Heritage Property & Casualty Insurance Company v. Veranda I at Heritage Links Association, Inc.
CourtDistrict Court of Appeal of Florida
Date FiledFebruary 25, 2022
Docket2D21-1715
StatusPublished
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Full Opinion
DISTRICT COURT OF APPEAL OF FLORIDA
SECOND DISTRICT
HERITAGE PROPERTY & CASUALTY INSURANCE COMPANY,
Appellant,
v.
VERANDA I AT HERITAGE LINKS ASSOCIATION, INC.,
Appellee.
No. 2D21-1715
February 25, 2022
Appeal from the Circuit Court for Collier County; Hugh D. Hayes,
Judge.
David A. Noel and Kara Rockenbach-Link of Link & Rockenbach,
P.A., West Palm Beach; and Jeffrey A. Rubinton and Veronica
Dossat of Rubinton & Associates, P.A., Tampa, for Appellant.
Cary J. Goggin, Amanda C. Broadwell, and Jessica Rodriguez of
Goede, Adamczyk, DeBoest & Cross, PLLC, Naples, for Appellee.
LUCAS, Judge.
Heritage Property & Casualty Insurance Company (Heritage)
appeals an order compelling it to participate in an appraisal
pursuant to its insurance policy with Veranda I at Heritage Links
Association, Inc. (Veranda), a condominium association. Because
Heritage had fully denied coverage for the supplemental claim at
issue, we reverse the order requiring appraisal of the amount of
loss.
In September of 2017, Veranda submitted a claim to Heritage,
its property insurer, for damages sustained in the wake of
Hurricane Irma. Veranda's first claim comprised solely of damages
pertaining to the condominium and garage roofing within the
association. In December 2017, Heritage determined that the roof
damages were a covered claim under Veranda's policy.
A dispute arose concerning the extent of repairs that were
needed to fix the roof damage. In March 2019, Veranda, now
represented by a public adjuster, submitted a new estimate and
sworn proof of loss. This new proof of loss sought an outright roof
replacement. It also included a new claim to replace all the
windows and doors of the condominium complex.1
1 As we will explain later, this new claim falls within the
insurance policy's definition of a "supplemental claim":
"Supplemental claim or reopened claim means an additional claim
for recovery from us for losses from the same hurricane or other
2
The dispute eventually became a lawsuit. On October 16,
2020, Veranda filed a complaint against Heritage alleging counts for
breach of contract and declaratory relief. Veranda's complaint also
requested the circuit court to compel the parties to participate in
the appraisal process set forth in the insurance policy.2 The case
proceeded with discovery. On April 13, 2021, Heritage sent
correspondence to Veranda in which it agreed to issue payment for
windstorm which we have previously adjusted pursuant to the
initial claim."
2 The policy's appraisal provision provides as follows:
If we and you disagree on the value of the property
or the amount of loss, either may request:
....
2. An appraisal of the loss, in writing. In this
event, each party will select a competent and impartial
appraiser. The two appraisers will select an umpire. If
they cannot agree, either may request that selection be
made by a judge of a court having jurisdiction. The
appraisers will state separately the value of the property
and amount of loss. If they fail to agree, they will submit
their differences to the umpire.
A decision agreed to by any two will be binding.
Each party will:
a. Pay its chosen appraiser; and
b. Bear the other expenses of the appraisal and
umpire equally.
If there is an appraisal, we will still retain our right to
deny the claim.
3
Veranda's roof replacement claim but "wholly den[ied]" coverage for
the supplemental windows and door claim "in its entirety."
This left the question of what to do with Veranda's request for
appraisal. Over the course of two hearings, the circuit court
considered the matter, and on May 12, 2021, entered an order
stating that the case would proceed "on a dual-track basis" and
compelled the parties to participate in an appraisal process.
Heritage now appeals that order. We have jurisdiction pursuant to
Florida Rule of Appellate Procedure 9.130(a)(3)(C)(iv).
We review a trial court's order compelling appraisal de novo
with respect to the application of law to facts; the trial court's
factual findings we review for competent, substantial evidence. See
Fla. Ins. Guar. Ass'n v. Hunnewell, 173 So. 3d 988, 991 (Fla. 2d
DCA 2015); Barbato v. State Farm Fla. Ins. Co., 319 So. 3d 96, 97
(Fla. 3d DCA 2021). Like the Third District, we have left it to trial
courts to decide the order in which damages and coverage issues
are ascertained vis-à-vis an appraisal process under an insurance
policy. See Am. Cap. Assurance Corp. v. Leeward Bay at Tarpon
Bay Condo. Ass'n, 306 So. 3d 1238, 1242 (Fla. 2d DCA 2020)
(adopting Sunshine State Ins. Co. v. Rawlins, 34 So. 3d 753, 755
4
(Fla. 3d DCA 2010)). But see Citizens Prop. Ins. Corp. v. Demetrescu,
137 So. 3d 500, 502 (Fla. 4th DCA 2014) ("[A]ppraisal is premature
where there is a disputed issue of fact regarding coverage and
where the trial court fails to 'resolve this dispute of fact with
competent evidence to support its determination of coverage.' "
(quoting Sunshine State Ins. Co. v. Corridori, 28 So. 3d 129, 131
(Fla. 4th DCA 2010))).3
However, when an insurance company wholly denies a claim,
the trial court cannot refer that claim to appraisal. See Johnson v.
