FLORIDA INSURANCE GUARANTY ASSOCIATION, INC., APPELLANT,
v.
JORGE AND HELENA CASTILLA, APPELLEES

Fla. 4th DCA | 2009-09-30
No. 4D09-103
GROSS, C.J., and CIKLIN, J., concur.
18 So. 3d 703 Florida District Court of Appeal, Fourth District (2009) Caution
Cited by 45 cases

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Synopsis

FIGA appeals a trial court's denial of its motion to compel appraisal of property damage under an insurance policy. The court reverses, holding that FIGA properly invoked its contractual appraisal rights and did not waive them by participating in litigation.


Holding

FIGA did not waive its appraisal rights. The court held that an appraisal clause may be invoked for the first time after litigation has commenced, provided the insurer raises the right in its first pleading, acts consistently with that right throughout the proceeding, and does not waive it through inconsistent conduct. FIGA satisfied these requirements by asserting its appraisal right in its motion to dismiss and maintaining that position through subsequent pleadings.


Headnotes

[1] An appraisal clause in an insurance policy is treated similarly to an arbitration clause for purposes of appellate review.

[2] A trial court's denial of a motion to compel appraisal is reviewed de novo, applying the relevant law to the facts in the record.

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Key Quotes

“An appraisal clause may be invoked for the first time after litigation has commenced.”

Establishes that FIGA was not required to demand appraisal before the lawsuit was filed.

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Facts & Procedural History

The Castillas filed an insurance claim with Florida Preferred Property Insurance Company for hurricane damage in 2005. PPI issued a check that the Cas…

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Opinion of the Court
WARNER, J.

WARNER, J.

Appellant Florida Insurance Guaranty Association (“FIGA”) appeals the non-final order denying its motion to compel an appraisal of property damage pursuant to its policy terms. The trial court denied the motion without explanation. We reverse, concluding that FIGA had properly raised and asserted its appraisal rights.

Jorge and Helena Castilla timely filed an insurance claim with Florida Preferred Property Insurance Company (“PPI”), alleging that their home sustained damages when Hurricane Wilma struck in October 2005. PPI issued a check for the claim, which the Castillas found insufficient and objected. When PPI was liquidated and taken over by FIGA, the Castillas re-raised their claim with FIGA. FIGA in*704spected the property and denied the additional claim, determining that the damages were not caused by the hurricane. The Castillas hired their own appraiser who set the damages at $93,000.

When FIGA did not accept the claim, the Castillas filed a complaint against FIGA for breach of the insurance contract in May 2008. The complaint alleged that they furnished FIGA with timely notice of loss and performed all conditions precedent to recover under the policy and the applicable Florida Statutes. FIGA refused to pay for the losses.

FIGA filed a motion to dismiss, claiming that the Castillas had failed to fulfill their contractual obligations, listing the various policy provisions regarding the insureds’ duties after a loss. It also cited to the provisions permitting the appraisal process and reproduced portions of the insurance contract, including the appraisal terms. Two months after the complaint was filed, FIGA determined that the patio damage was a covered loss and told the Castillas that it would formally withdraw its previous denial of the claim. FIGA filed an amended motion to dismiss or abate the action, referencing its withdrawal of the claim denial and rearguing that the Castil-las failed to satisfy all conditions precedent, including the appraisal process. FIGA requested that the Castillas provide documentation to substantiate their claim and requested that they submit to an examination under oath. The trial court denied the motion to dismiss or abate, ordering FIGA to answer the complaint.

In its answer, FIGA raised as an affirmative defense its right to appraisal pursuant to the terms and conditions of the insurance policy contract. The Castillas moved to strike the answer and affirmative defenses as a sham and argued that FIGA twice denied their claim without reserving any rights under the insurance policy. FIGA then filed a motion to compel appraisal pursuant to the insurance policy. FIGA contended that its denial of the claim did not constitute a waiver of its right to appraisal. The trial court held a hearing and denied the motion. FIGA appeals pursuant to Florida Rule of Appellate Procedure 9.130(a)(3)(C)(iv) (providing for review of non-final orders determining the entitlement of a party to appraisal under an insurance policy).

In United Healthcare of Florida, Inc. v. Brown, 984 So.2d 583, 585 (Fla. 4th DCA 2008), we articulated the applicable standard of review as follows:

A trial court’s conclusions regarding the construction and validity of an arbitration agreement are reviewed de novo. BDO Seidman, LLP v. Bee, 970 So.2d 869, 873-74 (Fla. 4th DCA 2007). “In reviewing the denial of a motion to compel arbitration, the trial court’s factual findings are reviewed under a competent, substantial evidence standard.” Id. at 873. However, our review of a trial court’s “application of the law to the facts found, is de novo.” Id. at 874. As the trial court made no findings of fact or law, we review the order de novo, applying the relevant law to the facts available in the record.

