WILLIAM A. BISHOP, INDIVIDUALLY AND AS PERSONAL REPRESENTATIVE OF THE ESTATE OF DONNA L. BISHOP, HIS DECEASED WIFE ("BISHOP"), ANZUALDA BROTHERS, INC., AND JESUS E. MARINO CASTILLO, INDIVIDUALLY AND AS AN EMPLOYEE OF ANZUALDA BROTHERS, INC., (COLLECTIVELY, "ANZUALDA BROTHERS"), APPELLANT,
v.
PROGRESSIVE EXPRESS INSURANCE COMPANY, APPELLEE
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The Florida First District Court of Appeal addressed whether an insurer can be estopped from denying coverage when it assumes a defense with knowledge of facts that would permit denial of coverage. The court reversed summary judgment for the insurer on the coverage-by-estoppel claim, holding that questions of reasonable reliance and prejudice are fact issues for the jury.
An insurer may be estopped from denying coverage when it assumes the defense of an action with knowledge of facts permitting denial, provided the insured establishes: (1) a representation of material fact, (2) reasonable reliance, and (3) detrimental change in position (prejudice). Questions of reasonable reliance and prejudice are generally for the trier of fact, not for summary judgment.
[1] An insurer may be estopped from denying coverage if it assumes the defense of an action with knowledge of facts that would permit it to deny coverage.
[2] A claim for coverage by estoppel requires a representation of material fact, reasonable reliance, and a detrimental change in position.
Previewing 2 of 5 headnotes on this case. FLexlaw’s editorially structured points of law — every proposition, pinpointed — are reserved for members.
Join FLexlaw to unlock all legal intelligence“When an insurance company assumes the defense of an action, with knowledge, actual or presumed, of facts which would have permitted it to deny coverage, it may be estopped from subsequently raising the defense of non-coverage.”
Establishes the primary legal principle governing coverage-by-estoppel claims against insurers
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Join FLexlaw to unlock all legal intelligenceBishop and Anzualda Brothers sought insurance coverage for an underlying action. Progressive Express Insurance Company made statements and undertook a…
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Undertaking communication, conduct, and steps in defense of an underlying action, heavily dependent upon the circumstances, may rise to a coverage by estoppel claim. This appeal involves an allegation an insurer made statements and undertook actions which led a business owner to believe she had insurance coverage for the underlying action; all this despite the insurer’s knowledge of facts which would have permitted it to deny coverage.
“When an insurance company assumes the defense of an action, with knowledge, actual or presumed, of facts which would have permitted it to deny coverage, it may be estopped from subsequently raising the defense of non-coverage.” Doe ex rel. Doe v. Allstate Ins. Co., 653 So.2d 371, 373 (Fla.1995) (quoting Cigarette Racing Team, Inc. v. Parliament Ins. Co., 395 So.2d 1238, 1239-40 (Fla. 4th DCA 1981)) (internal quotation marks omitted). This “coverage' by estoppel” claim requires a representation of material fact, reasonable reliance, and a detrimental change in position (i.e., prejudice) as a result of the reliance. See Tome v. State Farm Fire & Cas. Co., 125 So.3d 864, 867 (Fla. 4th DCA 2013); Phoenix Ins. Co. v. McQueen, 286 So.2d 570, 572 (Fla. 1st DCA 1973). Prejudice and whether the promisee’s reliance was reasonable are generally questions for the trier of fact. Cigarette Racing Team, Inc., 395 So.2d at 1239-40; see also Romo v. Amedex Ins. Co., 930 So.2d 643, 652-53 (Fla. 3d DCA 2006) (citing Thor Bear, Inc. v. Crocker Mizner Park, Inc., 648 So.2d 168 (Fla. 4th DCA 1994)); FCCI Ins. Co. v. Cayce’s Excavation, Inc., 901 So.2d 248, 251 (Fla. 2d DCA 2005).
*469Here, we do not pass on the strength of the business owner’s claims regarding the insurer’s conduct and actions or what the business owner believed afterwards. That is for the trier of fact to determine. We write only to confirm the cause of action exists, such a claim does not sound in bad faith, and here it was for the trier of fact to determine the ultimate weight to give the insurer’s conduct versus the reasonableness of the business owner’s reliance.1 We REVERSE the court’s grant of summary judgment in favor of the insurer as to this count2 and REMAND for further proceedings.
LEWIS, C.J., CLARK, and MARSTILLER, JJ., concur.
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United Auto. Ins. Co. v. Chiropractic Clinics of S. Fla., PL, 322 So. 3d 740 (Fla. 3d DCA 2021)…o. 2d 900, 902 (Fla. 5th DCA 1990) (holding the general rule in applying equitable estoppel to insurance contracts provides that estoppel may be used defensively to prevent a forfeiture of insurance coverage); Bishop v. Progressive Exp. Ins. Co., 154 So. 3d 467, 468 (Fla. 1st DCA 2015) (holding “coverage by estoppel” requires a representation of material fact, reasonable reliance, and a detrimental change in position (i.e., prejudice) as a result of the reliance, which are generally questions for the t…
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Progressive Express Ins. Co. v. Anzualda Bros., Inc., 208 So. 3d 1289 (Fla. 1st DCA 2017)…f must prove (1) the defendant company made a representation of material fact; (2) the plaintiff reasonably relied on that representation of material fact; and (3) the plaintiff was prejudiced by its reliance. Bishop v. Progressive Express Ins. Co., 154 So. 3d 467, 468 (Fla. 1st DCA 2015). Because appellee failed to sufficiently prove prejudice, we reverse, vacate the trial court’s final judgment in favor of ap-pellee, and remand for the trial court to enter final judgment in favor of appellant. Because we…
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City of Miami Beach v. Clevelander Ocean, LP (Fla. 3d DCA 2022)…3 (Fla. 2d DCA 1975). Like laches or waiver, equitable estoppel ordinarily turns on underlying factual determinations. 1 Gregory E. Upchurch, IP Litigation Guide: Patents & Trade Secrets § 11:8 (2021); see Bishop v. Progressive Exp. Ins. Co., 154 So. 3d 467, 468 (Fla. 1st DCA 2015) (holding “coverage by estoppel” requires a representation of material fact, reasonable reliance, and a 12 detrimental change in position as a result of reliance, which are generally questions for trier of fact). Al…
Previewing 3 of 5 citing cases — full citator treatment, depth of discussion, and citing context are member features.
Join FLexlaw to unlock all legal intelligenceAuthorities Cited
- Thor Bear, Inc. v. Crocker Mizner Park, Inc., 648 So. 2d 168 (Fla. 4th DCA 1994)
- DOE v. Allstate Ins. Co., 653 So. 2d 371 (Fla. 1995)
- Karem Elena Romo v. Amedex Ins. Co., 930 So. 2d 643 (Fla. 3d DCA 2006)
- Cigarette Racing Team, Inc. v. Parliament Ins. Co., 395 So. 2d 1238 (Fla. 4th DCA 1981)
- Fcci Ins. Co. v. Cayce's Excavation, Inc., 901 So. 2d 248 (Fla. 2d DCA 2005)
- The Phoenix Ins. Co. v. Cheri Ann McQUEEN, 286 So. 2d 570 (Fla. 1st DCA 1973)
- Tome v. State Farm Fire & Cas. Co., 125 So. 3d 864 (Fla. 4th DCA 2013)