The Effect of Willful Non-Compliance in a Florida Insurance Claim Proceeding

Owning a home is a major milestone, but also comes with significant responsibilities and costs. Unlike renting, maintenance is no longer a call away to help fix things when they break or leak in your home. Home insurance, however, can often provide recourse in unexpected situations that are out of your control. These insurance policies often have specific rules and instructions on how to file a claim in the event of an issue that gives rise to a claim. As a homeowner, it is crucial that you read and understand these rules so that if an incident arises in your home, you can properly assert your rights for recovery.

In a recent Florida District Court of Appeal opinion, a homeowner filed a lawsuit against his home insurance company, arguing that they had breached their contract. The plaintiff’s home was insured by the defendant. The insurance policy provided that in the event of a loss giving rise to the claim, the homeowner must provide “prompt notice” to the defendant, give the defendant the requested records and documents, and submit to an examination under oath to recover for the loss.

Following a major plumbing leak incident in the homeowner’s house, the plaintiff provided notice and documentation of loss, but failed to show up for his examination under oath because he was out of the country and unaware that the examination under oath had been scheduled. The defendant subsequently denied the plaintiff’s claim, arguing that the plaintiff had breached the insurance policy’s requirements. The lower court ruled in favor of the defendant, and the plaintiff appealed.

On appeal, the court reversed and ruled in favor of the plaintiff. Ruling in favor of the defendant, the court reasoned, would only have been appropriate if the insured’s refusal to comply with an examination under oath was willful. A total failure to comply with an insurance policy’s provisions would preclude the insured from recovery. In the present case, however, the plaintiff cooperated to some degree and explained their non-compliance.

In Florida, recovery is denied to homeowners in these situations only when there is a total failure to comply with the insurance company’s policies. As long as the homeowner provides an explanation and cooperates with the insurance company, they should not be precluded from receiving compensation for loss or damage in their home. If the homeowner’s actions, however, are purposely avoidant of their policy’s provisions and they willfully ignore or blatantly refuse to comply with the requirements outlined in their contract without explanation, they may be ineligible for compensation.

Because insurance policies and contracts can often be complex, it is crucial that homeowners are familiar with all of your policy’s requirements. If an issue arises and your insurance company denies your claim even when you believe you have complied with all of your contract’s requirements, you may consider contacting an experienced attorney who can represent you in your dispute.

Have You Been Involved in a Dispute with Your Insurance Company?

If you believe that your insurance provider has breached the terms of your policy, you should contact the attorneys at Friedman Rodman Frank & Estrada, P.A. Our South Florida insurance dispute attorneys have years of experience successfully representing clients on all sorts of claims. Contact our office today for a free initial consultation at 877-448-8585.

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