YOLANDA VARGAS
v.
SAFEPOINT INSURANCE COMPANY
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In a post-loss context, the term "false statement" in an insurance policy's concealment or fraud provision includes an element of intent to mislead, not merely an incorrect statement. Summary judgment was improper where the insured claimed she innocently forgot a prior similar claim.
[1] In the post-loss context, the term "false statement" in an insurance policy's concealment or fraud provision requires an element of intent to mislead, not merely an incor…
[2] Policy provisions that limit or avoid liability are interpreted strictly against the drafter and liberally in favor of the insured, and forfeitures of insurance coverage…
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“the term "false" has two distinct meanings. It has been defined as either "[c]ontrary to fact or truth" or as "deliberately untrue." American Heritage Dictionary (2d ed. 1985); see also Merriam-Webster's Ninth New Collegiate Dictionary 447 (9th ed. 1987) (defining "false" as "intentionally untrue," "tending to mislead," "adjusted or made so as to deceive," or "not true").”
This establishes that the word "false" has multiple dictionary definitions, requiring the court to determine which meaning applies in the insurance policy context.
Previewing 1 of 3 key quotes on this case — the court’s exact language, pinpointed for members.
Join FLexlaw to unlock all legal intelligenceVargas reported a water damage loss to Safepoint Insurance. When asked about prior claims in interrogatories and deposition, Vargas did not disclose a…
The full statement of facts, procedural history, and disposition for this case are member content.
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Third District Court of Appeal State of Florida
Opinion filed January 12, 2022. Not final until disposition of timely filed motion for rehearing.
________________
No. 3D19-1656 Lower Tribunal No. 17-12003 ________________
Yolanda Vargas, Appellant/Cross-Appellee,
vs.
Safepoint Insurance Company, Appellee/Cross-Appellant.
An Appeal from the Circuit Court for Miami-Dade County, Reemberto Diaz, Judge.
Giasi Law, P.A., and Melissa A. Giasi and Erin M. Berger (Tampa), for appellant/cross-appellee.
Bickford & Chidnese, LLP, and Andrew L. Bickford and Patrick M. Chidnese (Tampa); Bressler, Amery & Ross, P.C., and Hope C. Zelinger and Krista L. Elsasser, for appellee/cross-appellant.
Before EMAS, LOGUE and SCALES, JJ.
LOGUE, J.
2
Yolanda Vargas appeals the trial court’s entry of final summary judgment for Safepoint Insurance Company. This first-party property insurance case turns on the interpretation of an insurance policy’s “Concealment or Fraud” provision providing for forfeiture of coverage when an insured makes “false statements relating to this insurance.” The insured’s statement at issue arose post-loss: she denied making prior similar claims when, in fact, she had made and been reimbursed for a similar claim from another insurance company. Yet the insured maintains that her misstatement was innocent because she had forgotten the prior claim. The question is whether the term “false statement” in this post-loss context means (1) “incorrect statement” or (2) “intentionally incorrect statement.” We conclude the term “false statement” in this post-loss context includes an element of intent to mislead, which, in this case, involves a genuine issue of material fact. Accordingly, we reverse. Factual and Procedural Background
Vargas and Safepoint entered into a property insurance contract. Pertinent to this appeal, the contract included the following provision:
3.
Concealment or Fraud. With respect to all persons insured under this policy, we provide no coverage for loss if, whether before or after a loss, one or more persons insured under this policy have:
b. Engaged in fraudulent conduct; or
c. Made material false statements relating to this insurance.
Vargas reported a loss to Safepoint resulting from water damage due to a plumbing leak. Safepoint’s corporate representative testified that Safepoint immediately requested repair invoices from any prior claims and photographs of the pre-loss condition of the property. Vargas never provided this information. Instead, Vargas submitted a sworn proof of loss with an itemized estimate of her damages prepared by a claim consultant.
After conducting its own investigation, Safepoint denied coverage and Vargas initiated this suit. Safepoint served Vargas with its first set of interrogatories asking Vargas to disclose any previous claim made on the property. Vargas responded by recalling a roof claim made ten years prior. Vargas did not disclose any prior claims involving water damage. In her deposition, Vargas stated that she had not made any prior insurance claims involving a plumbing leak on the property.
After receiving these answers, Safepoint added an affirmative defense based on the “Concealment or Fraud” provision of the insurance policy. To support this affirmative defense, Safepoint deposed Christina Crossway, the
Safepoint moved for summary judgment based on the “Concealment or Fraud” affirmative defense.1 Volusia Cnty. v. Aberdeen at Ormond Beach, L.P., 760 So. 2d 126, 130 (Fla. 2000). “Summary judgment is proper if there is no genuine issue of material fact and if the moving party is entitled to a judgment as a matter of law.” Id.
“Insurance contracts are construed according to their plain meaning and, if a policy provision is clear and unambiguous, it should be enforced according to its terms.” Universal Prop. & Cas. Ins. Co. v. Johnson, 114 So. 3d 1031, 1035 (Fla. 1st DCA 2013) (citing Taurus Holdings, Inc. v. U.S. Fid. & Guar. Co., 913 So. 2d 528 (Fla. 2005)).
