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Insurer is Not Required to Show Intentionality Pursuant to Standard “Concealment or Fraud” Language in Homeowner’s Policy

The Plaintiff/policyholder (“PH”) suffered a water loss from a plumbing leak in her upstairs bathroom.  PH relied on an estimate prepared by a claims consultant.  PH relied on the estimate in discovery and at deposition, however, Plaintiff admitted that a portion of the damage captured by the estimate was related to a prior event. The insurer moved for and was granted summary judgment pursuant to the following “Concealment or Fraud” provision as follows:

(1)       Intentionally concealed or misrepresented any material fact or circumstance;

(2)       Engaged in fraudulent conduct; or

(3)       Made material false statements; relating to this insurance.

            The trial court found that the estimate contained false statements, and such statements were attributed to the PH because eh adopted the same in interrogatory answers as well as her deposition. PH appealed on the basis seeking error on the basis that she did not intentionally rely on the false statement articulated in the estimate.

            The appellate court found that PH’s testimony showed PH knew the some of the damages were not related to her water loss that was acknowledged in deposition but never revised prior to the summary judgment.  Most importantly, the Court found that “intent” is not required to be shown under the policy language. Universal Property 5 & Casualty Insurance Co. v. Johnson, 114 So. 3d 1031, 1036 (Fla. 1st DCA 2013).  The Court noted succinctly:

“….Simply put, an insured cannot blindly rely on and adopt an estimate prepared by his or her loss consultant without consequence.”

https://4dca.flcourts.gov/content/download/727103/opinion/200002_DC05_03262021_124024_i.pdfhttps://4dca.flcourts.gov/content/download/727103/opinion/200002_DC05_03262021_124024_i.pdf

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