The Southern District Court of Florida recently issued an opinion discussing the amount of detail required to state a claim for breach of contract in Florida in a Hurricane Wilma claim. Galison v. Fireman’s Fund Ins. Co., No. 10-81522, 2011 WL 3419620 (S.D. Fla. August 4, 2011). The insurer in the case filed a motion to dismiss, claiming that the insured’s complaint was too vague and ambiguous for it to respond or bring a defense.

Specifically, the insurer claimed that the complaint did not provide any facts or cite to any policy language that would explain why the property damage from Hurricane Wilma would be covered under the policy. The insurer also claimed that the insured failed to state when she first claimed that the damage would exceed the deductible and did not describe what was damaged in the hurricane.

The insured’s complaint makes the following pertinent allegations:

  • the insurer provided coverage to Plaintiff under policy number NZ01130712;
  • the policy provided dwelling coverage, including windstorm coverage for Plaintiff’s dwelling;
  • the insured property sustained windstorm and other damage to the insured dwelling on or about October 24, 2005;
  • Plaintiff contacted the insurer but was advised the property damage she described likely did not meet her deductible;
  • the insurer never sent an adjuster or engineer to inspect the damages;
  • the insurer breached the terms and conditions of its policy when it failed to investigate Plaintiff’s claim;
  • the Plaintiff recently engaged the services of an adjuster to review and inspect her roof and other interior damage, and concluded that more than 25% of the roof area was damaged and more likely than not by Hurricane Wilma and hurricane force winds;
  • the Plaintiff notified the insurer of her property damage immediately upon learning that her damage was much more extensive than previously known; and
  • the Plaintiff paid the required premium and the insurer has a duty to provide coverage and pay her claim.  

The Court denied the insurer’s motion to dismiss. The Court held that the Plaintiff sufficiently pled the elements for a cause of action for breach of contract: (1) the existence of a valid contract between the parties; (2) a material breach (failure to timely investigate); and (3) damages (more than 25% of roof damage, and having to hire an attorney).

It should be noted that this case is in federal court, and the pleading standards between federal and state court may differ, even in the same location.