Although United involved an arbitration clause, appraisal clauses are treated similarly to arbitration clauses. See Allstate Ins. Co. v. Suarez, 786 So.2d 645, 646 (Fla. 3d DCA 2001). Therefore, we apply the same standard of review.

The policy in question contained a clause requiring an appraisal of the amount of any claimed loss. FIGA asserted the right to an appraisal in its original motion to dismiss and in all subsequent pleadings and at hearings. It never waived its right to an appraisal.

*705An appraisal clause may be invoked for the first time after litigation has commenced. See Gonzalez v. State Farm Fire & Cas. Co., 805 So.2d 814 (Fla. 3d DCA 2000). In Gonzalez, the homeowners filed suit after the insurer denied them claim on the ground that the loss was not covered under the policy provisions. The insurance company demanded an appraisal and submitted both causation of the loss and its amount to the appraiser. The appraiser and umpire decided that the causation was not compensable under the policy and appraised the loss at zero. The trial court entered judgment in favor of the insurance company on the report, and the homeowners appealed making one claim relevant to this case. They contended that State Farm had waived its right to an appraisal by not requesting it prior to suit and by participating in the litigation.

The Third District rejected the homeowners’ position as without merit, finding that the policy did not require a presuit appraisal. The court noted, “It would make no sense to say that State Farm was required to request a presuit appraisal on a loss it had already refused to pay.” Id. at 817. It also rejected the claim that the insurance company had waived its right by participating in the litigation. Where the insurance company raised its right to an appraisal in its first pleading within thirty days of the filing of the complaint, it had made a timely demand.

In Preferred Mutual Insurance Co. v. Martinez, 643 So.2d 1101 (Fla. 3d DCA 1994), after the insureds and them insurance company could not agree on the amount of their insured loss, the insureds filed suit. The insurer filed a motion to dismiss and compel appraisal which the trial court denied. In reversing, the court held that the insurer had never acted inconsistently with its rights at any point in the proceeding, thus precluding waiver of the right. The court concluded, “Motions to compel arbitration should be granted whenever the parties have agreed to arbitration and the court entertains no doubts that such an agreement was made.” Id. at 1103.

Similarly, in this case FIGA has never acted inconsistently with its right to an appraisal, having raised that right at the earliest opportunity in this suit and continued to claim it through its subsequent pleadings. Asserting that the insured meet all other conditions precedent to claiming a loss is not inconsistent with demanding an appraisal. Claiming that the loss is not covered is also not inconsistent with a demand for an appraisal. See Gonzalez. That the court compelled FIGA to answer and give discovery is not the voluntary participation in the lawsuit which would constitute a waiver of the insureds’ rights.

Because the insurance contract provided the appraisal process, which agreement is not in doubt, and FIGA did not waive its right to an appraisal by participating in the lawsuit, the trial court erred in denying FIGA’s motion to compel the appraisal.

Reversed and remanded to grant the motion and, compel the appraisal.

GROSS, C.J., and CIKLIN, J., concur.


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Citator

Cited By (31 total)

  • Fla. Ins. Guar. Ass'n v. Branco, 148 So. 3d 488 (Fla. 5th DCA 2014)
    …litigation. In this regard, appraisal clauses are viewed similarly to arbitration clauses. Thus, we review the trial court’s findings of fact for competent, substantial evidence, and its conclusions of law de novo. Fla. Ins. Guar. Ass’n v. Castilla, 18 So. 3d 703, 704 (Fla. 4th DCA 2009); Doctors Assocs. v. Thomas, 898 So. 2d 159,162 (Fla. 4th DCA 2005) (reiterating that question of waiver is one of fact, reviewable for competent, substantial evidence, and all questions about waivers of arbitration should be…
  • Sunshine State Ins. Co. v. Corridori, 28 So. 3d 129 (Fla. 4th DCA 2010)
    …Appellant claims that the trial court erred by holding, as a matter of law, that the new claims are covered by the policy. We review de novo a trial court’s order compelling an appraisal under an insurance policy. Fla. Ins. Guar. Ass'n v. Castilla, 18 So. 3d 703, 704 (Fla. 4th DCA 2009). [*131] In Johnson v. Nationwide Mutual Insurance Co., 828 So. 2d 1021, 1025-26 (Fla.2002), the Florida Supreme Court recognized that coverage issues must be resolved before an appraisal of the amount of a loss is ordered. I…
  • People's Tr. Ins. Co. v. Tracey, 251 So. 3d 931 (Fla. 4th DCA 2018)
    …by all means, I will order. The trial court entered an order denying the insurer’s motion to compel appraisal. It is from this order that the insurer appeals. We have de novo review as the issue is a legal one. Fla. Ins. Guar. Ass’n v. Castilla, 18 So. 3d 703, 704 (Fla. 4th DCA 2009). “[C]ausation is a coverage question for the court when an insurer wholly denies that there is a covered loss and an amount-of-loss question for the appraisal panel when an insurer admits that there is covered loss, the amo…

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