JUAN JACOME, ET AL.
v.
PEOPLE'S TRUST INSURANCE COMPANY
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The Third District Court of Appeal affirmed a lower court decision in an insurance coverage dispute between Juan Jacome and People's Trust Insurance Company, applying established precedent regarding post-loss obligations and material breach of insurance policy provisions.
An insurer must plead and prove that the insured materially breached a post-loss policy provision to establish a coverage defense resulting in forfeiture. If material breach is established, the burden shifts to the insured to prove that the breach did not prejudice the insurer. A rebuttable presumption of prejudice framework applies, and no exception exists even where the policy recognizes coverage can be forfeited only if the insurer is prejudiced.
“for an insurer to successfully establish a coverage defense based upon an insured's failure to satisfy post-loss obligations such that an insured forfeits coverage under a policy, the insurer must plead and prove that the insured has materially breached a post-loss policy provision. If the insurer establishes such a material breach by the insured, the burden then shifts to the insured to prove that any breach did not prejudice the insurer.”
Establishes the two-step burden-shifting framework for coverage defenses based on post-loss obligations
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Join FLexlaw to unlock all legal intelligenceThe case involves a dispute over insurance coverage under a policy issued by People's Trust Insurance Company to Juan Jacome. The specific facts under…
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PER CURIAM.
Affirmed.
See Am. Integrity Ins. Co. v. Estrada, 276 So. 3d 905, 912 (Fla. 3d DCA 2019) (“[F]or an insurer to successfully establish a coverage defense based upon an insured’s failure to satisfy post-loss obligations such that an insured forfeits coverage under a policy, the insurer must plead and prove that the insured has materially breached a post-loss policy provision. If the insurer establishes such a material breach by the insured, the burden then shifts to the insured to prove that any breach did not prejudice the insurer.”); see also Arce v. Citizens Prop. Ins. Corp., 388 So. 3d 205, 211-12 (Fla. 3d DCA 2024) (declining to carve out an exception to the rebuttable presumption of prejudice framework where the insurance policy recognizes that coverage can be forfeited only if the insurer is prejudiced by the insured’s failure to comply with his or her post-loss obligation to promptly notify the insurer of a loss).
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Citator
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- People's Tr. Ins. Co. v. Socarras, 276 So. 3d 905 (Fla. 3d DCA 2020)
- Vanegas v. Citizens Prop. Ins. Corp. (Fla. 3d DCA 2026)