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11th Cir. Says: Estimate Not Required to Submit a Supplemental Claim

Posted by Phillip Warren | May 18, 2024 | 0 Comments

For many of us who have suffered hurricane damage, you know how hard it can be to obtain an accurate estimate of your damages.  It requires a contractor, adjuster, or estimator with the requisite skill, training, and time to thoroughly inspect your home and calculate the value of your loss.  What if, in order to simply submit a claim for additional damage that was not discovered during the initial adjustment of the loss (a “supplemental claim”), you had to include an estimate, even though an estimate is not required by the policy?  Meaning, if you submitted your supplemental claim timely—now, within 18 months after the loss—but without your own estimate of the damage, the insurance company could call your supplemental claim defective and deny coverage.  Does that sound fair?  Thankfully, the Eleventh Circuit, in a recent opinion, agreed with you in finding an estimate is not required to submit a supplemental claim.  Here's what you need to know about this recent opinion:

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Great Lakes Ins. v. Concourse Plaza Condos – The Supplemental Claim

As simply another reminder of how long hurricane litigation can go on, this case arose out of Hurricane Irma back in 2017—almost seven years ago.  The condo association suffered damage as a result of Irma and submitted a claim to its insurance company.  In early 2018, the insurance company determined the loss did not exceed the deductible, so it declined to issue any payment on the claim.  The condo association disagreed but was not able to organize and get help with submitting its supplemental claim, in the range of $3.6M, until September 2020.  But they did file within the deadline under former Fla. Stat. § 627.70132—three years—to file a supplemental claim.  The insurance company argued the condo association's failure to include an estimate when submitting its supplemental claim—something that is not required by Florida law or the policy—made the supplemental claim defective, allowing the insurance company to deny a $3.6M claim in its entirety. 

The Eleventh Circuit's Reversal of the S.D.Fla.'s Requirement for an Estimate

On appeal, the United States District Court for the Southern District of Florida (S.D.Fla.) relied on an opinion from Florida's Fourth District Court of Appeals (DCA), Goldberg v. Universal Prop. & Cas. Ins. Co., 302 So. 3d 919 (Fla. 4th DCA 2020), in finding a valid supplemental claim must set forth the damages sought—i.e., include an estimate outlining what was owed in excess of what the insurance company already paid or determined—although this is not required by the policy or Fla. Stat. § 627.70132.  Meaning, even though an estimate is not required by the insurance policy of Florida law, the S.D.Fla. deemed the condo association's timely notice of a supplemental claim defective because it did not include an estimate. 

Read Great Lakes Ins. SE v. Concourse Plaza, A Condo. Ass'n, 621 F. Supp. 3d 1300 (S.D.Fla. 2022).

Thankfully, on appeal from that ruling, the Eleventh Circuit disagreed.  Explaining Florida law applicable this case, which was filed in Miami, arises out of Florida's 3rd DCA, the Eleventh Circuit relied on Patios West One Condo. Ass'n, Inc. v. Am. Coastal Ins. Co., 2024 WL 24782 (Fla. 3d 2024) which concluded that notice of a supplemental claim need only be: 1) given in accordance with the policy; and 2) constitute an additional claim for recovery from the same hurricane.  According to Patios, the condo association's supplemental claim, which was within the three-year deadline, accomplished both of these things.  Accordingly, the Eleventh Circuit refused the insurance company's attempt to avoid its obligation to pay the $3.6M claim by creating some new requirement that is not stated in their policy and not required by Florida law.  Note, the law may change if the Florida Supreme Court reviews this case and enters a contrary ruling. 

Read Great Lakes Ins. SE v. Condo Plaza, A Condo. Ass'n, 2024 U.S. App. LEXIS 8958 (11th Cir. 2024).

What This Means for You: No Estimate Required to File a Supplemental Claim 

We are grateful for the Eleventh Circuit's review of this opinion and its diligence in following the correct law by ruling in favor of the policyholder in this opinion.  As community members who have been through multiple hurricanes, we all know how long it can sometimes take to find damage hidden behind the sheetrock and beams of our homes.  We also know how hard it can be to find and hire a skilled estimator to help prepare an accurate estimate of our loss.  Both of these difficult tasks require time.  For a homeowner running up against the deadline to file a supplemental claim—which the legislature shortened from three years to eighteen months—the need to submit an estimate with the notice of a supplemental claim, rather than a simple notice submitted in accordance with the policy, makes a huge difference. 

This also shows insurance claims for property damage can be very complicated and often require help from experienced professionals—estimators, contractors, or lawyers—who know the law and the ins and outs of insurance claims to assist.  If you have suffered damage and have questions about your insurance claim and/or your insurance company's attempt to avoid paying you in full, you should seek professional help immediately.  At Taylor, Warren, Weidner & Hancock, P.A., we never require any fee, cost, or obligation to talk with you about your claim, make sure you understand your rights, and answer any questions you may have.  There is no downside to contacting us.  We here to help policyholders just like you. 

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About the Author

Phillip Warren

Phillip devotes the same honor, courage, and commitment to his clients as he did in the USMC.

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