Liliana Williams as the Personal Representative of the Estate of Gerald Williams v. State Farm Florida Insurance Company
CourtDistrict Court of Appeal of Florida
Date FiledMarch 16, 2022
Docket2D20-2092
StatusPublished
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Full Opinion
DISTRICT COURT OF APPEAL OF FLORIDA
SECOND DISTRICT
GERALD WILLIAMS,
Appellant,
v.
STATE FARM FLORIDA INSURANCE COMPANY,
Appellee.
No. 2D20-2092
March 16, 2022
Appeal from the Circuit Court for Hillsborough County; Emmett
Lamar Battles, Judge.
George A. Vaka and Nancy A. Lauten of Vaka Law Group, Tampa;
and Kelly L. Kubiak of Merlin Law Group, Tampa, for Appellant.
Paul L. Nettleton and Jeffrey A. Cohen of Carlton Fields, Miami, for
Appellee.
SLEET, Judge.
Gerald Williams appeals the trial court's final summary
judgment entered in favor of State Farm Florida Insurance
Company in his first-party bad faith action. Because State Farm's
invocation of the appraisal process and its payment of the appraisal
award after the expiration of the sixty-day cure period on Williams'
civil remedy notice (CRN) did not cure the alleged bad faith, we
reverse.
Williams owned a home insured by State Farm. In July 2009,
while the policy was in effect, lightning struck Williams' home and
caused significant property damage throughout. After Williams
filed a claim of loss, State Farm acknowledged coverage, determined
the amount of loss, and made several payments over a span of eight
years. In 2017, Williams disputed the amount of loss and State
Farm invoked the appraisal provision under the policy to determine
the amount to be paid to repair the property. On May 4, 2018,
while the appraisal process was still ongoing, Williams filed the
statutorily required CRN, providing State Farm with notice of his
intent to pursue a bad faith claim against State Farm. See
generally § 624.155(3)(a), Fla. Stat. (2018). The appraisal award,
which set the amount of the loss at $504,913.11, was ultimately
issued on December 18, 2018. On February 15, 2019, State Farm
paid the full remaining amount due.
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On October 27, 2019, Williams filed a first-party bad faith
action against State Farm. In response, State Farm filed a motion
requesting that the court either dismiss the complaint or enter final
summary judgment and argued (1) that the sixty-day cure period
under section 624.155 was tolled pending the filing of the appraisal
award because there was no amount owed under the policy to
Williams at the time the CRN was filed, (2) the payment of the
appraisal award within sixty days of the award's issuance cured the
alleged bad faith allegations, and (3) Williams' CRN was legally
deficient. The trial court held a hearing on the motion and entered
an order granting final summary judgment based upon State
Farm's first argument.
We review a trial court's ruling on a motion for summary
judgment de novo. Volusia County v. Aberdeen at Ormond Beach,
L.P., 760 So. 2d 126, 130 (Fla. 2000). "This court also employs the
de novo standard when interpreting a statute or an insurance
policy." Ganzemuller v. Omega Ins. Co., 244 So. 3d 1189, 1190 (Fla.
2d DCA 2018).
On appeal, Williams argues that the trial court erred in
concluding that State Farm timely paid the appraisal award
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pursuant to the terms of the insurance policy and that the CRN was
cured. We agree.
This court previously addressed this identical issue in Fortune
v. First Protective Insurance Co., 302 So. 3d 485, 490 (Fla. 2d DCA
2020), and held that an insurer's statutorily required sixty-day
response to the CRN is not dependent on the determination of
damages following appraisal and that "section 624.155(3)(d) does
not toll the cure period until an appraisal is completed." State
Farm's present assertion that its sixty-day response to the CRN was
tolled because a condition precedent to payment had not been
fulfilled is simply another iteration of the same argument,
particularly because State Farm's asserted "condition precedent to
payment" is the completion of the appraisal process. Once again,
State Farm conflates its contractual duty to ultimately pay the
amounts due under the policy with its statutory duty to act
reasonably and in good faith in evaluating the claim prior to the
determination of damages.
