American Coastal Insurance Company v. Ironwood, Inc.
CourtDistrict Court of Appeal of Florida
Date FiledOctober 27, 2021
Docket2D20-3406
StatusPublished
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Full Opinion
DISTRICT COURT OF APPEAL OF FLORIDA
SECOND DISTRICT
AMERICAN COASTAL INSURANCE COMPANY,
Appellant,
v.
IRONWOOD, INC.,
Appellee.
No. 2D20-3406
October 27, 2021
Appeal from the Circuit Court for Collier County; Elizabeth V. Krier,
Judge.
Hope C. Zelinger, Samantha S. Epstein, Lilian Rodriguez-Baz, and
Krista L. Elsasser of Bressler, Amery & Ross, P.C., Fort Lauderdale,
for Appellant.
Cary J. Goggin and Amanda C. Broadwell of Goede, Adamczyk,
DeBoest & Cross, PLLC, Naples, for Appellee.
NORTHCUTT, Judge.
American Coastal Insurance Company appeals an order
staying litigation and compelling an appraisal of damage to property
of its insured, Ironwood, Inc. We reverse because the directive to
submit to an appraisal is premature.
This case arises from a dispute between Ironwood, a
condominium association in Naples, and American Coastal over the
former's claim for property damage caused by Hurricane Irma in
2017. Ironwood initially filed a claim for roof damage in November
2017. American Coastal adjusted the claim and issued several
payments for repairs. The resolution of that initial roofing claim is
not in dispute.
In February 2019, Ironwood filed an additional claim for
damage to doors and windows caused by the same hurricane.
American Coastal began investigating the new claim and requested
a variety of documents from Ironwood. Ironwood then invoked its
right to an appraisal before American Coastal made a coverage
determination on the windows-and-doors claim.
American Coastal maintained that an appraisal was
premature because Ironwood had not yet provided all the
documentation American Coastal requested regarding the damage
to the windows and doors. Ironwood disagreed and filed suit,
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claiming breach of contract and seeking an appraisal and
compensatory damages.
Ironwood eventually moved for a stay of the litigation and for
an order compelling an appraisal. The circuit court granted the
motion. Although the court held a hearing on the motion and took
limited testimony on the issue of Ironwood's compliance with its
postloss obligations, the court stated that its decision was based
solely on the pleadings and attachments. There are two infirmities
in the court's ruling.
First, although the testimony and pleadings evinced a genuine
dispute over Ironwood's compliance with its postloss obligations,
the court failed to resolve that dispute before compelling the parties
to appraisal.
In order to make a preliminary determination that
there is a disagreement between the insurer and the
insured regarding the amount of loss, the trial court
must be satisfied of the insured's compliance with the
policy's post-loss conditions. Where the insurer
reasonably disputes such compliance and raises a
question as to the sufficiency of the insured's compliance
with post-loss obligations, a question of fact is created
that must be resolved by the trial court before compelling
appraisal.
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United Prop. & Cas. Ins. Co. v. Concepcion, 83 So. 3d 908, 910 (Fla.
3d DCA 2012) (citations omitted).
The parties' insurance contract imposes on Ironwood a
postloss obligation to "[f]urnish all other documents or insurance
policies that [American Coastal] may reasonably require." In
response to Ironwood's claim for damage to the property's windows
and doors, American Coastal made several written requests for
documents. In particular, American Coastal requested that
Ironwood provide:
1) Sworn Proof of Loss; 2) All supporting estimates,
invoices, receipts, and contracts for work relating to the
subject loss; 3) All documentation received by the
Insured from Moisture Intrusion Solutions relating to the
subject loss; 4) Association board meeting minutes for
the past five years; 5) Association maintenance records
for the past five years (2014-2019); 5) Any photographs,
videos or otherwise that depict the condition of the
property at any time, both prior to and after the date of
loss; 6) Any reports, including appraisals, prepared on
behalf of the Association; 7) Any engineering, general
construction, or expert reports pertaining to the subject
loss and the damages being claimed; and 8) Any
Certificates of Completion, Certificates of Satisfaction,
final invoices, and evidence of paid invoices.
To all appearances, American Coastal's requests for
documents were reasonable. Consequently, Ironwood is not
entitled to an appraisal if it has not adequately responded to them
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as required by the policy. The parties presented evidence solely on
this dispute over Ironwood's compliance with American Coastal's
request, but the circuit court erroneously failed to resolve or even to
address it. See People's Tr. Ins. Co. v. Ortega, 306 So. 3d 280, 285
(Fla. 3d DCA 2020) ("[W]here there is a dispute over whether an
insured has sufficiently complied with his or her contractual duties
so as to trigger the policy's appraisal provision, that dispute must
be resolved before compelling the parties to proceed with an
appraisal of the disputed loss."); Concepcion, 83 So. 3d at 909
(holding that "the dispute as to whether Concepcion complied with
post-loss obligations created a fact issue which must be resolved by
the court through an examination of the evidence" prior to ordering
an appraisal); see also Gonzalez v. People's Tr. Ins. Co., 307 So. 3d
956, 960 (Fla. 3d DCA 2020) ("[U]ntil the subject homeowner's
insurance policy's post-loss obligations are met, there can be no
disagreement as to the amount of the loss.").
Second, the court below erred in concluding that Ironwood's
windows-and-doors claim is an aspect of the initial roof-damage
claim rather than a supplemental claim. This distinction is
important because a claim is not yet ripe for appraisal until a
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coverage determination has been made. See Am. Capital Assurance
Corp. v. Leeward Bay at Tarpon Bay Condo. Assoc., Inc., 306 So. 3d
1238, 1240 (Fla. 2d DCA 2020), review granted, SC20-1766, 2021
WL 416684 (Fla. Feb. 8, 2021). American Coastal has already made
its coverage determination regarding the roof damage. If the
windows and doors damage is part of the roof claim, then appraisal
might be appropriate. But if it is a supplemental claim for which a
separate coverage determination must be made, appraisal is
premature until "the insurer has a reasonable opportunity to
investigate and adjust the claim." Citizens Prop. Ins. Corp. v.
Galeria Villas Condo. Ass'n, Inc., 48 So. 3d 188, 191 (Fla. 3d DCA
2010).
Ironwood's insurance policy defines a supplemental claim as
"any additional claim for recovery from [American Coastal] for losses
from the same hurricane or windstorm which [American Coastal]
[has] previously adjusted pursuant to the initial claim." Ironwood's
windows-and-doors claim falls squarely within this definition. It is
undisputed that American Coastal "previously adjusted" damage
resulting from the same hurricane, i.e., losses related to damage to
Ironwood's roofs. Ironwood's "additional claim for recovery for
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losses from the same hurricane," i.e., alleged losses related to
damage to windows and doors, is therefore a supplemental claim for
which a coverage determination must be made before the
contractual appraisal right ripens. See Goldberg v. Universal Prop.
& Cas. Ins. Co., 302 So. 3d 919, 923 (Fla. 4th DCA 2020) (holding
that, under the same definition of "supplemental claim," an
insured's request for "additional payment for his losses from the
same hurricane after the adjustment of his initial claim" was a
supplemental claim).
Accordingly, we reverse the order compelling an appraisal and
remand for further proceedings.
Reversed and remanded.
KELLY and ATKINSON, JJ., Concur.
Opinion subject to revision prior to official publication.
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