Appeals Court Rejects Appraisal Demand Where the Insured Fails to Meet the Insurer's Post-Loss Claim Investigation Requests

Steven G. Schwartz, Esq.
February 3, 2010

In a decision of major importance to the entire insurance community, the firm won a trend-setting appeal rejecting the insured's petition to compel a homeowners claim appraisal where the insured had failed to comply with the insurer's post-loss requests for supportive documentation, Examination Under Oath and timely submission of a Proof of Loss.  In Sunshine State Insurance Company v. Corridori, 28 So.3d 129 (Fla. 4th DCA 2010), the Fourth District Court of Appeal directed that trial judges should deny an insured's demand to force the insurer to proceed with any appraisal of the claim unless the insured can demonstrate full cooperation with the insurer's loss investigation.  The Court ruled that where coverage disputes persist, the lower court should not impose upon the insurer some "dual track" burden of having to both litigate the coverage issues and also engage in some costly and possibly needless appraisal of the amount of loss absent record evidence that the insured earlier met all post-loss claim investigation requirements as insurance policy conditions precedent to any right to compel appraisal.  This decision is important because in the aftermath of Hurricane Wilma, insurers have been flooded with an unprecedented number of questionable claims.  Public adjusters and plaintiff attorney's are presenting literally thousands of so-called "supplemental" insurance claims seeking all sorts of new repairs to the dwelling often solicited by the public adjuster without clarity of true loss-related damages yet all too often accompanying the filing of these questionable claims with a refusal to cooperate with the insurer's requests for supportive information.  Many of the public adjusters and the plaintiff bar have also engaged in a persistent course of delaying or simply preventing the claim investigation all together, creating hurdles for the insurer's requests for policy-mandated Examinations Under Oath, timely return of company requested Sworn Statements in Proof of Loss and other investigation cooperation.  Instead without proper basis the public adjusters and plaintiff attorneys have demanded that the insurer submit the claim to an appraisal often without first providing clear explanation for the amounts in dispute only to use the appraisal demand clock or the inflated award as a tool to force payment before the claim investigation or coverage issues can be properly addressed.  In a decision of sweeping implications for how insurers conduct their investigaitons, in Corridori, the Court clarified this area of the law siding with the insurer in its reasonable investigation approach before any appraisal might be considered appropriate.  See full case decision.

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