With respect to paying claims, insurers have two independent
duties, one contractual and one statutory. First, they have a
contractual duty to "timely evaluate and pay benefits owed on the
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insurance policy." Vest v. Travelers Ins. Co., 753 So. 2d 1270, 1275
(Fla. 2000); see also Zaleski v. State Farm Fla. Ins. Co., 315 So. 3d
7, 12 (Fla. 4th DCA 2021) ("[W]hen an insurer receives a claim, it
has an independent duty to evaluate the claim in advance of a
determination of damages and take timely, independent action.").
This includes determining coverage, liability, and the amounts due
under the policy. Second, they have a statutory duty to act
reasonably and in good faith in evaluating the claim. See
§ 624.155(1). "Thus, the focus in a bad faith case is not whether
the insurer ultimately paid the amounts due under the policy, but
whether it acted reasonably in evaluating the claim prior to the
determination of damages." Zaleski, 315 So. 3d at 12 (citing Harvey
v. GEICO Gen. Ins. Co., 259 So. 3d 1, 7 (Fla. 2018)). While the
contractual and statutory duties are related, they each have distinct
procedures.
As to the contractual duty, generally the terms and conditions
of insurance policies dictate the process that the parties follow
before an insurer pays a claim. This can include, as is seen here,
the right to invoke appraisal if the parties disagree on the amount of
loss.
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As to the statutory duty, if a person has been damaged by an
insurer's failure to comply with its duty to act in good faith while
evaluating the claim, he or she may bring a civil action against the
insurer. § 624.155(1). However, as a condition precedent to
bringing such an action, the insurer must be given the CRN, which
puts it on notice of the violation. § 624.155(3)(a). Once the CRN is
filed, the insurer has sixty days to either pay the damages resulting
from such violation or correct the circumstances giving rise to the
violation. § 624.155(3)(c). Section 624.155 does not include any
language modifying or creating an exception to the mandatory sixty-
day cure period when an insurer invokes appraisal or fails to pay
damages because a condition precedent to payment under the
policy has not been fulfilled.1
1 In 2019, the legislature amended section 624.155 to add the
new subsection (3)(f) which states that "[a] notice required under
this subsection may not be filed within 60 days after appraisal is
invoked by any party in a residential property insurance claim."
Although the subsection is not applicable here, it nonetheless
further reinforces Williams' position that seeking an appraisal is not
a cure to a failure to attempt to timely settle a claim in good faith.
The legislature is well versed in insurance law and has not seen fit
to toll the sixty-day response for any reason.
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Here, State Farm argues that the sixty-day cure period was
tolled until the appraisal process was completed and that the
appraisal award determined the amount owed under the policy.
However, the amount owed under the policy relates back to State
Farm's contractual duty to evaluate and pay benefits owed, not its
statutory duty to act reasonably and in good faith. State Farm's
policy language that provides that no payment is due until a
condition precedent to payment has been fulfilled does not supplant
the clear language of section 624.155(3)(c), which establishes the
insurer's statutory obligation to pay the damages or correct the
circumstances giving rise to the violation within sixty days after the
insurer is given notice. "[A]n appraisal is not a condition precedent
to the insurer fulfilling its obligation to fairly evaluate the claim and
to either deny coverage or to offer an appropriate amount based on
that fair evaluation." Fortune, 302 So. 3d at 490. Rather, the
appraisal, along with the filing of the CRN, affects the ripeness of a
bad faith action. Landers v. State Farm Fla. Ins. Co., 234 So. 3d
856, 860 (Fla. 5th DCA 2018) ("Once the appraisal process is
complete, and a legally sufficient CRN had previously been
provided, the conditions precedent to filing a statutory bad-faith
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claim are met."); see also Zaleski, 315 So. 3d at 10-11 ("[A] statutory
bad faith claim under section 624.155 is ripe for litigation when
there has been (1) a determination of the insurer's liability for
coverage; (2) a determination of the extent of the insured's damages;
and (3) the required notice is filed pursuant to section
624.155(3)(a)." (alteration in original) (quoting Demase v. State Farm
Fla. Ins. Co., 239 So. 3d 218, 221 (Fla. 5th DCA 2018))).
