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What was once a trilogy has become a tetralogy. On April 24, 2019, March 16, 2020, and April 1, 2021, we published articles regarding the decisions in Alvarez v. State Farm,[1] Beseler v. Avatar,[2] and Mezadieu v. Safepoint,[3] respectively, on the topic of material misrepresentations voiding coverage under insurance policies. The Alvarez opinion was being used for the proposition that an allegedly overinflated estimate is de facto fraud/material misrepresentation. We argued that this was not the case due to established case law culminating in the holding in Beseler. This position was somewhat vindicated after the release of the Mezadieu opinion where the court found intent was not required when the misrepresentation was material in light of extenuating circumstances wherein the insured testified that she knew $11,000 of the total estimated amount should not have been in there. It was and is our argument that the Mezadieu court ignored analysis of this fact in reaching their holding.
Most recently, on June 2, 2021,[4] the Fourth District Court of Appeal released their opinion in the matter of Anchor Property and Casualty Insurance Company v. Alex Trif and George Trif (hereinafter "Trif").[5] In Trif, the appellate court performed an in depth analysis regarding the requirement for intent when an insurance carrier seeks to utilize the concealment or fraud provision to void coverage. In doing so, the Trif court distinguished Mezadieu in a manner similar to that of our prior analysis. Once again, we stand firm and confident in our argument that simply because an estimate is unilaterally deemed to be too high by an insurance company either in scope or price does not mean the insured has committed fraud or put forth a material misrepresentation sufficient to void coverage.
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As part of his pursuit of a Masters of Law (LLM) in Insurance Law, Michael Cassel has recently completed his dissertation on Sebo v. American Home Assurance and its effect on Florida's Multiple Peril Loss analysis.
Analysis and Interpretation by Michael A. Cassel
On April 24, 2019, and, again, on March 16, 2020, we published articles regarding the decisions in Alvarez v. State Farm[1] and Beseler v. Avatar,[2] respectively. The Alvarez opinion was being used for the proposition that an allegedly overinflated estimate is de facto fraud/material misrepresentation. We argued that this was not the case due to established case law culminating in the holding in Beseler. More recently, on March 26, 2021, the Fourth District Court of Appeal released their opinion in the matter of Jennifer Mezadieu v. Safepoint Insurance Company (hereinafter "Mezadieu").[3] In Mezadieu, the appellate court analyzed whether a material misrepresentation even without an element of intent was sufficient to void coverage under the concealment or fraud provision of the governing policy. While the Mezadieu court found that coverage could be voided without intent, it is the particular facts of the case that lend themselves to such a finding. Overall, the position outlined in our prior articles remains unchanged: simply because an estimate is unilaterally deemed to be too high by an insurance company either in scope or price does not mean the insured has committed fraud or put forth a material misrepresentation sufficient to void coverage. On May 13, 2020, the Third District Court of Appeal released their decision in Security First Insurance Company v. John Czelusniak (hereinafter “Czelusniak”).[1] The Czelusniak opinion discusses the application of the doctrine of anti-concurrent causation (hereinafter “ACC”) as it relates to exclusionary provisions in insurance policies.
As many of you know, on October 23, 2019, the Third District Court of Appeal released their opinion in Glendys Vazquez v. Citizens Property Insurance Corporation (hereinafter "Vazquez").[1] This opinion contained some drastic and far reaching implications with regards to the application of Section 626.9744, Florida Statutes,[2] more colloquially referred to as the “Matching Statute,” as it relates to calculations of payment for replacement cost value versus actual cash value on claims.
Analysis and Interpretation by Michael A. Cassel
On July 24, 2019, the Third District Court of Appeal released their decision in State Farm Florida Insurance Company v. Charles and Diana Sanders,[1] (hereinafter "Sanders"). The Sanders opinion discusses whether a public adjuster can act as a disinterested appraiser. Analysis and Interpretation by Michael A. Cassel
On May 8, 2019, the Fourth District Court of Appeals released their decision in Hershel Bryant and Betty Bryant v. GeoVera Specialty Insurance Company (hereinafter "Bryant"). The Bryant opinion discusses the payment of an appraisal award in suit operating as a confession of judgment and serving to ripen bad faith as well as the denial of payment operating as a waiver of compliance with post-loss conditions – namely the proof of loss requirement. Analysis and Interpretation by Michael A. Cassel
On April 17, 2019, the Third District Court of Appeals released their decision in Jose Alvarez and Hilda Alvarez v. State Farm Florida Insurance Company (hereinafter "Alvarez"). The Alvarez opinion discusses whether a verdict in favor the insureds should be invalidated based on the jury’s finding that the insureds intentionally and materially misrepresented the extent of the loss. Analysis and Interpretation by Michael A. Cassel
On April 17, 2019, the Third District Court of Appeals released their decision in Safepoint Insurance Company v. Daisy Sousa (hereinafter "Sousa"). The Sousa opinion discusses the requirement of compliance with post-loss conditions, namely the request for a Sworn Proof of Loss (hereinafter “SPOL”), prior to the ripeness of appraisal. Analysis and Interpretation by Michael A. Cassel
On July 25, 2018, the Fourth District Court of Appeals released their decision in Andrea Tracey and James Tracey v. People's Trust Insurance Company, (hereinafter "Tracey"). The Tracey opinion discusses the ability for an appraisal panel to determine causation for a denied portion of a claim when the claim has not been denied in its entirety. |
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*Spanish speakers are non-attorney staff assistants employed by Cassel & Cassel, P.A. The non-attorney staff assistants are not members of the State Bar of Florida and are not licensed to practice law. Los asistentes hispanoparlantes empleados por Cassel & Cassel, P.A., no son abogados. Nuestro personal no son miembros de la asociaciòn de abogados de la Florida, y no estàn licenciados para practicar la ley en el estado de la Florida.
*Spanish speakers are non-attorney staff assistants employed by Cassel & Cassel, P.A. The non-attorney staff assistants are not members of the State Bar of Florida and are not licensed to practice law. Los asistentes hispanoparlantes empleados por Cassel & Cassel, P.A., no son abogados. Nuestro personal no son miembros de la asociaciòn de abogados de la Florida, y no estàn licenciados para practicar la ley en el estado de la Florida.