Homeowners in Palm Beach, Broward, and Martin County – Are you prepared to pay out of pocket for repairs if your insurance company underpays or denies your claim?

Universal Property & Casualty Insurance Company v. Qureshi, No. 4D2023-1338 (Fla. 4th DCA, July 24, 2024) – To read the opinion click here : https://4dca.flcourts.gov/content/download/2438086/opinion/Opinion_2023-1338.pdf 

This opinion from the Fourth District Court of Appeal sets new legal precedent that could significantly affect your rights if you need to file an insurance claim. 

If you own a home in Florida, you have likely been paying several thousand dollars in premiums each year with the understanding that your insurance company would compensate you for damage and necessary repairs following any covered claim. But what if your insurance company doesn’t pay what you need to fix your home? What if you disagree with your property insurance companies claim decision? What for and why am I paying my property insurance company thousands of dollars every year?

This recent court decision may cause hurricane size impacts soon to insureds throughout Florida with immediate effects on Palm Beach, Broward, and Martin County homeowners.

Florida homeowners must now start facing difficult questions like – do you have $57,836.83 set aside to pay for repairs if you had an unexpected water leak in your house? 

If not, then picture this common scenario – whether it’s a bathroom or kitchen leak your home has water damage. Despite your efforts at cleanup, you notice spots of mold beginning to appear. Your insurance company refuses to pay anything or in this story pays you to clean up the mold but denies payment for the water damage. You get estimates for repairs, but your insurance company stands on its original decision and refuses to do anything further. 

Under this scenario, the Fourth District Court of Appeal in Universal v. Qureshi held that you as the homeowner must now bear the financial responsibility of paying for repairs before you would be entitled to sue your property insurance company, seemingly no matter how egregious your insurance company was wrong or clearly failed to comply with its obligations under the policy. 

In Universal v Qureshi, homeowners sued claiming their insurance company didn’t pay enough for water and mold damage caused by a sudden water leak. The insurance company issued payment for mold cleanup but denied any payment was owed for the water damage claiming the policy excluded coverage for damage that its investigation revealed occurred over months or years. 

The insured homeowners disputed that the leak had been ongoing for months and received estimates but did not have the money to pay for all the necessary repairs at their home. Before and during their trial, the insurance company, Universal Property & Casualty Insurance Company, requested that the trial judge prevent the introduction of any estimates or evidence about the estimated cost of repairs that the insureds were unable to perform. The trial court rejected the insurance company’s argument that the policy and Fla. Stat. §627.7011 prevented the insureds from using estimates at trial for work that hadn’t been performed yet. The jury returned a verdict in favor for the insureds finding that the insurance company breached the policy by denying coverage for the water damage and awarded the insureds $57,836.83 based off the estimated replacement cost. But the insurance company appealed, and the Fourth District Court of Appeal reversed. 

On July 24, 2024, the Fourth District Court of Appeal issued the Universal v. Qureshi opinion and ruled that the trial court improperly admitted replacement cost evidence, holding that “insureds are not entitled to their repair costs unless and until work is performed and expenses are incurred.” 

This is inapposite to a prior 2020 ruling in favor of homeowners from the Third District Court of Appeal in Citizens Prop. & Cas. Ins. Co. v. Tio, 304 So. 3d at 1278 (Fla. 3d DCA 2020). In that case the Third DCA rejected Citizens’ “rather creative, though unavailing argument that, when an insurer wrongfully denies coverage of a claim – causing its insured to file suit against the insurer for breaching the insurance contract – section 627.7011(3) limits the breach of contract damages a jury may award, as if the insurer had not breached the insurance contract.” 

We encourage everyone to read this recent Universal v. Qureshi opinion as well as the detailed dissent by Judge Warner, unrelated, which acknowledges the significant frustrations that all Florida homeowners will have when forced to deal with the financial implications of incorrect claim decisions by their insurance company. 

Despite this possibly coming as a surprise to many policyholders, the Fourth DCA stated that “the parties freely negotiated for that contractual provision and it is not the place of a court to red-line that obligation from the contract.” Our office is unaware of any standard issued homeowner policy in Florida that does not include the ambiguous provision referenced by the Court or any ability for a homeowner to “freely negotiate” the terms of a standard issued HO policy outside of coverages or amounts. 

Our office has handled many cases with obvious mistakes or omissions from insurance company payments or coverage determinations that nevertheless necessitated litigation for our clients to receive the money they should have initially been entitled to in order to fix their damaged home. 

Prior to 2023, if your insurance company issued an unsatisfactory payment or refused to pay for necessary repairs and you prevailed via settlement or trial your insurance company was responsible for your attorney’s fees and costs. Due to recent legislation and tort reform, the State of Florida ripped away this long standing right where homeowners could be made whole after prevailing and proving that their insurance company failed to issue the proper amounts or breached the contractual terms of a policy. 

This great shift of power to insurance companies will continue to harm Florida homeowners who have seen no rate reductions. Due to the passage of recent tort reform and anti-consumer legislation in Florida, residents may now have to find ways to pay for all their repairs and be responsible for their own attorney’s fees and any costs associated with obtaining any insurance payments that they were rightfully entitled to from the beginning.  

While the Florida Supreme Court may ultimately decide the issues in conflict between the opinions from the Fourth DCA in Universal v. Qureshi and the Third DCA in Citizens v. Tio, this case law is important for you to be aware of if you ever must make any type of claim for damage to your home in Palm Beach, Broward, and Martin County. In the meantime, these cases are persuasive authority for the rest of Florida. It may be now more important than ever for Florida homeowners to start saving and set aside an emergency fund for any unexpected damage. 

Warner & Fitzmartin can serve clients who want to prepare to fight back against their insurance companies when they wrongfully deny or underpay property damage claims. The estimates prepared by insurance companies and the policy exclusions they routinely raise can be very confusing and difficult to comprehend. If you have questions about your property damage insurance claim, call the attorneys at Warner & Fitzmartin at (561) 821-3098.

 

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