New Case Ruling Shows the Importance of Proper Action Before Filing a Lawsuit

The Garden-Aire Village South Condominium Association recently learned the hard way that failure to comply with certain pre-requisites can thwart efforts to address a claim. This association filed a lawsuit against its insurance company, QBE Insurance Corporation, in October of 2010 - shortly before five (5) years from Hurricane Wilma.

 The association requested the court to:

 

  1. Find that glass windows and sliding glass doors were covered under the association’s master insurance policy;
  2. Find that the association was entitled to have its Hurricane Wilma loss appraised under the policy; and to
  3. Find that the windstorm deductible was void because the policy didn't include specific disclosures in a specific font as required by Section 627.701(4), Florida Statutes.

The lawsuit was filed as an action for declaratory judgment.  There are both state and federal procedures available for someone to obtain a declaratory judgment from a court when there is a uncertainty involving differing interpretations of rights or obligations pursuant to a contract, statute or other legal documents.  In Florida this process is addressed in Chapter 86 of the Florida Statutes.  Section 86.021, Florida Statutes says:

"Power to construe.—Any person claiming to be interested or who may be in doubt about his or her rights under a deed, will, contract, or other article, memorandum, or instrument in writing or whose rights, status, or other equitable or legal relations are affected by a statute, or any regulation made under statutory authority, or by municipal ordinance, contract, deed, will, franchise, or other article, memorandum, or instrument in writing may have determined any question of construction or validity arising under such statute, regulation, municipal ordinance, contract, deed, will, franchise, or other article, memorandum, or instrument in writing, or any part thereof, and obtain a declaration of rights, status, or other equitable or legal relations thereunder."

The Federal laws are slightly different.  Federal law requires the party filing the action to show they have been harmed or are facing imminent harm as a result of the differences in interpretation or analysis of the rights and obligations of the parties.

In this case the association couldn't show there was an actual controversy at the time it filed the lawsuit.  The lawsuit alleged that QBE didn't "consider the windows and sliding glass doors".  It also alleged that QBE "has frequently taken the position in the past that windows and sliding glass doors are not covered", but QBE did not issue that statement or position with respect to the Garden-Aire claim as it wasn't forced to do so by actions on the part of the association.  Since the insurance carrier didn't formally deny a claim for coverage of windows and sliding glass doors before the lawsuit was file, the court dismissed the association's claim. [See Garden-Aire Village South Condominium Association, Inc. vs. QBE Insurance Corporation, Case No. 10-6195-CIV-DIMITROULEAS]

The court likewise dismissed the second portion of the claim, finding that the association didn't provide QBE with the reasonable opportunity to evaluate the damages alleged in the association's supplemental claim.  The association demanded an appraisal the day after it filed its lawsuit when it should have submitted evidence of the damages beforehand.

Since a ruling on the the third count depends upon a ruling in a case already pending before the Florida Supreme Court, that portion of the lawsuit was put on hold by agreement of the parties and the court itself.

Dismissal of the first two counts is quite significant.  The court mentioned the fact that some of the association's claims may be time-barred as a result of the Statute of Limitations.  The lesson here is that you can't skip steps when it comes to litigation.  If there are pre-requisites to filing suit, work with counsel to ensure they are met (or waived) beforehand.

FIGA Coverage Limits: Check Your Policies to Maximize Coverage

Are you completely familiar with the insurance coverage available to your association?  Will you have FIGA coverage in the event your insurance carrier becomes insolvent? 

The Florida Insurance Guarantee Association (FIGA) was created to ease the burden on policyholders with claims when an insurance carrier becomes insolvent.  FIGA coverage is limited to licensed insurers in the State of Florida, otherwise referred to as admitted carriers.  When an admitted insurance company becomes insolvent, the FIGA pays eligible claims.  However there is no FIGA coverage for non-admitted or unlicensed products, such as surplus lines or is a self-insurer covered in the non-admitted market.

