PEOPLE'S TRUST INSURANCE COMPANY v. MIGUEL TOSAR AND MARIA TOSAR

District Court of Appeal of Florida·Decided December 15, 2021·No. 20-0729·Published

Opinion

Third District Court of Appeal State of Florida

Opinion filed December 15, 2021.

Not final until disposition of timely filed motion for rehearing.

No. 3D20-0729

Lower Tribunal No. 18-28960

People’s Trust Insurance Company, Appellant,

vs.

Miguel Tosar and Maria Tosar, Appellees.

An Appeal from the Circuit Court for Miami-Dade County, David C.

Miller, Judge.

Beck Law, P.A., and Joshua S. Beck (Boca Raton); Brett R. Frankel, Jonathan Sabghir and Robert B. Gertzman (Deerfield Beach), for appellant.

Mintz Truppman, P.A., and Timothy H. Crutchfield, for appellees.

Before SCALES, HENDON and MILLER, JJ.

SCALES, J.

In this first party insurance action, People’s Trust Insurance Company (“People’s Trust”), the defendant below, appeals an April 23, 2020 order granting final summary judgment in favor of the plaintiffs below, Miguel and Maria Tosar (“the insureds”). The trial court’s order directs People’s Trust to issue a loss payment to the insureds in the amount of an appraisal award achieved through a court-ordered appraisal process. Because, under a policy endorsement, People’s Trust timely exercised its right to repair the insureds’ damaged property instead of making a loss payment, we reverse the challenged order and remand with directions for entry of an order requiring the insureds to comply with the policy’s endorsement.

I. RELEVANT FACTS AND PROCEDURAL BACKGROUND A. The Insureds’ Insurance Policy People’s Trust issued a homeowner’s insurance policy covering the insureds’ Miami home for the policy period between November 4, 2016 and November 4, 2017. The policy insured the dwelling (coverage A) and other structures (coverage B) at replacement cost value and included a $6,180 hurricane deductible.

In return for a premium discount, the subject policy contained a Preferred Contractor Endorsement (“the policy endorsement”). The policy endorsement gave People’s Trust a right-to-repair option, i.e., after

inspecting a covered loss, People’s Trust had the option to select its own contractor, Rapid Response Team, LLC (“RRT”), to repair the damages to the insureds’ property in lieu of issuing a loss payment that would otherwise be due under the policy.1 The policy endorsement required People’s Trust to notify the insureds of its election of its right to repair within thirty days of its inspection of the reported loss. Should People’s Trust exercise its right to repair, the policy required the insureds to pay the policy deductible and to execute the necessary work authorizations and permit applications for RRT to perform the repairs.2

1The policy endorsement added the following to the Loss Payment provision contained within “SECTION I – CONDITIONS”:

K. Loss Payment, the following is added to the policy:

4. When we have exercised our option to repair “your” damaged property pursuant to this Preferred Contractor Endorsement, we will repair the damaged property with material of like kind and quality without deduction for depreciation. Such repair is in lieu of issuing any loss payment that would otherwise be due under the policy.

2 “SECTION I – CONDITIONS” of the policy provided:

J. Our Option At our option:

....

The policy endorsement also contained an appraisal clause that applied only when People’s Trust exercised its right to repair and when the parties disagreed as to the amount of the covered loss and the scope of repairs to be performed by RRT. The appraisal clause expressly reiterated that the repairs to be performed by RRT were in lieu of any loss payment under the policy.3 The policy endorsement also modified that portion of the policy providing additional coverage (under coverage E) for reasonable expenses incurred by the insureds immediately following a loss to protect damaged property from further damage (i.e., the “Reasonable Repairs” provision).4

2. For losses covered under Coverage A – Dwelling, insured for Replacement Cost Loss Settlement as outlined in SECTION I – Conditions, Loss Settlement, we may repair the damaged property with material of like kind and quality without deduction for depreciation.

3. [As amended by the policy endorsement,] “We” will provide written notice to “you” no later than thirty (30) days after “our” inspection of the reported loss, unless factors beyond “our” control reasonably prevent “us” from doing so.

4. You must comply with the duties described in SECTION I – CONDITIONS, C. 7 and 8.

5. You must provide access to the property and execute any necessary municipal, county or other governmental documentation or permits for repairs to be undertaken.

6. You must execute all work authorizations to allow contractors and related parties entry to the property.

7. You must otherwise cooperate with repairs to the property.

8. You are responsible for payment of the deductible stated in your declaration page.

9. Our right to repair or replace, and our decision to do so, is a material part of this contract and under no circumstances relieves you or us of our mutual duties and obligations under this contract.

3The policy endorsement’s appraisal provision provided, in relevant part:

Where “we” elect to repair:

1. If “you” and “we” fail to agree on the amount of loss, which includes the scope of repairs, either may demand an appraisal as to the amount of loss and the scope of repairs. In this event, each party will choose a competent appraiser within 20 days after receiving a written request from the other. The two appraisers will choose an umpire. If they cannot agree upon an umpire within 15 days, “you” or “we” may request that the choice be made by a judge of a court of record in the state where the “residence premises” is located. The appraisers will separately set the amount of loss and scope of repairs. If the appraisers submit a written report of an agreement to “us,” the amount of loss and scope of repairs agreed upon will be the amount of loss and scope of repairs. If they fail to agree, they will submit their differences to the umpire. A decision agreed to by any two will set the amount of loss and the scope of repairs. Each party will pay its own appraiser, and bear the other expenses of the appraisal and umpire equally.

2. The scope of repairs shall establish the work to be performed and completed by Rapid Response Team, LLCTM. Such repair is in lieu of issuing any loss payment to “you” that otherwise

Essentially, this modification required the insureds to notify People’s Trust would be due under the policy. The amount of loss shall establish only the initial amount paid to Rapid Response Team, LLCTM by “us,” and any additional amounts required to complete repairs shall be “our” responsibility and will be paid to Rapid Response Team, LLCTM without regard to policy limits or the amounts of initial payments. . . .

(Emphasis added).

4 The policy endorsement replaces the policy’s Reasonable Repairs provision contained within “SECTION I – PROPERTY COVERAGES” with the following:

E. Additional Coverages

2. Reasonable Repairs is deleted and replaced by the following for losses other than sinkhole:

a. If a peril causing a loss and related damage are covered (other than sinkhole loss) and repairs are necessary to protect covered property from further damage, “you” must notify us before authorizing or commencing repairs so “we,” at our option, may select Rapid Response Team, LLCTM to make the covered Reasonable Repairs.

b. If “you” do not notify “us” and allow “us,” at our option, to select Rapid Response Team, LLCTM for the covered Reasonable Repairs, “our” obligation for repairs made to protect the covered property from further damage is limited to the lesser of the following:

(1) The reasonable cost “you” incur for necessary repairs made solely to protect the property from further damage;

or

(2) The amount “we” would have paid to Rapid Response Team, LLCTM for necessary repairs made solely to protect the property from further damage.

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PEOPLE'S TRUST INSURANCE COMPANY v. MIGUEL TOSAR AND MARIA TOSAR, (Fla. Ct. App. 2021).

PEOPLE'S TRUST INSURANCE COMPANY v. MIGUEL TOSAR AND MARIA TOSAR (PEOPLE'S TRUST INSURANCE COMPANY v. MIGUEL TOSAR AND MARIA TOSAR) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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