Kathy Johnson v. Omega Insurance Company

200 So. 3d 1207, 41 Fla. L. Weekly Supp. 415, 2016 Fla. LEXIS 2148, 2016 WL 5477795
CourtSupreme Court of Florida
DecidedSeptember 29, 2016
DocketSC14-2124
StatusPublished
Cited by34 cases

This text of 200 So. 3d 1207 (Kathy Johnson v. Omega Insurance Company) is published on Counsel Stack Legal Research, covering Supreme Court of Florida primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Kathy Johnson v. Omega Insurance Company, 200 So. 3d 1207, 41 Fla. L. Weekly Supp. 415, 2016 Fla. LEXIS 2148, 2016 WL 5477795 (Fla. 2016).

Opinions

LEWIS, J.

This case is before the Court to review the decision of the Fifth District Court of Appeal in Omega Insurance Co. v. Johnson, — So.3d —, 39 Fla. L. Weekly D1911, 2014 WL 4375189 (Fla. 5th DCA Sept. 5, 2014), which arose from a claim for insurance benefits by Kathy Johnson, the insured, submitted to Omega, her homeowner’s insurance provider. The decision is in conflict with both Universal Insurance Co. of North America v. Warfel, 82 So.3d 47 (Fla.2012), and Ivey v. Allstate Insurance Co., 774 So.2d 679, 683-84 (Fla.2000). In conflict with our decision in Warfel, the court below improperly applied a presumption of correctness that is limited to an initial process for an investigative report during the litigation proceedings. In conflict with Ivey, the district court incorrectly interpreted section 627.428, Florida Statutes, which provides for an award of attorney’s fees when an insured recovers benefits from an insurer. Therefore, the two issues we address today are [1209]*1209(1) consideration of whether the statutory presumption of correctness afforded to an insurer’s internal report during the investigation process in the sinkhole statutes extends to later trial proceedings, and (2) whether an insured’s recovery of attorney’s fees under section 627.428, Florida Statutes, requires that there be bad faith on the part of an insurance company in the denial of a valid claim, or simply an incorrect denial of benefits. We have jurisdiction. Art. V, § 3(b)(8), Fla. Const. We conclude that the decision below is in conflict with both Warfel and Ivey.

FACTUAL & PROCEDURAL BACKGROUND

Section 627.428, Florida Statutes, outlines the provision under which an insured may recover attorney’s fees incurred as a result of recovering on a valid claim for insurance benefits. See § 627.428, Fla. Stat. (2015). Today we address the interpretation of section 627.428, and we begin with a review of the actual text of the statute:

(1) Upon the rendition of a judgment or decree by any of the courts of this state against an insurer and in favor of any named or omnibus insured or the named beneficiary under a policy or contract executed by the insurer, the trial court or, in the event of an appeal in which the insured or beneficiary prevails, the appellate court shall adjudge or decree against the insurer and in favor of the insured or beneficiary a reasonable sum as fees or compensation for the insured’s or beneficiary’s attorney prosecuting the suit in which the recovery is had.
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(3) When so awarded, compensation or fees of the attorney shall be included in the judgment or decree rendered in the case. "

§ 627.428, Fla." Stat. (2015).1 We have consistently explained that the purpose of this statute is to provide an adequate means to afford a level process and make an already financially burdened insured whole again, and to also discourage insurance companies from withholding benefits on valid claims. See Ivey, 774 So.2d at 683-84; Bell v. U.S.B. Acquisition Co., Inc., 734 So.2d 403, 410-11 n. 10 (Fla.1999). This statutory provision is of significant importance to the citizens of Florida.

Florida law also includes several statutory provisions which specifically address claims for sinkhole damage, commonly referred to as the “sinkhole statutes.” In part, the sinkhole statutes require insurers to provide policyholders the option of paying an additional premium for sinkhole coverage. § 627.706(l)(b), Fla. Stat. (2015). In this context, a sinkhole is described as “a .landform created by subsidence of soil, sediment, or rock as underlying strata are dissolved by groundwater.” § 627.706(2)(h), Fla. Stat. Sinkhole “activity” is defined as a “settlement or systematic weakening of the earth supporting the covered building” resulting from “contemporaneous movement or raveling of soils, sediments, or rock materials into subterranean voids.” § 627.706(2)©, Fla. Stat. An insurer may require an inspection of the property pri- or to issuing a policy which provides sinkhole coverage benefits. § 627.706(l)(b), Fla. Stat. Upon submission of a claim for sinkhole damage, a professional engineer or geologist selected exclusively by the insurer.may examine the property to determine whether a [1210]*1210sinkhole loss covered under the insurance policy exists and make recommendations regarding building stabilization and foundation repair. § 627.7072, Fla. Stat. Thereafter, the engineer or geologist exclusively selected by the insurer tenders a report and certification to the insurer and the insured that outlines the analy-ses, any test methods, damages, and recommendations for repair. § 627.7073(1), Fla. Stat. During this initial claims process, these findings and recommendations by the insurer’s experts receive a statutory presumption of correctness. § 627.7073(l)(c), Fla. Stat. (2015).

If the insured disputes whether the insurance company’s report is correct, the sinkhole statutes also provide for a neutral evaluation procedure. § 627.7074, Fla. Stat. (2015). Neutral evaluation is mandatory if requested by either party, section 627.7074(4), Fla. Stat. (2015), but the insurer bears the cost for the neutral evaluation. § 627.7074(6), Fla. Stat. Court proceedings are stayed pending the completion ■ of any neutral evaluation. § 627.7074(10), Fla. Stat. Once the neutral evaluation is completed, the neutral evaluator prepares an independent report to address whether there was damage to the insured property caused by sinkhole activity, and an estimated cost for repairs. § 627.7074(12), Fla. Stat. Significantly, the results of the neutral, independent evaluation are not binding in any subsequent legal proceedings, § 627.7074(4), Fla. Stat.

At the time of the events material to this case, Johnson was covered under a homeowner’s insurance policy issued by Omega, which included sinkhole coverage. On January 13, 2010, Johnson filed a claim with Omega to recover damages resulting from conditions which Johnson believed to be sinkhole activity. Specifically, Omega was alerted that there were cracks in the walls, as well as separations between the walls and ceilings of the kitchen, dinette, bathrooms, family room, bedrooms, foyer, windows, and garage of Johnson’s home. Cracks were additionally found in the closets and floorboards. The extent of the cracking was such that several of the doors inside the home were difficult to open. As a result, Johnson was forced to hire a drywall company to repair the cracks in the drywall and a carpenter to reset the doors. The fireplace and kitchen cabinets were also displaced by separation, and cracks were additionally observed on the exterior walls of the home and driveway. Moreover, in the utility room, a sag was observed along the top of the cabinet that housed Johnson’s washing machine and dryer. As a result, Johnson had been unable to perform routine maintenance on these appliances because the sag prevented these appliances from being moved.

Omega selected and retained Rimkus Consulting Group to perform an initial sinkhole investigation. After performing three Standard Penetration Test.borings, Rimkus concluded that there was no sinkhole activity present on Johnson’s property. Although Rimkus conceded that the property was damaged, it attributed the damage to causes that were not covered under the policy, such. as volumetric changes of clay-based soil underlying the site, concrete shrinkage, and defective construction processes.

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Cite This Page — Counsel Stack

Bluebook (online)
200 So. 3d 1207, 41 Fla. L. Weekly Supp. 415, 2016 Fla. LEXIS 2148, 2016 WL 5477795, Counsel Stack Legal Research, https://law.counselstack.com/opinion/kathy-johnson-v-omega-insurance-company-fla-2016.