PHILLIP LANDERS, APPELLANT,
v.
STATE FARM FLORIDA INSURANCE COMPANY, APPELLEE

Fla. 5th DCA | 2018-01-19
No. Case No. 5D15-4032
NICHOLS, D., Associate Judge,, concurs, and concurs specially with opinion., BERGER, J., concurs in part and dissents in part, with opinion.
234 So. 3d 856 Florida District Court of Appeal, Fifth District (2018) Caution
Cited by 16 cases

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Synopsis

Phillip Landers appealed the grant of summary judgment in State Farm's favor on his statutory bad-faith claim. The Fifth District held that an insured is not required to wait for the appraisal process to be completed before filing a civil remedy notice (CRN) under Florida Statute § 624.155, reversing and remanding for trial.


Holding

An insured is not required to wait for appraisal to be completed before filing a CRN. The plain language of section 624.155(3)(d) contains no time limitation requiring a final determination of coverage and damages before filing a CRN. Filing a CRN during an ongoing appraisal process does not render it a legal nullity, and once appraisal is complete and a legally sufficient CRN has been provided, the conditions precedent to a bad-faith claim are satisfied.


Headnotes

[1] A civil remedy notice (CRN) alleging bad faith may be filed before the completion of an insurance appraisal process.

[2] The filing of a CRN does not require a final determination of coverage and damages before it is filed.

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Key Quotes

“there is no statutory requirement which prevents the insured from sending the statutory notice before there is a determination of liability or damages. Nor is the insurer's appropriate response to that notice dependant on such a determination.”

Establishes the primary holding that a CRN can be filed before appraisal is complete, citing Vest v. Travelers

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Facts & Procedural History

Landers's home sustained sinkhole damage in 2009. State Farm hired an engineer (SDII) who recommended a grout injection repair plan without underpinni…

The full statement of facts, procedural history, and disposition for this case are member content.

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Opinion of the Court
COHEN, C.J.

ON. MOTION FOR REHEARING

COHEN, C.J.

Upon consideration of Appellee State Farm Florida Insurance- Company’s Motion for Rehearing, we grant the motion, withdraw our prior opinion, and substitute this one' in its place.

In this appeal, we consider whether, when an insurance contract provides for an appraisal process, an insured must wait until that process is completed before filing a civil remedy notice pursuant to section 624.155, 'Florida Statutes (2008). Because we find no such limitation in the statute or relevant case law, we reverse.

In 2009, Phillip Landers’s home sustained a loss from suspected sinkhole activity. He submitted a claim to his insurer, State Farm Florida Insurance Company (“State Farm”).1 State Farm hired SDII Global Corporation (“SDII”) to conduct a *857subsidence investigation. SDII verified that sinkhole activity was the cause of the damage, and State Farm admitted coverage'. SDII initially concluded that 975 cubic yards of grout needed to be injected into forty-nine holes around the home’s perimeter. SDII did not recommend underpinning. After considering the report of a neutral evaluator from the Department of Financial Services, pursuant to section 627.7074, Florida Statutes (2008), SDII amended its report to require an additional fifteen grout injection points.

Landers obtained an independent opinion from Biller Reinhart Structural Group (“Reinhart”). In Reinhart’s opinion, proper stabilization required underpinning.2 State Farm provided Reinhart’s report- for review by the neutral evaluator. The neutral evaluator concluded that underpinning was unwarranted. While State Farm demanded appraisal under the policy to resolve the parties’ disagreement over the amount of the loss,3 Landers agreed, pursuant to the terms of the insurance contract, to proceed with SDH’s recommended repair plan, despite his belief that the repairs were inadequate. State Farm placed its appraisal demand on hold while the stabilization repairs were made. Further appraisal would be required to address cosmetic repairs to the home.