While FIGA steps into the shoes of the dissolved carrier, payment limits are established by statute, not the original policy.   The way the policy is written for a multi-building association is important - very important as demonstrated by the recent ruling in Florida Insurance Guarantee Association v. B.T. of Sunrise Condominium Association, Inc.  The ruling is hot off the press and therefore subject to rehearing upon proper Motion.

There are seven (7) buildings within the B.T. of Sunrise Community.  All of them were damaged by Hurricane Wilma.  The association filed its insurance claim with the carrier, Southern Family.  Southern Family assigned one claim number to the entire claim and paid for certain damages before it went insolvent. 

The association was not satisfied with the amount paid by Southern Family and therefore requested supplemental payments from FIGA.  FIGA issued a check for what it believed was its statutory limit: $300,000 minus $100 for the FIGA deductible.  The association then challenged FIGA's finding - there were seven (7) buildings, each listed separately, each covered for a specific amount and each had a specific premium payment based on the coverage amount.  Why would FIGA only pay for one claim?  The association argued FIGA should pay for seven (7) claims.

That issue was decided in the association's favor at the trial level.  FIGA appealed and the Fourth District likewise ruled in favor of the association.  FIGA will now have to participate in the appraisal process with respect to each building - with separate limits of coverage for each building.

Please review your policies and declaration pages carefully, then discuss this issue with your insurance professional.   Make sure your community has the maximum benefit fromFIGA coverage.

Coral Insurance Company Placed in Receivership - FIGA is now Handling Claims

Florida Insurance Guaranty Association (FIGA) issued the following announcement:

Effective July 26, 2010, Coral Insurance Company (“CIC”) was ordered into receivership for the purposes of liquidation by the Second Judicial Circuit Court in Leon County, Florida.

With the entry of the liquidation order, the Florida Insurance Guaranty Association (“FIGA”) has been activated to help pay outstanding claims for property and casualty policies. The processing and payment of covered claims will be made by FIGA (subject to the lesser of policy limits or FIGA’s maximum cap). The maximum amount FIGA will cover is generally $300,000 per claim or $100,000 per unit for condominium and homeowner association claims. An additional $200,000 is available for structure and contents on homeowners’ claims.

FIGA is the state backed system that pays portions of claims against insolvent insurance companies.   Since FIGA is statutory, there is a shorter period of time to report and/or file an action with respect to a disputed claim.  Pursuant to Section 631.68, Florida Statutes, the deadline for settling a claim or filing suit against FIGA for damages from a loss formerly insured by Coral Insurance Company is July 25, 2012.

For more information on claim filing deadlines or refunds of unearned premiums, please visit Alex Sink's website: myfloridacfo.com.

 

Anatomy of a Disaster Claim: Webinar Available for Replay

If you missed the recent webinar Anatomy of a Disaster Claim, it is now available for replay by following the link below:

DISASTER CLAIM WEBINAR

We thank all the participants for their valuable input.  If your community has not developed or implemented a disaster plan, I suggest reviewing the lead article in one of the more recent Community Updates.  Click below to link to the article:

 

HURRICANE CHECKLISTS PART TWO: What to do after the storm

Within hours of any disaster, affected communities will be besieged with offers by companies and individuals offering disaster recovery assistance.

 Please resist the urge to contract with these initial providers until you have done the following:

 

