Heritage Property & Casualty Insurance Company v. Forest Mere Townhouse Community Association, Inc.
CourtDistrict Court of Appeal of Florida
Date FiledJuly 1, 2022
Docket2D21-1470
StatusPublished
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Full Opinion
DISTRICT COURT OF APPEAL OF FLORIDA
SECOND DISTRICT
HERITAGE PROPERTY & CASUALTY INSURANCE COMPANY,
Appellant,
v.
FOREST MERE TOWNHOUSE COMMUNITY ASSOCIATION, INC.,
Appellee.
No. 2D21-1470
July 1, 2022
Appeal pursuant to Fla. R. App. P. 9.130 from the Circuit Court for
Lee County; Leigh Hayes, Judge.
David A. Noel and Kara Rockenbach Link of Link & Rockenbach,
PA, West Palm Beach; and Jeffrey A. Rubinton and Laila Mina of
Rubinton & Associates, P.A., Hollywood, for Appellant.
Cary J. Goggin, Amanda C. Broadwell, and Jessica Rodriguez
of Goede, Adamczyk, DeBoest & Cross, PLLC, Naples, for Appellee.
MORRIS, Chief Judge.
Heritage Property & Casualty Insurance Company (Heritage)
appeals an order compelling appraisal of a supplemental insurance
claim brought by Forest Mere Townhouse Community Association,
Incorporated (Forest Mere). Because we conclude that Heritage
fully denied coverage of the supplemental claim at issue, we reverse
the order compelling appraisal of the amount of loss.
This case involves damages alleged to have been caused by
Hurricane Irma. Forest Mere initially submitted two claims under
its policy with Heritage for roof damage to its seven condominium
buildings. Heritage determined that the roof damages were covered
under the policy, and it issued two payments to Forest Mere.
Almost nineteen months later, Heritage received a letter from
Forest Mere's public adjuster containing a supplemental claim1 for
replacement of all windows and doors on the condominium
buildings due to alleged Hurricane Irma damage. Heritage
investigated the claim but ultimately denied coverage for the
supplemental claim in its entirety.
1 As articulated herein, this new claim meets the definition of a
"supplemental claim" as set forth in the insurance policy:
"Supplemental claim or reopened claim means an additional claim
for recovery from us for losses from the same hurricane or other
windstorm which we have previously adjusted pursuant to the
initial claim."
2
Forest Mere then filed a complaint against Heritage for breach
of contract, and Forest Mere sought to compel Heritage to submit to
an appraisal as set forth in the insurance policy.2 Heritage asserted
that appraisal was inappropriate because it had never
acknowledged coverage for the supplemental claim. Forest Mere
filed a motion to stay the litigation and to compel appraisal arguing
that the claim should not be considered supplemental because it
had not been previously adjusted as part of the original claim. After
2 The policy's appraisal provision provides in relevant part:
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
an evidentiary hearing, the trial court agreed with Forest Mere and
entered an order compelling appraisal.
The issue in this case was recently decided in another case
involving Heritage. See Heritage Prop. & Cas. Ins. Co. v. Veranda I
at Heritage Links Ass'n, 334 So. 3d 373 (Fla. 2d DCA 2022). In that
case, the insurance policy contained identical language to the policy
in this case regarding the definition of a "supplemental claim" as
well as the rights and responsibilities relating to an appraisal. As in
this case, Heritage acknowledged coverage for the claim for roof
repairs but wholly denied coverage for the supplemental claim for
damages to windows and doors. See id. at 375. We acknowledged
that where an insurer admits coverage but disputes the amount of
loss, that issue is appropriately referred to an appraisal panel. Id.
at 376 (citing Villagio at Estero Condo. Ass'n v. Am. Capital
Assurance Corp., 46 Fla. L. Weekly D879, D886 (Fla. 2d DCA Apr.
16, 2021)). But we explained that where an insurer wholly denies
coverage for a claim, it cannot be referred to appraisal because that
is a coverage question which must be decided by the court. Id.
(citing Johnson v. Nationwide Mut. Ins. Co., 828 So. 2d 1021, 1022
(Fla. 2002)).
4
Relying on this court's opinion in American Coastal Insurance
Co. v. Ironwood, 330 So. 3d 570 (Fla. 2d DCA 2021), which involved
nearly identical facts and policy language, we concluded that the
windows-and-doors claim made by Veranda was not part of the
original roof-damage claim but was instead a supplemental claim as
defined by the policy. Veranda I at Heritage Links Ass'n, 334 So. 3d
at 376-77. As a result, we explained that it had to be considered
separately from the initial roof claim that had been fully adjusted.
Id. at 377. And because Heritage had wholly denied coverage for
the windows-and-doors claim, we held that the trial court was
precluded from referring that claim to appraisal. Id.3
Here, because Heritage wholly denied coverage of the
supplemental windows-and-doors claim, we conclude that our
disposition is controlled by our decisions in both Veranda I at
Heritage Links Ass'n and Ironwood.4 Accordingly, we reverse the
3 See also Heritage Prop. & Cas. Ins. Co. v. Fairway Oaks, Inc.,
47 Fla. L. Weekly D938 (Fla. 2d DCA Apr. 22, 2022) (applying
Veranda I at Heritage Links Ass'n and reversing order compelling
appraisal on the same basis).
4 For the reason explained in Veranda I at Heritage Links
Ass'n, we reject Forest Mere's attempt to distinguish between a
"covered loss" and a "supplemental claim" for purposes of
5
order compelling appraisal of the supplemental claim and remand
for further proceedings.
Reversed and remanded.
SLEET and LABRIT, JJ., Concur.
Opinion subject to revision prior to official publication.
determining whether appraisal is appropriate. See Veranda I at
Heritage Links Ass'n, 334 So. 3d at 376 n.4.
6