After the repairs were completed in September 2011, State Farm reiterated its request for appraisal of the cosmetic damage to the home. The home continued to experience damage after repairs were completed. As a result, Landers hired Sonny Gulati, a geotechnical engineer, to examine the property. In January 2012, while Gulati’s-report was pending, Landers filed a civil remedy-notice (“CRN”), alleging,-among other things, claim delay,, failure to promptly and properly investigate the claim, failure to adjust the loss, and the failure to fender policy limits. Landers contended that the repairs were completed pursuant to State Farm’s .expert’s recommendation, yet his home remained unlivable. Landers demanded the immediate tender of “the policy limits for dwelling ... of $1,026,500.00. minus any . prior payments that have been made to the insured ... so that [Landers] may adequately complete the repairs [he] has started to [his] home.” In response, State Farm requested that all issues be submitted to appraisal.

In March 2012, Landers brought suit against State Farm for breach of contract. In that suit, State Farm sought to compel appraisal, which Landers opposed. The circuit court compelled appraisal, and Lan-ders appealed from that order. This Court affirmed. Landers v. State Farm Fla. Ins. Co., 149 So.3d 33 (Fla. 5th DCA 2014). In July 2014, the appraisal panel determined that the amount of loss exceeded the policy limits. State Farm tendered the policy limits in August 2014, without any deduction for the amounts previously paid.

Landers then brought the underlying first-party bad-faith suit against State *858Farm, alleging ten purported violations of sections 624.155(1)(b)(1) and 626.9541(1)(i), Florida Statutes (2008), including allegations of claim delay and low-balling. Lan-ders contended that his damages always exceeded the policy limits and that State Farm acted in bad faith by delaying payment of the policy limits until after appraisal.

State Farm moved for summary judgment. State Farm asserted that when Ldn-ders filed the CRN, “there was no contractual amount due and no damages owed under the contract” because a condition precedent to - payment — determining the amount of loss through appraisal — had not been fulfilled. Therefore, the CRN was not valid and Landers had no claim. The trial court granted summary judgment, but the order granting summary judgment contained no explanation, findings of fact, or conclusions of law.4 This appeal followed.

This Court reviews orders granting summary judgment de novo. Volusia Cty. v. Aberdeen at Ormond Beach, 760 So.2d 126, 180 (Fla. 2000). The issue presented on appeal is primarily a question of law: whether the insurer’s demand for appraisal tolls the filing of a CRN until the amount of the appraisal has been established. State Farm asserts the CRN was void because Landers’s claim was not yet ripe.5

Bad-faith claims are governed by section 624.155, Florida Statutes (2008). Section 624.155(1) provides that:

(1) Any person may bring a civil action against an insurer when such person is damaged:
(b) By the commission of any of the following acts by the insurer:
1. Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests ....

§ 624.155(1)(b) 1., Fla. Stat.

As a condition precedent to bringing such an action, Florida’s Department of Financial Services and the insurer must be given sixty days’ written notice of the claim. See id. § 624.155(3)(a). The CRN must set forth the specific statutory provision the insurer allegedly violated, the facts giving rise to the violation, the relevant policy language, and a statement that the notice is given to perfect the right to pursue the civil remedy authorized by the statute. Id. § 624.155(3)(b). During the sixty-day period, the insurer has an opportunity to cure the alleged violation — no action will lie if, within those sixty days, “the damages are paid or the circumstances giving rise to the violation are corrected.”6 See id § 624.155(3)(d).

*859There are three ■ prerequisites to filing a statutory bad-faith claim: (1) determination of the insurer’s liability for coverage; (2) determination of the extent of the insured’s damages; and (3) the required notice must be filed under section 624.155(3)(a). See Cammarata v. State Farm Fla. Ins. Co., 152 So.3d 606, 612 (Fla. 4th DCA 2014). The settlement of a sinkhole claim via the appraisal process is sufficient to satisfy the first two requirements. See id. (finding,, that appraisal award was “ ‘favorable resolution’ of an action for insurance benefits, so that [the insured] ... satisfied the necessary prerequisite to filing a bad faith claim” (alteration in original) (quoting Trafalgar at Greenacres, Ltd. v. Zurich Am. Ins. Co., 100 So.3d 1155, 1158 (Fla. 4th DCA 2012))).7

State Farm argues that the CRN is not effective until all of the contractual preconditions to suit are met and there has been a final determination of coverage and the amount owed. The plain language' of section 624.155(3)(d) provides no time limitation for when a CRN may be filed and does not require a final determination of coverage and damages before it is filed. The statute simply states that “no action shall lie” if the bad-faith allegation is corrected or the damages are paid within sixty days of the insurer receiving the notice.

