RICHARD LEMON AND LEANNE LEMON vs PEOPLE'S TRUST INSURANCE COMPANY

CourtDistrict Court of Appeal of Florida
DecidedJune 3, 2022
Docket21-2771
StatusPublished

This text of RICHARD LEMON AND LEANNE LEMON vs PEOPLE'S TRUST INSURANCE COMPANY (RICHARD LEMON AND LEANNE LEMON vs PEOPLE'S TRUST INSURANCE COMPANY) is published on Counsel Stack Legal Research, covering District Court of Appeal of Florida primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
RICHARD LEMON AND LEANNE LEMON vs PEOPLE'S TRUST INSURANCE COMPANY, (Fla. Ct. App. 2022).

Opinion

IN THE DISTRICT COURT OF APPEAL OF THE STATE OF FLORIDA FIFTH DISTRICT

NOT FINAL UNTIL TIME EXPIRES TO FILE MOTION FOR REHEARING AND DISPOSITION THEREOF IF FILED

RICHARD LEMON AND LEANNE LEMON,

Appellants, Case No. 5D21-2771 v. LT Case No. 2018-CA-057724-X

PEOPLE'S TRUST INSURANCE COMPANY,

Appellee. ________________________________/

Opinion filed June 3, 2022

Appeal from the Circuit Court for Brevard County, Curt Jacobus, Judge.

Matthew G. Struble and Christine M. Deis, of Struble, P.A., Indialantic, for Appellants.

Robert Alden Swift, of Swift Legal Group, P.A., Orlando, for Appellee.

WOZNIAK, J.

Richard and Leanne Lemon appeal the final judgment rendered in

favor of their homeowners insurance carrier, People’s Trust Insurance Company (“PTI”), after a jury trial. The Lemons’ home sustained damage

caused by Hurricane Matthew, and after cashing PTI’s check covering the

cost to repair the roof, fence, and master bedroom ceiling, the Lemons

subsequently discovered additional damage to their home and sought to

supplement their damage claim with PTI. PTI refused additional payment

because, it asserted, the Lemons’ act of cashing the check constituted full

settlement of all claims, and thus their supplemental claim was barred by

accord and satisfaction. The jury agreed with PTI, determining that while the

Lemons had a supplemental claim against PTI, that claim was barred by

accord and satisfaction. On appeal, the Lemons argue that they were not

precluded from submitting a supplemental claim because neither common

law nor statutory accord and satisfaction applies. We agree and reverse the

final judgment. 1

The Lemons’ home was damaged by Hurricane Matthew on October

6, 2016. They reported their damage claim to PTI, and the property was

inspected on December 8, 2016. Eleven days later, on December 19, 2016,

PTI sent the Lemons two letters. One letter advised the Lemons that there

was coverage for the loss and that PTI had elected to use its preferred

1 Because of our holding that PTI’s accord and satisfaction defense is inapplicable in its entirety, we do not address the Lemons’ other arguments raised on appeal.

2 contractor, Rapid Response Team, LLC (“RRT”) to repair their property. The

letter further advised:

Sometimes this scope changes as repairs move forward and new conditions are discovered. If that happens, you have the right to supplement your claim to include newly discovered damages so long as they are damages which are covered under your policy.

(Emphasis added). The letter instructed the Lemons how to proceed if they

did not agree with the scope of repairs attached to the letter, but if there was

no disagreement, the assigned adjuster or RRT would be contacting the

Lemons to request execution of a written work authorization granting

permission for RRT to commence repair work.

The scope of repairs document attached to the letter stated in pertinent

part:

Please refer to the enclosed itemized estimate. This estimate contains our scope and valuation of the damages for the reported loss and was prepared using reasonable and customary prices for your geographic region. If any hidden, or additional damage and/or damaged items are discovered, please contact me immediately. Coverage for hidden or additional damages and/or damaged items, would need to be determined, and may require an inspection/re-inspection for further consideration. Please do not destroy, or discard any of the hidden or additional damages and/or damaged items, until we have had an opportunity to review and inspect the hidden or additional damages and/or damaged items.

3 (Emphasis added).

The other letter sent the same day, titled “Claim Settlement Letter,”

contained statements inconsistent with those in the previously described

letter. It stated that PTI had been unable to obtain an executed work

authorization from the Lemons and, as a consequence, PTI was foregoing

its right to repair covered damages using RRT and instead was issuing them

a check for $15,286.40. The Claim Settlement Letter specified, “This

agreement is based upon our mutual agreement as to the scope and amount

of your loss.” It continued:

Your endorsement of this check memorializes your acceptance of the scope and amount of damages we previously reviewed and as reflected in the attached estimate, it is offered solely to bring about a complete and final resolution of your claim. If, for one reason or another, you choose not to endorse the enclosed check, or you no longer agree with scope and/or amount of loss we previously agreed upon, please notify the undersigned at your earliest convenience and PTI will proceed with repairs in accordance with the E023 Preferred Contractor Endorsement, and any scope disputes will be resolved in accordance with the scope dispute mechanism in your policy.

(Emphasis added).

On December 20, 2016, the day after PTI sent the letters to the

Lemons, PTI issued a check to the Lemons in the amount of $15,286.40,

which it reissued on December 28 because the first check was made out to

4 an incorrect mortgagee. The check stub bore the notation: “REASON:

FULL AND FINAL PAYMENT - Full & final settlement in accord w/ claim

settlement.”

Approximately a month after cashing the check, the Lemons

discovered more moisture damage in their home’s ceilings, garage, and

home office and advised PTI, through a public adjuster, of their supplemental

claim. Ultimately, the Lemons submitted a Sworn Proof of Loss claim to PTI

for $35,155.53. When PTI did not respond to their claim, the Lemons filed

the underlying breach of contract action. PTI answered and raised, pertinent

to this appeal, accord and satisfaction as an affirmative defense:

As its First Affirmative Defense, without waiver of any defense as to coverage based the terms and conditions of the policy, Defendant asserts that the Plaintiffs’ claim and lawsuit are barred by Accord and Satisfaction. Plaintiffs and Defendant reached a mutually agreed settlement of Plaintiffs’ entire claim and Defendant issued the mutually agreed payment to Plaintiffs in performance of the settlement agreement.

The affirmative defense made no distinction between common law and

statutory accord and satisfaction.

At trial, the Lemons testified that prior to PTI’s issuance of the check,

they never had any conversations with PTI that quantified the amount of

damage to their home. Rather, PTI unilaterally determined the amount of

5 loss it was going to pay based on an agreed-upon scope of work; the Lemons

did not dispute the amount of the check as payment for the unilaterally

determined amount of loss because they understood they could file a

supplemental claim later if needed. Such supplemental claim was necessary

because the Lemons discovered additional damage to their home after

depositing PTI’s check.

After the Lemons rested their case, PTI sought a directed verdict,

arguing that once it tendered the check and the Lemons accepted it, there

was an accord and satisfaction that barred any further recovery. The trial

court denied the motion, and PTI presented its witnesses. None of PTI’s

witnesses testified to the existence of any dispute with the Lemons prior to

the Lemons’ supplemental claim.

After PTI’s final witness, the Lemons moved for a directed verdict on

PTI’s accord and satisfaction affirmative defense, arguing that it was

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RICHARD LEMON AND LEANNE LEMON vs PEOPLE'S TRUST INSURANCE COMPANY, Counsel Stack Legal Research, https://law.counselstack.com/opinion/richard-lemon-and-leanne-lemon-vs-peoples-trust-insurance-company-fladistctapp-2022.