SUNSHINE STATE INSURANCE COMPANY, APPELLANT,
v.
MAURICE RAWLINS, APPELLEE
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Sunshine State Insurance Company appeals a trial court order compelling appraisal of an insurance claim while preserving the insurer's right to contest coverage. The court affirms, holding that when an insurer admits a covered loss exists but disputes the amount, the appraisal and coverage issues may proceed on a dual-track basis.
The trial court did not abuse its discretion in allowing appraisal to go forward on a dual-track basis while preserving the insurer's non-causation defenses as a matter of law. When an insurer admits a covered loss exists but disputes the amount, the amount-of-loss question is for an appraisal panel, and the coverage issue remains for the trial court.
[1] When an insurer admits a covered loss exists and only the amount is disputed, the amount of loss is for an appraisal panel.
[2] When an insurer denies a covered loss exists, the issue of coverage is for the trial court.
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Join FLexlaw to unlock all legal intelligence“If an insurer admits that there is a covered loss, the amount of which is disputed, the amount of loss question is for an appraisal panel. If an insurer denies that there is a covered loss, the issue of coverage is one for the trial court.”
Establishes the foundational rule from Johnson v. Nationwide that divides causation issues between appraisal (for amount of admitted losses) and trial court (for coverage denials).
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Join FLexlaw to unlock all legal intelligenceSunshine State Insurance Company issued an insurance policy to Maurice Rawlins. The insurer twice admitted that there was a loss covered by the policy…
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Sunshine State Insurance Company appeals the trial court’s Order on Plaintiffs Motion to Compel Appraisal and to Abate the Action. We affirm because the trial court did not abuse its discretion when it allowed the appraisal to go forward while preserving all of Sunshine States’s rights to contest coverage as a matter of law.
In Johnson v. Nationwide Mutual Insurance Company, 828 So.2d 1021, 1025-26 (Fla.2002), the Florida Supreme Court adopted this Court’s holding in Gonzalez v. State Farm Fire and Casualty Company, 805 So.2d 814 (Fla. 3d DCA 2000). In Johnson, the Court divided the issue of causation into two questions. If an insurer admits that there is a covered loss, the amount of which is disputed, the amount of loss question is for an appraisal panel. Id. at 1022. If an insurer denies that there is a covered loss, the issue of coverage is one for the trial court. Id.
In the case before us, the insurer twice admitted there was a loss. Under the Johnson holding, the matter is thus ripe for appraisal.
Moreover, it is the law in our district that the order in which the issues of damages and coverage are to be determined by arbitration and the court is left to the discretion of the trial court. See Paradise Plaza Condo. Assoc., Inc. v. The Reinsurance Corp. of New York, 685 So.2d 937 (Fla. 3d DCA 1996). In Paradise Plaza, we recognized that putting the issue of coverage first before arbitration in ev*755ery case might have adverse effects on the expeditious, out of court disposition of litigation, which is the reason arbitration is a favored remedy. Id. It also saves “judicial resources which might otherwise be required in resolving the factual and legal issues involved in the [coverage issue] by a relatively swift and informal decision by the appraisers as to the amount of the loss.” Id. at 941. We thus follow Paradise Plaza and agree with its policy arguments in allowing the trial court to make the determination as to whether or not to allow the appraisal and coverage processes to move forward on a dual track basis.
In addition, we do not find that Sunshine State Insurance Company v. Corridori, 28 So.3d 129 (Fla. 4th DCA 2010) is on point because in Corridori, the insured did not provide the requested examinations under oath and sworn proof of losses as requested by the insurer. The trial court in Corridori took no evidence and did not consider the issue of coverage due to the insured’s failure to comply with the insurer’s request. In the case before us, however, the trial court specifically reserved the insurer’s non-causation defenses as a matter of law.
Accordingly, we affirm the trial court’s Order on Plaintiffs Motion to Compel Appraisal and to Abate the Action. The trial court did not abuse its discretion in allowing the appraisal to go forward on a dual track basis, while preserving all of Sunshine States’s rights to contest coverage as a matter of law.
Affirmed.
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Citizens Prop. Ins. Corp. v. Galeria Villas Condo. Ass'n, Inc., 48 So. 3d 188 (Fla. 3d DCA 2010)…dressed Citizens’ argument. Once the trial court determines that a demand for appraisal is ripe, the court has the discretion to control the or [*192] der in which an appraisal and coverage determinations proceed. Sunshine State Ins. Co. v. Rawlins, 34 So. 3d 753, 754-55 (Fla. 3d DCA 2010).7 That holding does not require an interlocutory order for appraisal to explicitly reserve jurisdiction to determine legal questions regarding the policy terms after the appraisal has been completed. The order compelling…
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Citizens Prop. Ins. Corp. v. Mango Hill Condo. Ass'n 12 Inc., 54 So. 3d 578 (Fla. 3d DCA 2011)…at “putting the issue of coverage first before arbitration in every case might have adverse effects on the expeditious, out of court disposition of litigation, which is the reason arbitration is a favored remedy.” Sunshine State Ins. Co. v. Rawlins, 34 So. 3d 753, 754-55 (Fla. 3d DCA 2010). Thus, we have left it to the trial court’s discretion to decide “the order in which the issues of damages and coverage are to be determined by arbitration and the court.” Id. (also stating that the trial court should dete…
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Citizens Prop. Ins. Corp. v. Mango Hill # 6 Condo. Ass'n, Inc., 117 So. 3d 1226 (Fla. 3d DCA 2013)…ens Prop. Ins. Corp. v. River Manor Condo. Ass’n, — So. 3d -, 38 Fla. L. Weekly D820, 2013 WL 1441294 (Fla. 4th DCA 2013); Citizens Prop. Ins. Corp. v. Mango Hill Condo. Ass’n 12, 54 So. 3d 578 (Fla. 3d DCA 2011); Sunshine State Ins. Co. v. Rawlins, 34 So. 3d 753 (Fla. 3d DCA 2010); Kendall Lakes Toumhomes Developers, Inc. v. Agricultural Excess & Surplus Lines Ins. Co., 916 So. 2d 12 (Fla. 3d DCA 2005); 4 Am.Jur.2d Alternate Dispute Resolution § 3. Arbitrations, on the other hand, are quasi-judicial procee…
Previewing 3 of 22 citing cases — full citator treatment, depth of discussion, and citing context are member features.
Join FLexlaw to unlock all legal intelligenceAuthorities Cited
- Johnson v. Nationwide Mut. Ins. Co., 828 So. 2d 1021 (Fla. 2002)
- Mariano R. Gonzalez and Rene Gonzalez v. State Farm Fire & Cas. Co., 805 So. 2d 814 (Fla. 3d DCA 2000)
- Sunshine State Ins. Co. v. Corridori, 28 So. 3d 129 (Fla. 4th DCA 2010)
- N. Shore Hosp. & Totura & Co. v. Joseph, 685 So. 2d 937 (Fla. 3d DCA 1996)
- Paradise Plaza Condo. Ass'n, Inc. v. The Reinsurance Corp. of N.Y., 685 So. 2d 937 (Fla. 3d DCA 1996)
- Graham v. State, 28 So. 3d 129 (Fla. 1st DCA 2010)