Posted tagged ‘Claims File’

Discovery of Insurer’s Claims File Was Improper and Would Result in Irreparable Harm

March 28, 2013

State Farm Fla. Ins. Co. v. Meir Aloni (Fla. 4th DCA 2012)

Four years after Hurricane Wilma ran its course, an insured filed a claim to its property insurer, alleging damages sustained four years prior. Although the insurer sent a reservation of rights letter rather than disclaiming coverage outright, a coverage dispute nevertheless ensued and the insured sent a request for production. Among the items requested was the insurer’s “complete claims file.” The insured maintained that the claims file materials would be relevant since it had to overcome the presumption that its belated notice of claim prejudiced the insurer.

The insurer argued that its file, and especially its activity log notes, were protected work product that contained personal thoughts, evaluations, mental impressions, and recommendations regarding the claim and the possibility of litigation. The trial court ordered discovery of the activity log notes, emails, and photographs contained in the claims file, and denied to rehear the matter. The court nevertheless granted a stay pending resolution of a petition to the fourth district.

Indeed, the fourth district accepted the petition and quashed the discovery order, explaining that the trial court departed from the essential requirements of the law in compelling the disclosure of the claims file materials since the insurer had demonstrated that such disclosure would result in irreparable harm and the insured had not proven its need and inability to obtain the substantial equivalent of the material without undue hardship.

Florida Law Prohibits Discovery on Insurer’s Claims File Until Coverage Litigation Has Been Concluded

March 19, 2013

State Farm Fla. Ins. Co. v. Desai (3d DCA 2013)

Roshani Desai filed a declaratory action to determine whether an alleged ‘plumbing loss’ was covered by her homeowners’ insurance policy. Prior to a determination as to coverage, the trial court entered a discovery order requiring the insurer to (1) produce claim manuals and/or guidelines relating to certain policy language and (2) provide a representative to testify as to the claims manual, guidelines, and insurance policy.

The insurer sought certiorari review of the discovery order, contending that Florida law prohibits insureds from obtaining discovery into an insurer’s claims file and claims handling materials until contract/coverage litigation has been concluded. The court agreed and thus granted the petition and quashed the discovery order.