., 894 So. 2d 5, 12 (Fla. 2004)) (original emphasis).
“[T]he purpose of a declaratory judgment is to afford parties relief from
insecurity and uncertainty with respect to rights, status, and other equitable or legal
relations.” Coal. for Adequacy & Fairness in Sch. Funding, Inc. v. Chiles, 680 So.
2d 400, 404 (Fla. 1996) (quoting Santa Rosa Cty. v. Admin. Comm’n, Div. of
Admin. Hearings, 661 So. 2d 1190, 1192 (Fla. 1995)). A request for a declaratory
judgment should be construed liberally. See § 86.101, Fla. Stat. (stating that Chapter
86 is to be “substantive and remedial” and, due to its purpose, it “is to be liberally
administered and construed”); Kelner v. Woody, 399 So. 2d 35, 37 (Fla. 3d DCA
1981) (same). “[Q]uestions of fact and disagreements concerning coverage under
insurance policies are proper subjects for a declaratory judgment if necessary to a
construction of legal rights. Further, an insurer may seek determination of its
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obligation to defend its insured by filing a declaratory judgment action.” Travelers
Ins. Co. v. Emery, 579 So. 2d 798, 801 (Fla. 1st DCA 1991) (footnotes omitted).
“A motion to dismiss a complaint for declaratory judgment is not a motion on
the merits. Rather, it is a motion only to determine whether the plaintiff is entitled
to a declaration of rights, not to whether it is entitled to a declaration in its favor.”
Romo, 930 So. 2d at 648 (internal quotations and citations omitted). To survive a
motion to dismiss, a complaint for declaratory relief must show:
[(1)] [T]here is a bona fide, actual, present practical need for the
declaration; [(2)] that the declaration should deal with a present,
ascertained or ascertainable state of facts or present controversy as to a
state of facts; [(3)] that some immunity, power, privilege or right of the
complaining party is dependent upon the facts or the law applicable to
the facts; [(4)] that there is some person or persons who have, or
reasonably may have an actual, present, adverse and antagonistic
interest in the subject matter, either in fact or law; [(5)] that the
antagonistic and adverse interest[s] are all before the court by proper
process or class representation and [(6)] that the relief sought is not
merely giving of legal advice by the courts or the answer to questions
propounded from curiosity. These elements are necessary in order to
maintain the status of the proceeding as being judicial in nature and
therefore within the constitutional powers of the courts.
Chiles, 680 So. 2d at 404 (quoting Santa Rosa Cty., 661 So. 2d at 1192-93 (quoting
Martinez, 582 So. 2d at 1170)); Romo, 930 So. 2d at 648 (same); Floyd v. Guardian
Life Ins. Co., 415 So. 2d 103, 104 (Fla. 3d DCA 1982) (“A complaint seeking
declaratory relief must allege ultimate facts showing a bona fide adverse interest
between the parties concerning a power, privilege, immunity or right of the plaintiff;
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the plaintiff’s doubt about the existence or non-existence of his rights or privileges;
that he is entitled to have the doubt removed.”).
Applying these requirements to the detailed allegations in the 15 pages and
53 numbered paragraphs of PTIC’s declaratory judgment count in the complaint, the
elements of a sufficient cause of action are evident. In prior lawsuits and appeals,
PTIC sought to enforce its election-to-repair provision with a count for injunctive
relief and an effort to compel the insureds to execute work authorizations and allow
contractors and related parties to enter the home to perform the repairs. Such
injunctions were denied on the grounds that irreparable harm did not exist and the
insurer had adequate remedies at law. See, e.g., People’s Trust Ins. Co. v. Acosta,
259 So. 3d 179 (Fla. 3d DCA 2018).
In the present lawsuit, PTIC seeks a declaration regarding those rights and
remedies—not in a prohibited advisory or abstract form of opinion, but based on
detailed allegations that an insured and its public adjuster are repudiating the
endorsement and impeding the Contractor’s performance. This is the kind of
concrete scenario addressed by Florida’s declaratory judgment statute.
The second count, for breach of contract based on the Insureds’ alleged non-
performance of post-loss conditions and refusal to cooperate with the Contractor’s
performance of repairs, is partially subsumed within the declaratory judgment count.
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Like the declaratory judgment count, the contract count seeks a judgment against the
Insureds “permanently voiding any further coverage obligations.”
PTIC’s contract count does, however, also include a prayer for relief seeking
contract remedies: PTIC claims that the policy terms were anticipatorily repudiated
by the Insureds, thus breaching the Policy, excusing further performance by PTIC
and allowing it to seek damages. See A.I.C. Trading Corp. v. Susman, 40 So. 3d
769, 773 (Fla. 3d DCA 2010) (finding that conduct anticipatorily repudiating a
contract “creat[es] an immediate cause of action for breach”); Twenty-Four
Collection, Inc. v. M. Weinbaum Constr., Inc., 427 So. 2d 1110, 1112 (Fla. 3d DCA
1983) (same). In this case, PTIC seeks damages for its reasonable costs incurred in
prosecuting its lawsuit. This count, too, states a legally sufficient cause of action.
Conclusion
Following our de novo review of the complaint and its attachments, our
review of the parties’ briefs, and our consideration of counsel’s presentation at oral
argument, we conclude that the final judgment below dismissing PTIC’s complaint
with prejudice must be reversed. Both counts of the complaint state legally
sufficient causes of action, although we express no opinion regarding PTIC’s ability
to prove the allegations of fact within the complaint. The case is remanded for
further proceedings.
Reversed and remanded.
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