Nationwide Mut. Ins. Co., 828 So. 2d 1021, 1022 (Fla. 2002)
("[C]ausation is a coverage question for the court when an insurer
wholly denies that there is a covered loss and an amount-of-loss-
question for the appraisal panel when an insurer admits that there
is covered loss, the amount of which is disputed."); Merrick Pres.
Condo. Ass'n v. Cypress Prop. & Cas. Ins. Co., 315 So. 3d 45, 50
(Fla. 4th DCA 2021); Kendall Lakes Townhomes Devs., Inc. v. Agric.
Excess & Surplus Lines Ins. Co., 916 So. 2d 12, 15-16 (Fla. 3d DCA
3 The Florida Supreme Court accepted jurisdiction to consider
Leeward Bay in American Capital Assurance Corp. v. Leeward Bay
at Tarpon Bay Condo. Ass'n, No. SC20-1766, 2021 WL 416684 (Fla.
Feb. 8, 2021).
5
2005); Arch Specialty Ins. Co. v. BP Inv. Partners, LLC, No. 6:18-cv-
1149-Orl-78DCI, 2020 WL 5534279, at *2 (M.D. Fla. Mar. 11,
2020); 767 Bldg., LLC v. Allstate Ins. Co., 10-60007-CIV, 2010 WL
1796564, at *2 (S.D. Fla. May 4, 2010). As our court summarized
in another Hurricane Irma dispute, Villagio at Estero Condominium
Ass’n v. American Capital Assurance Corp., 46 Fla. L. Weekly D879,
D886 (Fla. 2d DCA Apr. 16, 2021):
It is undisputed that a coverage challenge "is
exclusively a judicial question" rather than one for
appraisal. But " 'when the insurer admits that there is a
covered loss,' any dispute on the amount of loss is
appropriate for appraisal."
(Citations omitted) (first quoting Johnson v. Nationwide Mut. Ins.
Co., 828 So. 2d 1021, 1025 (Fla. 2002); then quoting Cincinnati Ins.
Co. v. Cannon Ranch Partners, Inc., 162 So. 3d 140, 143 (Fla. 2d
DCA 2014)).
The only ripple the case at bar presents is the manner in
which the claims were presented to the insurer—Heritage acceded
to the initial claim for roof repairs but wholly denied Veranda's
supplemental claim for damages to the windows and doors. Yet
another Hurricane Irma insurance case resolves this ripple.
6
In American Coastal Insurance Co. v. Ironwood, Inc., 46 Fla. L.
Weekly D2315, D2315 (Fla. 2d DCA 2021), a condominium
association made a property insurance claim for roof damages,
which its insurer paid. More than a year later, the association
sought coverage for damages to the condominiums' windows and
doors. A dispute arose as to whether the subsequent request for
damages to the windows and doors could be subject to appraisal
because the insurer had not yet determined whether it would
provide coverage for those damages. The circuit court nevertheless
compelled appraisal as to the windows and doors.
In reversing that order, our court held:
[T]he 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. . . .
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.
Id. at D2315-16 (second, third, and fourth alterations in original).
7
The facts and policy language at issue in Ironwood are
virtually indistinguishable from the case at bar.4 Because
Veranda's claim for windows and doors was a supplemental claim
for coverage, Ironwood instructs that we must consider that claim
separately from the initial roof claim that had been fully adjusted.
And since Heritage wholly denied coverage for that supplemental
claim, Johnson and its progeny precluded the trial court from
referring it to appraisal.
Accordingly, we reverse the order compelling appraisal of the
supplemental claim and remand for further proceedings.
Reversed and remanded.
ATKINSON and LABRIT, JJ., Concur.
Opinion subject to revision prior to official publication.
4 In arguing for affirmance, Veranda suggests we should ignore
the manner in which insurance coverage is typically reviewed and
adjusted—that is, through "claims" made on policies—and instead
look at "the overall loss as the determinative factor" for appraisal.
As Veranda puts it, "The dispute lies in causation of whether
damages arose from Hurricane Irma." That may be true. But
Veranda submitted a separate "supplemental claim" (as that term is
defined in the policy) for coverage for its windows and doors.
Because what was presented was a separate, supplemental claim,
Heritage could adjust it separately (as, indeed, it did).
8