Martinez v. Universal Prop. & Cas. Ins. Co.

• Decision Date: 09 February 2023
• Docket Number: 5D21-3016
• Court: Florida District Court of Appeals
• Parties: EDDRIN MARTINEZ AND CARMEN MARTINEZ, Appellants, v. UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY, Appellee.

EDDRIN MARTINEZ AND CARMEN MARTINEZ, Appellants, v. UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY, Appellee.

No. 5D21-3016

Florida Court of Appeals, Fifth District

February 9, 2023

NOT FINAL UNTIL TIME EXPIRES TO FILE MOTION FOR REHEARING AND DISPOSITION THEREOF IF FILED

Appeal from the Circuit Court for Hernando County, Donald Scaglione Judge. LT Case No. 2016-CA-1296

Melissa A. Giasi, and Erin M. Berger, of Giasi Law, P.A. Tampa, for Appellant.

Paulo R. Lima, and Elizabeth K. Russo, of Russo Appellate Firm P.A., Miami, for Appellee.

EVANDER, J.

In this homeowners' insurance case, Eddrin and Carmen Martinez ("Insureds") appeal a summary final judgment entered in favor of Universal Property & Casualty Insurance Company ("Universal"). The summary judgment was granted on the grounds that Insureds failed to file a sworn proof of loss prior to filing suit against Universal. We reverse. The timeline stipulated to by the parties at the summary judgment hearing reflects that Universal denied coverage prior to the date on which Insureds were required to submit the sworn proof of loss. Consequently, the trial court erred in granting summary judgment in favor of Universal.

In their operative complaint,^[1] Insureds alleged that they suffered damage covered under their insurance policy with Universal as a result of two separate plumbing leaks. A plumbing leak in the bathroom was alleged to have occurred on November 6, 2015, and a plumbing leak in the kitchen was alleged to have occurred on November 23, 2015. Written notice of the claims was provided to Universal on December 16, 2015, and Universal inspected the property on January 13, 2016. On January 20, 2016, Universal requested Insureds to provide a sworn proof of loss and other documentation within sixty days. However, prior to the expiration of the sixty-day period, Universal denied coverage on both claims on the grounds of Insureds' "repeated lack of cooperation, failure to comply with . . . post-loss obligations, and failure to provide requested documents." Subsequent to its denial of Insureds' claims, Universal did tender a payment on one of the two claims. However, Insureds rejected that tender and subsequently filed suit. It is undisputed that Insureds did not provide a sworn proof of loss to Universal prior to commencing the actions below.

The insurance policy at issue provided that in case of a loss to covered property, Insureds were required to send Universal "within 60 days after [Universal's] request," a sworn proof of loss. The policy further stated that no action could be brought against Universal under the policy "unless the policy provisions have been complied with." "[A] policy provision requiring an insured to submit a sworn proof of loss is a condition precedent to a suit against an insurer." Bryant v. GeoVera Specialty Ins. Co., 271 So.3d 1013, 1021 (Fla. 4th DCA 2019). However, "[w]hen an insurer denies in advance that it has any liability under the policy coverage, the formal filing of a proof of loss becomes, in the eyes of the law, a useless and unnecessary thing that would accomplish nothing." Keel v. Indep. Life & Accid. Ins Co., 99 So.2d 225, 227 (Fla. 1957); see also ...