AMERICAN COASTAL INSURANCE CO.
v.
SOUTH BAY PLANTATION CONDOMINIUM ASSOC., INC.

Fla. 2d DCA | 2022-02-11
No. 21-0794
Florida District Court of Appeal, Second District (2022)

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Synopsis

The appellate court reversed a lower court's order compelling appraisal, holding that the appraisal demand was not ripe because the trial court failed to first determine if the insured had met its post-loss obligations. This decision clarifies that an insured must satisfy all post-loss conditions before demanding appraisal.


Holding

No, the demand for appraisal was not ripe because the trial court did not first determine whether South Bay had complied with its post-loss obligations. The court must make a preliminary decision on ripeness before compelling appraisal.


Headnotes

[1] A demand for appraisal under an insurance policy is not ripe unless the insured has complied with all post-loss conditions and the trial court has made a preliminary dete…

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Key Quotes

“A demand [for appraisal] is ripe where postloss conditions are met, 'the insurer has a reasonable opportunity to investigate and adjust the claim,' and there is a disagreement regarding the value of the property or the amount of loss.”

This quote defines the conditions under which a demand for appraisal is considered ripe.

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Facts & Procedural History

South Bay Plantation Condominium Association filed a claim with its insurer, American Coastal Insurance Company, for hurricane damage. After the parti…

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Opinion of the Court
Morris

KELLY, Judge. American Coastal Insurance Company appeals from a nonfinal order granting, in part, South Bay Plantation Condominium

Association, Inc.'s motion to stay and compel appraisal. Because the trial court did not first determine that South Bay's demand for appraisal was ripe, we reverse. South Bay filed a claim with its insurer, American Coastal, for damage to its property caused by Hurricane Irma. South Bay and American Coastal were unable to agree on the amount of the loss. Eventually, American Coastal denied the entire claim citing South Bay's failure to satisfy its postloss obligations and its misrepresentation of facts regarding the loss. South Bay then requested an appraisal pursuant to the terms of the policy. When American Coastal did not comply, South Bay sued it for breach of contract. In its amended answer, affirmative defenses, and counterclaim, American Coastal asserted that coverage was barred based on South Bay's "gross inflation of its claim" and its failure to satisfy the postloss conditions under the policy. South Bay then moved to stay the proceedings and compel appraisal.

The trial court granted the motion to compel appraisal. American Coastal argues this was error because the demand for appraisal was not ripe. "A demand [for appraisal] is ripe where postloss conditions are met, 'the insurer has a reasonable opportunity to investigate and adjust the claim,' and there is a disagreement regarding the value of the property or the amount of loss." Am. Cap. Assur. Corp. v. Leeward Bay at Tarpon Bay Condo. Ass'n, 306 So. 3d 1238, 1240 (Fla. 2d DCA 2020) (quoting Citizens Prop. Ins. Corp. v. Galeria Villas Condo. Ass'n, 48 So. 3d 188, 191 (Fla. 3d DCA 2010)), review granted, No. SC20-1766, 2021 WL 416684 (Fla. Feb. 8, 2021). "[T]he party seeking appraisal must comply with all post-loss obligations before the right to appraisal can be invoked under the contract." State Farm Fla. Ins. Co. v. Hernandez, 172 So. 3d 473, 476-77 (Fla. 3d DCA 2015); see also Leeward Bay, 306 So. 3d at 1241 (concluding that appraisal was ripe where the insurer disputed the amount of the loss but did not allege that the insured failed to satisfy any postloss conditions).

Here, the record reflects that the trial court relied upon this court's decision in Leeward Bay in ordering that the parties proceed with appraisal and conduct discovery simultaneously.

However, Leeward Bay, which allows for such a dual-track approach, is distinguishable because it did not involve the insured's alleged failure to comply with any postloss conditions. See 306 So. 3d at

1241. Because the trial court did not make a preliminary decision on whether South Bay complied with its postloss obligations, South Bay's demand for appraisal was not ripe. We therefore reverse the order compelling appraisal and remand for an evidentiary hearing. See Citizens Prop. Ins. Corp. v. Admiralty House, Inc., 66 So. 3d 342, 344 (Fla. 2d DCA 2011) (reversing an order compelling appraisal and remanding for an evidentiary hearing to determine whether the insured's demand for appraisal was ripe). "[O]nce the trial court determines that [the] demand for appraisal is ripe, the court has the discretion to control the order in which [the] appraisal and coverage determinations proceed." Id. (quoting Galeria Villas Condo. Ass'n, 48 So. 3d at 191-92); see also Leeward Bay, 306 So. 3d at 1242-43. American Coastal also argues that the court erred in compelling appraisal because South Bay's claim was denied based on its intentional misrepresentation of the amount of the loss which voided coverage under the policy. It asserts that where a claim is wholly denied based on lack of coverage, the trial court must resolve the coverage issue before ordering appraisal. American Coastal acknowledges that if South Bay's compliance with the policy's postloss conditions was not in question, this argument would be unavailing in light of this court's decision in Leeward Bay.1 MORRIS, C.J., and SMITH, J., Concur. Opinion subject to revision prior to official publication.1 The Florida Supreme Court has accepted jurisdiction to review this court's decision in Leeward Bay based on direct conflict with the decisions of other district courts of appeal. See Am. Cap. Assur. Corp. v. Leeward Bay at Tarpon Bay Condo. Ass'n, No. SC20-1766, 2021 WL 416684 (Fla. Feb. 8, 2021).

Footnotes
1 Reversed and remanded with directions.

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