Insurance Company and Insurance Agent Were Deemed Same Entity Regarding Notice Requirements

In Siguenza v. Citizens Prop. Ins. Corp. (Fla. 3d DCA 2013), the insurer, Citizens, denied a claim based on late notice and insured sued for breach of contract, testifying that she gave prompt notice directly to insurance company.

Citizens contradicted testimony through affidavit, prompting insured to file affidavit clarifying that she gave prompt notice to insurance agent. The court granted summary judgment in insurer’s favor, finding the insured’s subsequent affidavit in contradiction with her testimony. Appellate court reversed, ruling a material question of fact existed regarding timeliness of loss since insured considered the insurance company and the insurance agent to be the same entity and since the policy provided that prompt notice could be given to either one.

Insurance Agents Are Not Liable for Attorney’s Fees Under Florida Statute Sec. 627.428

Underwood Anderson & Assoc., Inc. v. Lillo’s Italian Rest., Inc., (Fla. 1st DCA 2010)

An insurance agent appealed the trial court’s award of $100,000 in attorney’s fees to the insured under Fla. Stat. § 627.428(1) after a judgment for negligence procurement of a flood insurance policy in the insured’s favor, because, the agent claimed, he did not qualify as an insurer under the terms of the statute. The court agreed and held that the agent did not constitute an insurer under § 627.428(1) because he merely facilitated the insurance contract to which he was not a party.

Whether an Insurance Broker Was the Insurer’s Agent Was an Issue of Fact

Frank Gay Plumbing, Inc. v. Ass’n Cas. Ins. Co., et al. (Fla. 5th DCA 2012)

An individual (“Gay”) operating a vehicle owned by his company was in an automobile accident with an at-fault underinsured motorist. After the accident, the tortfeasor’s carrier, GEICO, provided Gay with a settlement check and a release of all claims. Before cashing the check or signing the release, Gay contacted his insurance broker who advised Gay that he could cash the check but should not sign the release. For whatever reason, Gay ignored the advice and cashed the check and signed the release.

Gay then made an underinsured motorist claim to his company’s insurer, who denied coverage on the bases that Gay had violated the policy conditions by settling and failing to give timely notice of the claim. Gay instigated a declaratory action and the parties filed cross-motions for summary judgment.

The trial court ruled in the insurer’s favor, finding that Gay failed to comply with the express terms of the policy since notice to the insurance broker was not notice to the insurer. Because Florida law holds that notice to one’s agent is notice to the principal, the focus of the appeal was whether the broker was simply an insurance broker or was instead an agent or apparent agent for the insurer.

The fifth district explained that the evidence was conflicting on the issue since, on the one hand, there was evidence that the broker was not permitted to use the insurer’s name or logo in advertising, but, on the other hand, was permitted to collect premiums and receive, accept, and bind parties to certain proposals for contracts of insurance with the insurer. In addition to the agency issue, there was also a material issue of fact as to whether or not the insurer was in some way prejudiced by the settlement with GEICO. For these reasons, the court reversed and remanded.

Bill Frisbie, Yankee Trailer Court, LLC v. Carolina Cas. Ins. Co. (Fla. 5th DCA 2012)

A client who sued his law firm for malpractice and then intervened in a declaratory judgment action between the firm and its insurer appeals from a final judgment allowing the insurer to rescind the insurance policy for material misrepresentations on the policy renewal application.

In a very short opinion, the fifth district reversed and remanded for further proceedings, explaining “genuine issues of fact existed as to whether waiver or estoppel barred rescission [since] record evidence exists from which a jury could conclude that shortly after the client sued the firm in February, 2006, the insurer was made aware of the facts it now claims justify rescission, but it did not assert rescission until November 2007.”