Insurance Services – Coverage & Bad Faith Litigation

The Fourth District Court of Appeals ruled that the final judgment against the appellant stands because the appellant failed to comply with the requirement to submit a proof of loss. 

The insured, Alton Forbes, purchased a homeowners’ insurance policy from People’s Trust Insurance Company, which was effective January 19, 2011, through January 19, 2012. The insured alleged his property sustained roof damage on/or around October 15, 2011, and subsequently reported a claim to People’s Trust. When the insurance carrier eventually denied full payment of the claim, the insured filed a lawsuit on February 10, 2015.

In the underlying suit, the insurance carrier moved for summary judgment, arguing the insured’s lawsuit must be dismissed due to their failure to comply with their post-loss obligations, as outlined in the insurance policy. Namely, Alton Forbes failed to timely submit a sworn proof of loss. 

In response, while the insured conceded they did not submit a proof of loss upon People’s Trust, they argued that People’s Trust failed to establish the requisite prejudice from their failure to comply with submission of their proof of loss. The trial court disagreed and found that the undisputed evidence showed the insurer requested a formal proof of loss. Since the insured did not comply with the policy requirement, the court granted People’s Trust’s motion for summary judgment.

The insureds appealed to the Fourth District Court of Appeal, which affirmed the final judgment and ruled that Alton Forbes breached a condition precedent when he failed to submit a sworn proof of loss. 

Additionally, the district court rejected the appellant’s argument that the insurer’s attempt to utilize a preferred contractor (pursuant to a policy endorsement) relieved him of his contractual duty to provide a sworn proof of loss. The district court held itself as bound by the decision in Goldman v. State Farm Fire General Insurance Co., 660 So. 2d 300, 303 (Fla. 4th DCA 1995), which holds that an “insurer need not show prejudice when the insured breaches a condition precedent to suit.” Therefore, the district court further certified conflict with the Third District Court’s decisions of Am. Integrity Ins. Co. v. Estrada, 276 So. 3d 905, 916 (Fla. 3d DCA 2019) and Shivdasani v. Universal Prop. & Cas. Ins. Co., 306 So. 3d 1156, 1162 (Fla. 3d DCA 2020). 

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