  1. Activate Your Disaster Plan. Once residents are safe, the community must begin surveying the property and assessing the damage. A designated information facilitator should set up system of information sharing among local homeowners and a disaster coordinator should serve as liaison to emergency services providers;
  2. Secure your community from acts of vandalism and looting;
  3. Remove storm debris to prevent accidents from occurring on the property;
  4. Secure building structures to mitigate further damage;
  5. Evaluate & Determine needs for immediate reconstruction and evaluate financing options including advances from insurance company for financial advances. BEWARE OF ANY INSURANCE COMPANY OFFERING MONEY IN EXCHANGE FOR RELEASES OR SETTLEMENTS.
  6. Suspend or cancel on-going contracts such as lawn or pool maintenance if allowed for in your contract;
  7. Review governing documents particularly anything related to "repair after casualty" provisions in the insurance section to establish process for reconstruction;
  8. Initiate reconstruction planning using the five phases of reconstruction: project planning/scheduling; construction bidding; contract negotiations; construction/repair/rehabilitation; project completion/close out.
  9. Review Insurance policies to determine filing requirements for proof of loss forms.
  10. Meet with licensed professionals familiar with your community which may include: a) architect/engineer to assess damage and prepare plans; b) construction manager to oversee selection of general contractor and begin competitive bidding process; c) attorney to review insurance policies, governing documents, construction contracts and any vendor agreements; and d) public adjuster who is independent of your insurance company's adjuster who can be helpful with the nuances of an ambiguous insurance policy. Most independent adjusters work for a fee based upon percentage of insurance proceeds.

Following these ten steps will help communities recover and rebuild as quickly and effectively as possible.

Best Advice: Make sure every contract is with a Florida Licensed and Insured Contractor and that it is reviewed by a Licensed Florida Attorney, prior to signing.

We thank all the webinar participants who shared personal experiences and submitted well thought-out questions to the facilitators.  If you could not attend today, please return to this site for a link to the recorded presentation.

HURRICANE CHECKLISTS: WHAT TO DO BEFORE & AFTER THE STORM

In anticipation of Friday's webinar, here is the first in our two-part checklists for community associations.

Becker & Poliakoff's 12-point Hurricane Preparedness Checklist includes the following tips for those who need to prepare their communities for the upcoming hurricane season: 

 

 

  1. Disaster Plan – Do a risk analysis of potential consequences of a storm and develop a complete disaster plan, designating a responsible community member as Disaster Plan Coordinator and another as Information Facilitator to field queries and respond to from community members;
  2. Evacuation Routes - Establish clear building or community evacuation routes and be sure that all community members are provided with copies or printouts and that routes are clearly marked as storms approach; conduct building or community evacuation drills in the weeks leading up to hurricane season;
  3. Emergency Generators & Supplies – Be sure emergency generators are in working order and have adequate fuel supplies, stock a building or community emergency supplies storeroom with flashlights, batteries, water and other necessities for residents and employees in the aftermath of a tropical storm;
  4. Backup Computer Files – Be sure that computer files crucial to running the building and association are backed up to CDs or Portable Storage Devices and keep a list of office computer hardware and software vendors and repairmen in case computers crash or systems fail; 
  5. Secure the Premises – Make preparations for routine lockdown of the building or other facilities as a storm approaches, so the building is secure during the storm and safe from vandalism or looting if a hurricane strikes; 
  6. List of Owners & Employees – Have on hand a current, hard-copy reference list complete with the names all property owners, emergency contact numbers and details of second residence addresses, as well as a list of all association employees, with full contact details; 
  7. Photograph or Video Premises – Keep a visual record through video or photographs of premises, facilities and buildings to facilitate damage assessment and speed damage claims in a storm aftermath; 
  8. Building and Facilities Plans – Make sure a complete set of building or community plans are readily available for consultation by first-responders, utilities workers and insurance adjusters following a storm; 
  9. Insurance Policies & Agent Details – Be sure all insurance policies are current and coverage is adequate for community property, facilities and common areas and compliant with State Law; full contact details for insurance companies and agents should be readily available in the event of a storm; 
  10. Bank Account Details & Signatories – Keep handy a list of all bank account numbers, branch locations and authorized association signatories, and make contingency plans for back-up signatories in case evacuation or relocation becomes necessary; 
  11. Mitigation of Damages – In the immediate aftermath of a storm, take the necessary steps to mitigate damages -- this includes "Drying- In," which is the placement of tarps on openings in the roof and plywood over blown out doors and windows, and " Drying –Out," which is the removal of wet carpet and drywall to prevent the growth of mold; and, 
  12.  Debris Removal – Have a plan for speedy removal of debris by maintenance staff, outside contractors or civic public works employees, should a hurricane topple trees and leave debris in its wake. 

