Florida Man—Appraisal in the Brand New World of Initial, Additional, Supplemental, and Re-Opened Claims

Florida Man—Appraisal in the Brand New World of Initial, Additional, Supplemental, and Re-Opened Claims

When it comes to insurance law, the Florida legislature epitomizes Florida Man. Wikipedia describes Florida Man as follows:

Florida Man is an Internet meme first popularized in 2013, referring to an alleged prevalence of people performing irrational, maniacal, illogical, delusional, insane, and absurd actions in the U.S. state of Florida. Internet users typically submit links to news stories and articles about unusual or strange crimes and other events occurring in Florida, with stories’ headlines often beginning with ‘Florida Man…’ followed by the main event of the story. Because of the way news headlines are typically written, they can be creatively interpreted as implying that the subjects of the articles are all a single individual known as ‘Florida Man.’

Florida is unique for making slang terms adjusters and contractors refer to as codified insurance law. “Supplemental” and “re-opened” claims are only recognized as legal terms of significance in Florida. 

 An appellate finding this week1 made the following ruling referring to “supplemental” and “re-opened” claims as “additional” claims when considering if an appraisal should be compelled: 

How to categorize insurance claims for the purpose of determining ripeness for appraisal is questioned in this appeal. An insurer appeals an order granting the insured’s motion to stay litigation and compel an appraisal. It argues the trial court erred in granting the stay and compelling the appraisal because the insurer had not yet determined coverage on the insured’s additional claims after the insurer had accepted coverage on the initial claim. We disagree and affirm.

The explanation for the ruling is:

Here, like in Tracey, the insurer admitted coverage for the insured’s loss as a whole and determined the initially reported roof damage was covered….The claim was never settled and was still open when the insured subsequently reported additional roof damage and damage to its windows and doors. We have generally recognized that a subsequent claim should be treated as part of the initial claim if the insurer has accepted coverage for the initial claim and the claim has not been settled. Compare Luciano, 156 So. 3d at 1109–10 (treating subsequent claims as part of the initial claim where coverage accepted for initial claim and not settled or resolved), with Corridori, 28 So. 3d at 130–31 (treating subsequent claim as a ‘separate claim’ where coverage accepted for initial claim but settled, resolved, or otherwise closed).

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Like the insureds in Tracey, the insured in this case has only one claim, and because the insurer has not wholly denied coverage, any dispute as to whether the insurer is required to pay for all the reported damage is an ‘amount of loss’ or causation dispute that must be resolved in appraisal….

In summary, the insured’s claim is ripe for appraisal because the insurer admitted coverage for the initial claim, and the claim remained open for adjustment when the insured reported additional damage pursuant to the policy. The parties’ disagreement as to whether the insurer is required to pay for the additional damage is an ‘amount-of-loss’ issue for appraisal to resolve, not a coverage issue. We therefore affirm the order staying the litigation and compelling appraisal.”

The new Florida terms regarding supplemental and re-opened claims are certain to be litigated much more frequently. I can appreciate that many readers from other states are thinking, “What will Florida Man do next regarding insurance?” 

Thought For The Day 

Florida man charged with throwing alligator into Wendy’s

—The Washington Post

1 Heritage Prop. & Cas. Ins. Co. v. Wellington Place HOA, No. 4D2022-2749 (Fla. 4th DCA Sept. 13, 2023).