Late notice = No claim
Citizens Property Insurance gets a meaningful win against a late hurricane claim, and Frontline Insurance finds a similar success against a late windstorm damage claim involving an Assignment of Benefits agreement. It’s all in this week’s Legal Briefs.
Citizens Win: Florida’s Third District Court of Appeal in Miami last week affirmed that Citizens Property Insurance can deny claims reported years after the storm, adding to an extensive body of evidence which reinforces the legitimacy and limitations on prompt notice clauses. Maria Morales, a Miami-Dade homeowner, filed a claim with Citizens regarding damage to her property more than three years after Hurricane Irma made landfall. In the time since, Morales has been through circuit court, where the Judge Maria de Jesus Santovenia ruled in favor of Citizens, and two rounds of appeals including this ruling, which both upheld the lower court’s decision. While this decision is not final, pending further motions, it is a clear lesson to policyholders in promptness, echoing previous cases such as Arce v. Citizens Property Insurance Corporation and Navarro v. Citizens Property Insurance Corporation. This is a moment of respite in the litigation landscape for insurance companies, showing clear support for claim denial when policyholders do not comply with reporting requirements.
Backing up Frontline: Frontline Insurance saw a similar win because of late reporting, with Florida’s Fourth District Court of Appeal ruling in its favor over a windstorm damage dispute. Homeowners Corina and Cesar De Leon said an April 2020 windstorm caused significant damage to their home, but didn’t report this to Frontline until 694 days later, in March 2022. They had signed an Assignment of Benefits (AOB) agreement with their contractor, You Restorations LLC, who then sued Frontline for breach of contract. While the policy in question was an all-risk homeowners policy, like most policies, it does not cover wear and tear damage, including water seepage. Frontline argued because the homeowners waited so long to act, they impeded all ability to find the source and scope of the windstorm damage – damage to the area could be from any resulting storms or wear and tear within the 694-day lapse in reporting. The nail in the coffin was a recorded statement from Mr. De Leon to a Frontline adjuster, where he admitted to seeing the stain shortly after the storm but didn’t contact his insurance company or a contractor. The stain grew as water seeped into the rotted wood with each passing storm, and only when You Restorations came out in 2022 were the initial repair steps taken. Since Florida law presumes insurers are harmed by late notice and the burden of proof falls to the policyholder, the appeals judges affirmed the lower court rulings, stating the late notice alone spelled the win for Frontline.
LMA Newsletter of 8-11-25