Learn more valuable tips during the free webinar Anatomy of a Disaster Claim, presented by Board Certified Construction Law attorneys and special guest engineer Rick Slider.  Return to this site for a checklist of items for communities to consider immediately after a storm.

Live Webinar: Anatomy of a Disaster Claim

Live Webinar
Friday, July 23, 2010 from 2:00 PM–3:00 PM EDT
(1:00 PM-2:00 PM CDT)

Anatomy of a Disaster Claim
With hurricane season upon us, now is the time to gear up for the potential of a disaster claim against your insurance company. Learn what you can do now to prepare a complete and well-documented claim, thereby lessening the worry and ensuring the likelihood of a maximized recovery.

Steven B. Lesser, Esq. Herbert O. Brock, Jr., Esq. Rick Slider, P.E.

Join Board Certified Construction Lawyers Steve Lesser, Esq., and Herb Brock, Esq. of Becker & Poliakoff, along with Rick Slider, P.E., of Slider Engineering Group, a firm specializing in structural engineering and forensic investigation, for this live webinar on the Anatomy of a Disaster Claim.

Register below and you will receive a confirmation email with information on how to participate.

 

Register

http://event.vcallinteraction.com/r.htm?e=226711&s=1&k=023C0E8B69E94BF7A3493AF48E9B32E9

 

Industry Leaders Request Veto of SB 2044 Citing Ability for Insurer's to Withhold Partial Payment of Claims

Large Insurance Bill Addresses Fees & Advertising by Public Adjusters, Deadlines for Filing Windstorm/Hurricane Related Claims, Policy Terms and Payouts by Carriers. 

 CS for CS for SB 2044 is a rather large bill addressing many aspects of insurance.  It limits payments to public adjusters for supplemental or reopened claims to 20% of additional insurance proceeds obtained and prohibits public adjusters from charging more than 10% of proceeds paid by a carrier if the claim involves losses from events that are subject to a declaration of a state of emergency by the Governor.  While the bill goes on to regulate advertising or solicitation by public adjusters and the form of contract between the public adjuster and the insured, more attention is being paid to three new provisions that, if they become law, impact property owner obligations, the carrier's ability to change the terms of the contract upon renewal and payment of claims.

These portions of the bill pertain to residential (personal lines) coverage.  Policies issued to multi-family property owners/managers (the Association) are generally (if not always) classified as commercial policies.

One part of the bill purportedly bars homeowners from filing claims.  It says that the insured must provide notice of any claim (including supplemental or reopened claims) based on a windstorm or hurricane loss to the carrier within three (3) years of the date of the storm.  While it doesn't change the applicable statute of limitations for civil actions, in some cases homeowners do not have a full understanding of all the damages caused by the windstorm/hurricane until after demolition and reconstruction begins.  Thus, the three (3) year time frame may result in loss of insurance proceeds, depending upon whether the homeowner has the ability to attend to reconstruction after the storm.

Another section of the bill allows the insurance carrier to change the terms of the policy upon renewal by use of a notice entitled "Notice of Change in Policy Terms".  Payment of the renewal premium constitutes acceptance of the new terms.

Most importantly, the bill removes the prompt payment requirements on the part of carriers.  It only requires the carrier to pay "actual cash value" minus the deductible, regardless of whether the homeowner paid for replacement cost coverage.  The carrier then only pays additional amounts once a contract for reconstruction is in place and the costs are incurred (as the work progresses).  Critics argue that this provision disproportionately impacts lower income families that do not have funds available to pay for reconstruction (along with all the non-insured items) and/or replacement of personal property without insurance proceeds.