Francis v. Tower Hill Prime Insurance Co.
2017 Fla. App. LEXIS 9982, 2017 WL 2960690, 224 So. 3d 259 (2017)
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Rule of Law:
A large discrepancy between an insurer's and an insured's sworn estimates of the actual cash value of a covered loss creates a genuine issue of material fact that precludes summary judgment in a breach of contract action.
Facts:
- Latonya Francis held a homeowner's insurance policy with Tower Hill Prime Insurance Company.
- Francis's home sustained interior rainwater damage due to roof leaks, and she filed a claim with Tower Hill.
- Tower Hill's appraiser calculated the actual cash value of the interior damage to be approximately $15,000 after the deductible.
- Francis's public adjuster submitted sworn statements of proof of loss estimating the same damage at over $139,000 after the deductible.
- Tower Hill paid Francis the amount determined by its own appraiser, informing her she could claim depreciation after repairs were complete.
- Francis used the insurance proceeds to repair the roof rather than the damaged interior.
- Tower Hill also preemptively denied any claim for the roof itself, citing a policy exclusion for 'wear and tear' after its adjuster concluded the leaks were due to sealant deterioration.
Procedural Posture:
- Latonya Francis sued Tower Hill Prime Insurance Company in a Florida trial court for breach of contract.
- Tower Hill filed a motion for summary judgment, arguing it had paid the actual cash value and that Francis had not used the proceeds for the intended repairs.
- The trial court granted Tower Hill's motion for final summary judgment.
- The trial court denied Francis's subsequent motion for rehearing.
- Francis, as the appellant, appealed the summary judgment to the Florida Third District Court of Appeal, with Tower Hill as the appellee.
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Issue:
Does a significant discrepancy between an insurer's and an insured's competing estimates for the cost of repairing covered property damage create a genuine issue of material fact sufficient to prevent a grant of summary judgment for the insurer?
Opinions:
Majority - Salter, J.
Yes. A significant discrepancy between competing damage estimates creates a genuine issue of material fact, making summary judgment improper. The court reasoned that under the standard for summary judgment, all evidence and reasonable inferences must be viewed in the light most favorable to the non-moving party, Ms. Francis. The 'widely-divergent estimates' of repair costs, with Francis's sworn proof of loss valued at over nine times Tower Hill's estimate, constitute a clear factual dispute that must be resolved by a fact-finder, not a judge on a motion. The court also found summary judgment on the potential roof damage claim was improper because Francis had not yet submitted a formal, detailed claim for it, meaning the issue was not yet crystallized or ripe for adjudication.
Analysis:
This decision reinforces the high bar for granting summary judgment in insurance disputes where the amount of loss is contested. It clarifies that an insurer cannot secure summary judgment simply by paying its own adjuster's estimate when the insured presents competing, sworn evidence of a much higher loss. The case serves as a reminder that substantial factual disputes over valuation are questions for a jury. Furthermore, it limits an insurer's ability to use summary judgment to proactively extinguish a potential claim that has not yet been formally and fully submitted by the insured.
