Florida Appellate Court Holds Concealment Or Fraud Provision Applies When Insured Relies On Materially False Estimate Even If Insured Did Not Prepare It

A Florida appellate court held that when an insurer relies on or adopts an estimate containing materially false statements, the insured cannot avoid application of a concealment or fraud provision simply because the insured did not prepare the estimate. Mezadieu v. Safepoint Ins. Co., 46 Fla. L. Weekly D691c (Fla. 4th DCA Mar 26, 2021).

The insured filed a claim under her homeowners’ policy, which the insurer investigated and denied. The insured filed a breach of contract action against the insurer, and relied on a loss consultant’s estimate in her sworn interrogatory responses and at her deposition. The insurer asserted an affirmative defense based on the policy’s concealment or fraud provision and moved for summary judgment based on the insured’s reliance on the questionable estimate. At the hearing on the motion, the insured admitted that the estimate should not have included certain damages, and the trial court granted the insurer’s motion. The insured appealed.

On appeal, the insured argued that she did not prepare the estimate and did not intentionally rely on the false statements contained therein. The appellate court held that intentionality is not required under the provision and that she adopted the estimate as her own statement. The appellate court found that the insured made no attempt to revise the estimate before the summary judgment hearing, even after the estimate’s contents were challenged at her deposition. The appellate court held that an insured cannot blindly rely on and adopt an estimate prepared by a loss consultant without consequence, and affirmed the trial court’s decision.