Subsection (c) of the “Concealment or Fraud” provision states that Safepoint will not provide coverage for loss where an insured “[m]ade material false statements relating to this insurance.” Because the policy does not define “false statements,” we look to the ordinary, dictionary meaning of the term. This brings us to the first problem in this dispute: the term “false” has two distinct meanings. It has been defined as either “[c]ontrary to fact or truth” or as “deliberately untrue.” American Heritage Dictionary (2d ed. 1985);
This problem is not as serious as it first appears. While “false” includes both meanings, the more common usage of the word, certainly in the legal context, carries the connotation of an intentionally deceptive statement. “Only when the context strongly suggests mere error is the connotation of being deceived absent . . . false has an overlay of perfidy that is absent from wrong: false advice is both incorrect and two-faced, while wrong advice is simply incorrect.” Bryan A. Garner, Garner’s Dictionary of Legal Usage 352 (3d ed. 2011).
In Anchor Property & Casualty Insurance Company v. Trif, 322 So. 3d 663 (Fla. 4th DCA 2021), the Fourth District recently interpreted the use of “false statements” in a similar concealment or fraud provision of an insurance policy. Judge Robert M. Gross, writing for the majority, found that “in jurisprudence, ‘the word “false” implies something more than mere untruth: it imports knowledge and a specific intent to deceive.’” Id. at 675 (quoting State v. Tedesco, 397 A. 2d 1352, 1358 (Conn. 1978)). We agree with the Fourth District and apply this “more common” definition of the term “false statement” to include an element of intent. Id.
This result is bolstered by the fact that “words are given meaning by their context.” Antonin Scalia & Bryan A. Garner, Reading Law: The Interpretation of Legal Texts 56 (2012). Here, the term “false statement” arises in the context of forfeiture of coverage. As the Supreme Court stated decades ago, “a forfeiture of rights under an insurance policy is not favored by the law, especially where, as here, a forfeiture is sought after the happening of the event giving rise to the insurer’s liability.” Johnson v. Life Ins. Co. of Ga., 52 So. 2d 813, 815 (Fla. 1951). In the forfeiture context, as Judge Gross pointed out in Trif, the Supreme Court has long interpreted similar language (such as “false swearing”) in a concealment or fraud provision to require not simply incorrectness or untruth but also “the element of fraud.” 322 So. 3d at 674 (citing U.S. Fire Ins. Co. v. Dickerson, 90 So.
The second difficulty with our interpretation concerns “false statements” in the application process. While this issue is technically not before us as this case concerns post-loss “false statements,” we make one observation. Even if the reference to “false statements” in the policy language at issue includes an element of intent, general principles of contract formation and recission may provide a basis to set aside an insurance contract for a merely incorrect statement made in an insurance application. Illustrative of this point is Universal Property & Casualty Insurance Co. v. Johnson, 114 So. 3d 1031 (Fla. 1st DCA 2013).
As stated by the First District, “[t]his case law relating to insurance policies is consistent with the general principle in contract law that, to obtain rescission of a contract, based upon misrepresentation, it is not necessary that ‘the party making the misrepresentation should have known that it was false. Innocent misrepresentation is sufficient . . . .’” Johnson, 114 So. 3d at 1035 (quoting 27 Williston on Contracts § 69:49 (4th ed.)). We do not abandon this long-standing precedent regarding contract recission based upon incorrect information provided in an insurance application. It simply does not apply here where the incorrect statement was made post-loss.
11
Finally, Safepoint argues that, even if the policy required the insured’s statement to be intentionally misleading, we should nevertheless affirm because Vargas’s current and previous claims are so similar that no one could credit her assertion that she forgot about the prior claim. Because the trial court did not reach this issue, we similarly decline to consider it.2
Reversed and remanded.
2 We affirm without extended discussion the denial of Safepoint’s motion to dismiss for fraud on the court. See Leo’s Gulf Liquors v. Lakhani, 802 So. 2d 337, 338 (Fla. 3d DCA 2001) (reviewing the trial court’s ruling on a motion to dismiss for fraud on the court for abuse of discretion).
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- Taurus Holdings, Inc. v. United States Fid. & Guar. Co., 913 So. 2d 528 (Fla. 2005)
- Johnson v. Life Ins. Co. of Ga., 52 So. 2d 813 (Fla. 1951)
- People's Tr. Ins. Co. v. Socarras, 276 So. 3d 905 (Fla. 3d DCA 2020)
- Robert K. Fabric, M.D. v. Provident Life & Accident Ins. Co., 115 F.3d 908 (11th Cir. 1997)
- Kieser v. Old Line Life Ins. Co. of Am., 712 So. 2d 1261 (Fla. 1st DCA 1998)
- State v. Johnson, 949 So. 2d 219 (Fla. 3d DCA 2006)
- Smith v. State, 114 So. 3d 1031 (Fla. 1st DCA 2013)