In Florida, §627.7015 of the statutes exists to encourage insurers and policyholders to resolve disputes without litigation or appraisal. The statute requires insurers to provide notice to policyholders of their right to participate in the statutory mediation process before insurers can seek to force policyholders into the process of appraisal or litigate their appraisal rights. Recently, a Florida appellate court decided a case involving this statutory provision.1 At issue in the case was whether the statutory notice provisions of F.S.A. §627.7015 applies once a policyholder files a lawsuit against an insurer.
The policyholder (Gainey) brought a claim under her homeowner’s insurance policy with American Integrity, claiming that her residence was damaged by a water leak. After an inspection, American Integrity issued a check in the amount of $16,349.13 for damages. Counsel for Gainey sent American Integrity a letter advising that the payment was “significantly inadequate” to cover the losses. That same month, Gainey filed and served American with a breach of contract complaint. American Integrity asserted by letter that its investigation was ongoing and that it reserved the right to demand appraisal. It also requested Gainey to provide a sworn proof of loss statement. In response to Gainey’s complaint, American Integrity filed a motion to dismiss, urging the trial court to abate litigation in favor of appraisal. Once Gainey provided the sworn proof of loss statement, the insurer requested appraisal, advising Gainey that it did not agree with her estimate. In this correspondence, American Integrity provided the statutory notice of mediation under F.S.A. §627.7015.
The parties actually proceeded to the statutory mediation process, post-suit. It proved unsuccessful, and the insurer moved to abate the proceedings in favor of appraisal, and the motion was initially granted. However, Gainey then moved to enjoin or stop the appraisal and lift the stay of litigation, arguing American Integrity waived its right to appraisal by failing to provide timely notice of mediation under the statute. Adopting Gainey’s position, the trial court judge granted Gainey’s motion to enjoin appraisal, and the insurer filed an appeal of that ruling.
The appellate court noted that F.S.A. §627.7015 permits policyholders and insurers “to use the mediation process to encourage an inexpensive and speedy resolution of insurance claims ‘prior to commencing the appraisal process, or commencing litigation’.” The appellate court held that “Gainey cannot rely on the statute to avoid appraisal proceedings where her filing of the lawsuit rendered the statute inapplicable.”
The appellate court found the trial court erred by concluding American Integrity waived its right to appraisal, and reversed the order granting Gainey’s motion to enjoin appraisal and lift the stay of litigation.
1 American Integrity Ins. Co. of Florida v. Gainey, 2012 WL 4465519 (Fla. 2d DCA September 28, 2012).