Legal Alert: Fourth District Affirms Summary Judgment in Favor of Insurer Where Insureds Never Notified Carrier that They Disputed Its Payment Before They Filed Suit
Posted in Legal Alerts on April 18, 2018
On April 18, 2018, the Fourth District Court of Appeal issued its opinion in Goldman v. USAA, Case No. 4D17-1098 (Fla. 4 th DCA, April 18, 2018), which is a succinct, but very significant, first party case. In Goldman, the insureds suffered a plumbing leak and the insurer investigated the claim and issued payment. The insureds did not inform their carrier that they disputed the amount of the payment, but simply sued the carrier who promptly moved for compel appraisal. After the appraisal was completed and the loss paid in accordance with the law, the insurer moved for summary judgment. The trial court granted the motion, and the insureds appealed.
On appeal, the Fourth District affirmed the summary judgment finding that suit was never necessary because the insureds never notified the carrier that it disputed its payment for any particular reason. The Court found that “[t]here was never a breakdown in the claims adjusting or communications process, nor was there a refusal to pay the claim” and that it is only where the adjusting process has broken down and the parties are no longer attempting to resolve the claim that the insureds may be entitled to attorneys’ fees for the wrongful denial or failure to pay their claim. The Court relied, in part, on Hill v. State Farm Fla. Ins. Co., 35 So. 3d 956 (Fla. 2d DCA 2010), for the proposition that where an insured never gave an insurer the opportunity to incorrectly deny his or her claim before filing a lawsuit, the insured may not be entitled to recover its fees. Accordingly, the Court affirmed the trial court’s finding that, in this case, the sole purpose of the lawsuit was to generate attorneys’ fees rather than to resolve a legitimate dispute, and for that very reason, the trial court’s summary judgment was affirmed.