This case is controlled by Vest v. Travelers Insurance Co., 753 So.2d 1270, 1272 (Fla. 2000). In Vest, the Florida Supreme Court expressly noted .that under section 624.155, “there is no statutory requirement which prevents the insured from sending the statutory notice before there is a determination of liability or damages. Nor is the insurer’s appropriate response to that notice dependant on such a determination.” 753 So.2d at 1275. Vest clarifies that the purpose of the CRN is to facilitate and encourage good-faith efforts to timely settle claims before litigation, not to vindicate continuing efforts to delay. Filing a CRN before the appraisal process is complete and damages are determined does not render the CRN a legal nullity, precluding Landers’s bad-faith claim.8

*860Preventing an insured from filing a CRN before coverage and liability have been conclusively established would frustrate the purpose of the statute by further delaying the time necessary to assess and pay out claims and discouraging insurers from taking timely,-independent action on claims. Accordingly, we find that pursuant to the plain ■ language of section 624.155(1)(d), the .fact ..that the appraisal process is ongoing does not render a CRN filed during that process a legal nullity. Once the appraisal process is complete, and a legally sufficient CRN had previously been provided, the conditions precedent to filing a statutory -bad-faith claim are met. Cf. Cammarata, 152 So.3d at 612.

In this case, Landers filed his CRN before the appraisal process was complete. State Farm did not cure the alleged violation within the sixty-day window in section 624.155(3)(d). Landers’s position is that had State Farm properly investigated his claim, it would have known that the subsurface repair plan was inadequate. Whether State Farm actually acted in bad faith in resolving his claim presents a question of fact that remains to be resolved. Yet, nothing in the statute or case law precludes the filing of a CRN while a dernand for appraisal is outstanding. We reverse the order granting summary judgment and remand for further proceedings.

REVERSED arid REMANDED.

NICHOLS, D., Associate Judge,, concurs, and concurs specially with opinion.

BERGER, J., concurs in part and dissents in part, with opinion.

NICHOLS,'D., Associate Judge,

concurring specially, with opinion.

I concur with the opinion of the Court and write to specifically address the “Loss Payment” provision of the insurance contract.

It is undisputed that there is a provision in the insurance contract that provides in the event of a disagreement:

Moss will be payable: ... '60 days after [insurer] -receive[s] [insured’s] proof of loss and:
(1) there is an entry of a final judgment; or
(2) there is a filing on an appraisal award with us.

As stated by the majority, bad-faith claims are governed by section 624.155, Florida Statutes. Although State Farm paid the claim within sixty days of the appraisal award, section 624.165(b)(1) specifically provides:

(1) Any person may bring a civil action against an insurer when such person is damaged:
(b) By the commission of any of the following acts by the insurer:
1. - Not attempting in good faith to settle claims when, under all the circumstances, it could and should.have done so, had it acted fairly and honestly toward its insured arid with due regard for her or his interests ....

§ 624.155(1)(b) 1., Fla. Stat. (2008).

State Farm argues that because it-paid the claim within sixty days ’of the completion of the appraisal process as set forth in the insurance contract, it is immune from the application of section .624.155. No language in the statute or the contract prohibited Landers from filing a civil remedy notice under the circumstances of this case.

State Farm’s position implies that an insurer could cause delays, or otherwise act in .bad faith, so long as payment was made within! the sixty-day time period of the appraisal award with impunity. State Farm’s-position would render the bad-faith statute meaningless.

*861No opinion is expressed on the merits of Lander’s bad-faith cause of action. As the majority aptly concludes, “[wjhether State Farm actually acted in bad faith in resolving the claim presents a question of fact that remains to be resolved.”

BERGER, J.,

concurring in part and dissenting in part, with opinion.

I agree with the majority that nothing precludes the filing of a CRN while a demand for appraisal is outstanding. However, because I also agree with the trial court that no bad faith claim can be maintained under the facts of this case, I would affirm the order granting summary judgment. Accordingly, in all other respects, I dissent.

