In Hope v. Citizens Property Insurance Corporation, No. 3D11-3147, (Fla. 3DCA 2013), the Florida Third District Court of Appeal determined that a homeowner’s reporting of a Hurricane Wilma insurance claim four-years after the storm was untimely notice pursuant to the insurance policy and carried with it a presumption of prejudice as to the insurance company’s ability to investigate the claim.
Insurance Claim Late Notice
Hurricane Wilma damaged the homeowner’s property in 2005. For the next four years, the homeowner made his own repairs to the property. In 2009, the homeowner for the first time reported the claim to the insurance company when he could fix all the damages. The insurance company denied the claim for failure to give prompt notice of the claim and because it was unable to determine what damages if any were from the hurricane. The trial court granted the insurance company’s motion for summary judgment holding that notice four years after the alleged loss was, as a matter of law, failure to comply with the insurance policy notice requirements. The trial court did not address the issue of prejudice to the insurer.
Late Notice is a Rebuttable Presumption
The Third District Court affirmed the trial court’s decision as being the right ruling but for the wrong reason. Under Florida insurance law, when late notice is given for an insurance claim, there is a presumption that the late notice prejudices the insurance company’s ability to investigate and adjust the loss. In that case, the insurance claim can be properly denied since the insurance company will be unable to determine what exactly transpired during the claim and is therefore not required to pay for the same. When there is a presumption of prejudice to the insurance company, the burden shifts to the homeowner to establish that the insurance company was not prejudiced by the late notice. The claim is lost If the homeowner cannot prove that there is no prejudice to the insurance company due to the late notice.
In this case, the trial court did not make a ruling as to prejudice but at the same time, the homeowner did not prove that there was no prejudice to the insurance company. Having had the opportunity to prove the lack of prejudice but failing to do so, the Third District Court of Appeal held that the motion for summary judgment was properly granted for the insurance company.
Lessons Learned
Based on this decision and those others recently decided before it, a Florida homeowner must report an insurance claim immediately to the insurance company or risk a denial. Further, a Florida insurance claimant would be best served to refrain from undertaking major repairs on his/her own until at least the insurance company has had the opportunity to view the scene. The insurance company needs the opportunity to review the damages to best determine what the damages are and what caused them. Should you as the homeowner destroy all that evidence by making significant repairs, you have erased the evidence of damages and their cause. Your obligation at the outset should be to (1) notify the insurance company of the claim; (2) make sure that no additional damages are caused to the property for those things you can control; and (3) preserve the scene so the insurer can see the damages and determine their cause.
Related Topics: Florida Insurance Law, Florida insurance claim notice, Florida insurance claim denial, Florida insurance policy
