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State Farm Florida Insurance Company v. Figueroa

Florida Court of Appeals, Fourth District

February 8, 2017

STATE FARM FLORIDA INSURANCE COMPANY, Appellant,
v.
DINA FIGUEROA, Appellee.

         Not final until disposition of timely filed motion for rehearing.

         Appeal from the Circuit Court for the Seventeenth Judicial Circuit, Broward County; Dale Ross, Judge; L.T. Case No. 10-31874 (08).

          Elizabeth K. Russo and Kevin D. Franz of Russo Appellate Firm, P.A., Miami, and Green & Ackerman, P.A., Boca Raton, for appellant.

          George A. Vaka and Nancy A. Lauten of Vaka Law Group, Tampa, and David J. Pettinato of Merlin Law Group, Tampa, for appellee.

          Gross, J.

         State Farm raises two issues in this appeal of a final judgment entered for the insured. State Farm argues first that the trial court erred in denying its summary judgment and directed verdict motions because the insured failed to timely comply with policy obligations following the loss. State Farm also argues that, at a minimum, a new trial is required because the introduction of the insured's health issues at trial was both irrelevant and highly prejudicial.

         We reject the first issue because the insured's substantial compliance with her post-loss obligations under the policy involved issues of fact properly resolved by the jury. On the second issue, because evidence of the insured's health should never have been introduced, we reverse for a new trial.

         The insured, Dina Figueroa, first filed a claim on October 30, 2005, after Hurricane Wilma hit on October 24, 2005. State Farm sent an adjuster to her home on December 17, 2005. The adjuster believed that 29 roof tiles had been damaged by the hurricane, but that, because the cost to repair those roof tiles did not exceed the insured's policy deductible, it was unable to provide a payment. State Farm advised the insured that she was free to obtain her own estimate of the cost of repairs, and to contact it immediately if she obtained an estimate that was above her deductible. In 2005, State Farm did not insist that the insured file a sworn proof of loss.

         The insured contacted a few roofers, but none were interested in the job. In January 2006, the insured began dealing with a serious medical condition, which distracted her from following up with her claim.

         In late 2008, the insured obtained a contractor's estimate that included a new roof because more than 25% of her roof tiles had been loosened by wind damage. The contractor estimated that a new roof would cost $43, 648. The insured informed State Farm in early 2009 that she wanted to reopen her claim, sending along the contractor's estimate.

         State Farm sent another adjuster to the insured's home in April 2009, who concluded that the original estimate was correct. After that inspection, State Farm sent the insured a letter that outlined her obligations under the policy following a loss. In relevant part, the policy required her to protect the property from further damage by making reasonable and necessary temporary repairs, and to submit to State Farm a signed sworn proof of loss within 60 days of the loss. The policy provided that no action could be brought against State Farm unless there was compliance with these provisions.

         The insured submitted a sworn proof of loss along with the contractor's estimate on June 8, 2009. Counsel for State Farm responded in late September 2009, informing the insured that the proof of loss did not comply with policy provisions. Subsequently, upon State Farm providing a proof of loss form to the insured in March 2010, the insured completed and submitted the proof of loss form on June 10, 2010.

         On June 22, 2010, State Farm notified the insured that it was relieved of its obligations under the policy because of the insured's material breach, specifically, her failure to timely submit a valid sworn proof of loss. The insured filed suit the following month.

         State Farm moved for summary judgment, arguing that the insured failed to comply with her post-loss obligations under the policy. It argued that the insured failed to submit a sworn proof of loss within 60 days of the loss and failed to protect her property from further damage by making reasonable and necessary repairs. The insured responded that she substantially complied with her post-loss obligations and that State Farm was not prejudiced by her untimely compliance. The insured also explained that she was unable ...


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