Professional Liability

In a decision clarifying the role of the jury in insurance coverage disputes, the Second District Court of Appeal reversed three directed verdicts previously entered in favor of the insurer in a breach of contract case. The underlying dispute centered on whether damage to more than 25% of the plaintiffs’ roof required full replacement and whether the insurer failed to pay the actual cash value of the loss. Although the trial court concluded the plaintiffs presented no evidence of underpayment and had not triggered the defendant’s obligation to issue additional benefits, the appellate court held that the parties’ sharply conflicting evidence regarding roof damage, interior repairs, and valuation created factual disputes that should have been decided by a jury.

The underlying breach of contract suit involved a coverage dispute pertaining to roof repairs at Clifton and Velona Westons’ property. After the claim was filed, Universal Insurance inspected the property and found damaged shingles on the roof and interior damage. Universal then prepared an estimate and sent a payment to the Westons after applying the deductible. The Westons disagreed with Universal’s assessment and obtained estimates from roofers. 

At trial, the Westons’ engineer opined there was damage to more than 25% of the roof; thus, the entire roof needed to be replaced. This expert also noted that the new shingles would not match the color of the old shingles. 

The trial court determined that the Westons’ estimate was not an actual cash value estimate because it included costs for matching the shingles, costs incidental to the repair and construction process and costs for compliance with the building code’s 25% rule, all of which address repairs to portions of the property that were not directly and physically damaged by the claimed loss.

The trial court ruled that: (1) the Westons presented no evidence on which a reasonable juror could find that Universal failed to pay at least the actual cash value of the loss; (2) as the Westons did not begin to replace their roof prior to filing suit, Universal was under no obligation to make any additional payments; and (3) the only estimate in evidence presented to Universal prior to suit was the estimate on which it made payment.

However, the Second District Court of Appeal concluded that the evidence presented at trial, when viewed in the light most favorable to the Westons, could support a verdict in their favor and that the trial court erred in not allowing the jury to hear the parties' competing valuations of the Westons' loss. The court concluded that the dispute over the interior damage, the percentage of the roof damaged, and the cost to repair the damages to the property were disputes over facts that should have been submitted to a jury; therefore, the trial court erred in entering a directed verdict.

As it was undisputed that Universal rejected the Westons' claim that their roof needed to be replaced, Universal maintained that it had no further obligation to the Westons and was unwilling to pay the actual cash value of the roof replacement and interior damage. Thus, the second directed verdict was erroneous as Universal was arguably in breach of the policy by rejecting the Westons’ claim for roof replacement and related damages and, as a result, failing to pay the actual cash value of the loss.

Further, the court determined that the trial court erred in entering the third directed verdict because “the policy did not require the Westons to provide the company with an actual cash value estimate before filing suit. This is especially notable as Universal had taken the position well before suit was filed that its payment fulfilled its obligation to the Westons.” Further, the corporate representative of Universal testified that they “received estimates for roof repairs from the Westons before they filed suit. Universal simply disagreed with the estimates because they were for roof replacement and related repairs, which Universal had determined were unnecessary. Thus, the Westons satisfied their obligations under the policy before filing suit.”

Thus, the Second District Court of Appeal reversed the final judgment in favor of Universal. 

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_{Legal Update for Florida Coverage & Property Litigation – December 2025 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 © 2025 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.}