Concurrence
NICHOLS,'D., Associate Judge,

NICHOLS,'D., Associate Judge,

concurring specially, with opinion.

I concur with the opinion of the Court and write to specifically address the “Loss Payment” provision of the insurance contract.

It is undisputed that there is a provision in the insurance contract that provides in the event of a disagreement:

Moss will be payable: ... '60 days after [insurer] -receive[s] [insured’s] proof of loss and:
(1) there is an entry of a final judgment; or

(2) there is a filing on an appraisal award with us.

As stated by the majority, bad-faith claims are governed by section 624.155, Florida Statutes. Although State Farm paid the claim within sixty days of the appraisal award, section 624.165(b)(1) specifically provides:

(1) Any person may bring a civil action against an insurer when such person is damaged:
(b) By the commission of any of the following acts by the insurer:
1. - Not attempting in good faith to settle claims when, under all the circumstances, it could and should.have done so, had it acted fairly and honestly toward its insured arid with due regard for her or his interests ....

§ 624.155(1)(b) 1., Fla. Stat. (2008).

State Farm argues that because it-paid the claim within sixty days ’of the completion of the appraisal process as set forth in the insurance contract, it is immune from the application of section .624.155. No language in the statute or the contract prohibited Landers from filing a civil remedy notice under the circumstances of this case.

State Farm’s position implies that an insurer could cause delays, or otherwise act in .bad faith, so long as payment was made within! the sixty-day time period of the appraisal award with impunity. State Farm’s-position would render the bad-faith statute meaningless. No opinion is expressed on the merits of Lander’s bad-faith cause of action. As the majority aptly concludes, “[wjhether State Farm actually acted in bad faith in resolving the claim presents a question of fact that remains to be resolved.”

Other
BERGER, J.,

BERGER, J.,

concurring in part and dissenting in part, with opinion.

I agree with the majority that nothing precludes the filing of a CRN while a demand for appraisal is outstanding. However, because I also agree with the trial court that no bad faith claim can be maintained under the facts of this case, I would affirm the order granting summary judgment. Accordingly, in all other respects, I dissent.


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Cited By (15 total)

  • Fortune v. First Protective Ins. Co., 302 So. 3d 485 (Fla. 2d DCA 2020)
    …faith action are: "(1) determination of the insurer's liability for coverage; (2) determination of the extent of the insured's damages; and (3) the required notice must be filed under section 624.155(3)(a)." Landers v. State Farm Fla. Ins. Co., 234 So. 3d 856, 859 (Fla. 5th DCA), review denied, No. SC18-292, 2018 WL 6839539 (Fla. Dec. 31, 2018). An appraisal award satisfies the first two requirements. Id.; see also Hunt v. State Farm Fla. Ins. Co., 112 So. 3d 547, 549 (Fla. 2d DCA 2013) (recognizing…
  • Demase v. State Farm Fla. Ins. Co., 239 So. 3d 218 (Fla. 5th DCA 2018)
    …when there has been (1) a determination of the insurer's liability for coverage; (2) a determination of the extent of the insured's damages; and (3) the required notice is filed pursuant to section 624.155(3)(a). Landers v. State Farm Fla. Ins. Co., 234 So. 3d 856, 859 (Fla. 5th DCA 2018) ; Cammarata v. State Farm Fla. Ins. Co., 152 So. 3d 606, 612 (Fla. 4th DCA 2014). In Blanchard, the United States Court of Appeals for the Eleventh Circuit asked the Florida Supreme Court the following question: "Does an in…
  • Zaleski v. State Farm Fla. Ins. Co., 315 So. 3d 7 (Fla. 4th DCA 2021)
    …rer, however, must evaluate a claim based upon proof of loss required by the policy and its expertise in advance of a determination by a court or arbitration. Vest, 753 So. 2d at 1275–76 (emphasis added); accord Landers v. State Farm Fla. Ins. Co., 234 So. 3d 856, 859 (Fla. 5th DCA 2018) (“The plain language of section 624.155(3)(d) provides no time limitation for when a CRN may be filed and does not require a final determination of coverage and damages before it is filed. The statute simply states that ‘no…

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