District Court for the Middle District of Florida rules insurance company cannot be compelled to go to appraisal without the insured first satisfying all post-loss obligations.

The plaintiff filed a claim for property damage resulting from Hurricane Ian pursuant to a property insurance policy. The carrier found partial coverage for the loss, but did not provide the amount of the covered damages. 

The policy issued by the carrier contained a post-loss obligation provision, which required the insured to send a signed, sworn proof of loss containing the information it requests to investigate the claim on a form supplied by the carrier and to cooperate in the investigation or settlement of the claim. The plaintiff provided a signed, sworn proof of loss, but did not use the required form. The carrier sent twelve requests for a signed, sworn proof of loss on its form without success. The carrier also asked for documents to support the claim for damages on eight occasions, all of which were ignored. 

The plaintiff filed a motion to compel appraisal, claiming it substantially complied with the policy. The plaintiff argued the sworn proof of loss form it used was substantially similar and the policy did not state the form supplied by the carrier is “mandatory.” Further, the plaintiff claimed it did not need to comply with the document requests because the carrier should have obtained everything it needed during its two inspections and examination of the plaintiff’s representative. 

The court found that, based upon the wording in the policy, which stated the carrier would supply the “necessary” forms, the carrier’s sworn proof of loss form was mandatory. However, the court found that, even if it was not mandatory, there was information on the carrier’s form that was not included on the form provided by the plaintiff and that the plaintiff did not even complete all of the information included on the form it did submit. Therefore, the court found the plaintiff did not provide a signed, sworn proof of loss containing the information the carrier requested. 

The court also found that the plaintiff did not cooperate with the investigation of the claim by failing to produce documents. The court stated it is not on the carrier to “dig up evidence, [plaintiff] was required to provide it.” The court ultimately ruled that, because “an insured seeking appraisal must comply with all post-loss obligations before the right to appraisal can be invoked,” the court denied the plaintiffs motion to compel appraisal. 

_{Legal Update for Florida Coverage & Property Litigation – September 2024 is prepared by Marshall Dennehey to provide information on recent legal developments of interest to our readers. This publication is not intended to provide legal advice for a specific situation or to create an attorney-client relationship. We would be pleased to provide such legal assistance as you require on these and other subjects when called upon. ATTORNEY ADVERTISING pursuant to New York RPC 7.1 Copyright © 2024 Marshall Dennehey, all rights reserved. No part of this publication may be reprinted without the express written permission of our firm. For reprints or inquiries, or if you wish to be removed from this mailing list, contact tamontemuro@mdwcg.com.}