In Vest, the Florida Supreme Court cogently articulated that
the insurer's evaluation of a claim for purposes of bad faith is not
dependent on the determination of damages:
As in the present case, there is no statutory requirement
which prevents the insured from sending the statutory
notice before there is a determination of liability or
damages. Nor is the insurer's appropriate response to
that notice dependant [sic] on such a determination. The
insurer's appropriate response is based upon the
insurer's good-faith evaluation of what is owed on the
insurance contract. What is owed on the contract is in
turn governed by whether all conditions precedent for
payment contained within the policy have been met. An
insurer, however, must evaluate a claim based upon proof
of loss required by the policy and its expertise in advance
of a determination by a court or arbitration.
753 So. 2d at 1275-76 (emphasis added).
Furthermore, in Zaleski, the Fourth District followed this
court's reasoning in Fortune and rejected State Farm's similar
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argument that because the parties did not agree on the amount of
the loss, the appraisal was a condition precedent to State Farm's
obligation to make a payment under the policy, thus tolling the
sixty-day cure period under section 624.155.
We agree with Fortune and hold that "[t]he language
of section 624.155(3)(d) does not toll the cure period until
an appraisal is completed." 302 So. 3d at 490. The
appraisal award is not a condition precedent to State
Farm's obligation to pay the Homeowners a fair amount
due under the policy. To allow the sixty-day cure period
to toll at the invocation of the appraisal process would
allow insurers to cause delay or otherwise act in bad
faith while escaping liability as long as it makes payment
within the sixty-day time period of the appraisal award.
This would negate and frustrate the purpose of the
statute. See Landers, 234 So. 3d at 859 ("[T]he purpose
of the CRN is to facilitate and encourage good-faith
efforts to timely settle claims before litigation, not to
vindicate continuing efforts to delay." (internal citation
omitted)).
315 So. 3d at 12.
As such, State Farm's response to Williams' CRN was not
dependent on the ultimate determination of the amount of loss in
accordance with the condition precedent to payment of completing
the appraisal process which was contained within State Farm's
policy. Consistent with Fortune and Zaleski, we hold that State
Farm's invocation of the appraisal process and payment of the
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appraisal award after the cure period did not, as a matter of law,
cure the alleged bad faith claim. State Farm's policy language
withholding payment until the fulfillment of a condition precedent
to payment does not absolve State Farm of its statutory duty to
comply with section 624.155. "Whether State Farm's initial
evaluation of the claim and actions during the sixty-day cure period
were reasonable remains an issue of fact for a jury to resolve."
Zaleski, 315 So. 3d at 13.
State Farm also argues in the alternative that this court
should affirm the summary judgment because Williams' CRN
was legally deficient. However, the trial court did not rule on
the issue and made no oral or written findings concerning the
sufficiency of the CRN. Therefore, we decline to reach the
issue. See Landers v. State Farm Fla. Ins. Co., 234 So. 3d 856,
858 n.5 (Fla. 5th DCA 2018) ("State Farm argues alternatively
that the CRN was invalid because it failed to comply with the
bad-faith statute. Because we cannot determine whether the
court ruled on this basis, we decline to address this issue for
the first time on appeal."); Maynard v. Fla. Bd. of Educ., 998
So. 2d 1201, 1207 (Fla. 2d DCA 2009) ("Since the trial court
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has never addressed this question, we will not do so for the
first time on appeal."); Gearity v. Stuart, 324 So. 3d 560, 561
(Fla. 5th DCA 2021) ("We also reject the Appellees' alternative
basis for affirmance because the trial court never reached the
merits of Appellant’s section 57.105 motion. We 'cannot
employ the tipsy coachman rule where a lower court has not
made factual findings on an issue and it would be
inappropriate for an appellate court to do so.' " (quoting
Featured Props., LLC v. BLKY, LLC, 65 So. 3d 135, 137 (Fla.
1st DCA 2011))); Kokhan v. Auto Club Ins. Co. of Fla., 297 So.
3d 570, 576 (Fla. 4th DCA 2020) ("As for the policy's 'wear and
tear' exclusion, the circuit court did not rule on that exclusion,
so the homeowners' argument that the 'wear and tear'
exclusion did not apply is not ripe for our review.").
Accordingly, we reverse the final summary judgment
entered in favor of State Farm and remand for further
proceedings.
Reversed and remanded.
ATKINSON and SMITH, JJ., Concur.
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Opinion subject to revision prior to official publication.
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