Citizens v Mendoza

On July 5, 2018 the Fourth District Court of Appeal reversed a judgment entered at trial in favor of the insureds, Risbel Mendoza and Vicente Jubes.  The case involved a homeowner’s claim for water damages resulting from a water heater leak.  The insurance company, Citizens Property Insurance Corporation, denied the claim, asserting that the damage fell under the policy’s constant or repeated seepage or leakage exclusion.

According to the policy:

Constant or repeated seepage or leakage of water or steam, or the presence or condensation of humidity, moisture or vapor; which occurs over a period of time, whether hidden or not and results in damage such as wet or dry rot, “fungi,” deterioration, rust, decay or other corrosion.

At the trial, the attorney for the homeowners argued that Citizens picked the wrong exclusion to deny the claim and that it should have picked a “more specific” exclusion over the “more general” exclusion, and therefore the insurance company violated its duty to adjust.

Additionally, the insureds complained about how the adjuster from Citizens denied the claim, asserting that it was a “violation of the ethical responsibilities.  It is a violation of the ethical – of the adjuster’s law.  It is a violation of the contract itself where it says, we will adjust all losses.”

The jury found that Citizens did not properly exclude the claim from coverage and awarded the homeowners $22,000 in damages.

The appellate court reversed, finding that the jury instructions focused on whether the adjuster properly investigated or properly adjusted the claim and whether Citizens violated a code of ethics.  While such considerations may be appropriate in a bad faith case, they have no place in a simple breach of contract action.  See Citizens Prop. Ins. Corp. v. Calonge, 43 Fla. L. Weekly D855b (Fla. 3d DCA Apr. 18, 2018).  The homeowners were free to criticize Citizens’ adjuster’s conclusions without arguing that he breached a duty or obligation to them.

Download Citizens v. Mendoza (duty to adjust) PDF

Incredible Insurance Claim Stories

Proeprty Claim Law

New house destroyed by fire

Insurance claims stories seems to make news headlines nearly everyday, which is no surprise, as 1 in 15 homeowners make a claim each year, according the Huffington Post. Given the many potential disasters that come with homeownership there is a high chance all of us will be reaching out to our insurance provider at one point or another to make use of the insurance we pay for.

While there are certainly stories of simple claims processes, the anecdotes below show there may not be such thing as a standard insurance claims. Some of these stories highlight fraud; others show instances where homeowners were required to pay out of pocket for disasters and faulty appliances. As you’ll see, most of these stories took quite a negotiation to get claims paid and others were unable to collect payment from their provider.

  • After a fire, a homeowner threw out a charred designer purse. Noticing the purse, the claims adjuster opened it up to find $400,000 of precious jewels and jewelry inside – saving the homeowner another catastrophic loss.
  • A homeowner was hiding cash in her bookshelf and claimed it was stolen. Fortunately, she was covered and able to recover most of the money, but if a house fire had destroyed the money, she would be out of luck as this instance was not on her policy.
  • A house was completely burnt down, but the homeowner’s claim was denied because she owned a dog on her insurance company’s prohibited dog breeds list, even though the dog had nothing to do with the fire.
  • A homeowner was denied, by their insurance company, after filing a claim for damage from their broken refrigerator. The claim was originally denied because the home was ‘customarily unoccupied,” although the insurance company is now reevaluating this decision.
  • In an attempt to cash in on his property and automobile a homeowner lit them both on fire. He did not receive money, but did receive five years in federal prison for insurance fraud.
  • An electric cooker, used by children, caused a kitchen fire, which was reported to the insurance company.
  • An insurance company denied a claim for damage, from excess steam, caused by a malfunctioning washing machine. After taking legal action and pointing out to the judge, steam is a form of water, the homeowner won the case.
  • A homeowner’s wine collection was damaged due to sewer backup, which exposed the wine to heat. The homeowner was able to win the claim, but not before a challenging battle.
  • While a family was away on vacation, their home had a kitchen fire causing nearly $16,000 in damage. Upon arriving home, they were shocked to discover they were not covered, by their policy, for insurance fire.
  • In another odd instance, a goose swallowed a homeowner’s diamond ring and the insurance company refused to cover it.
  • Another homeowner had a toilet flood causing damage to his home, Even though this was immediately reported to the insurance company, they avoided his calls, did not pay out the claim and even became hostile causing an already stressful situation to become even worse.

To ensure you are covered and receiving the appropriate compensation from your homeowner’s claim please call the Mineo Salcedo Law Firm at 954-463-8100.

8-year-old attempts armed robbery at West Palm store

An eight-year-old boy remains in police custody after attempting to rob a local convenience store at gunpoint, in West Palm Beach.

The boy rode his bike to the store and entered wearing a motorcycle helmet and baggy clothes while covering his face with a sweater. The odd behavior of this child alerted the employees that something was not quite right.

The boy confidently told the cashier, “give me the money,” while pointing a gun at him. Fortunately, another employee was keeping an eye on the situation and twisted the boy’s hand allowing the employee to secure the gun. At this point, the employee locked the gun in an office and put the ‘would be robber,’ in another room to wait for the police to arrive.

The minor told his mother, Ebony Alls, he was going to the park and gave her a hug before leaving to attempt his stick-up. The mother realized something was wrong when she picked up her purse and noticed it was lighter than usual. Upon investigation, she discovered her loaded handgun had been taken from her purse.

Customers who were interviewed at the scene were shocked that an eight-year-old was able to secure a loaded gun.

This minor is undergoing a mental health evaluation as he mentioned wanting to kill himself after the incident. While the boy will be taken to a juvenile detention center, charges have not yet been filed against him or his mother.

If your home or business has been burglarized, you may be entitled to insurance benefits. Call The Mineo Salcedo Law firm for a free case evaluation. (954) 463-8100.

EF-1 tornado touched down in Coconut Creek

EF-1 tornado touched down in Coconut Creek

Property Claim LawIt is believed a tornado touched down in several areas throughout Broward County January 27, 2016, causing significant damage. While each of the touchdowns lasted only 10 or 15 seconds, it was plenty of time to cause several car accidents, tear off roofs, overturn vehicles and cause injuries to people in the area.

The first of the three touchdowns came on Broward College’s North Campus where students heard loud banging and severe rain around 9:30 am. Fortunately, there were no injuries reported at the college, as class was in session and students were safely indoors. In response, the college followed emergency protocol, alerting students and canceling daytime classes to allow for clean up.

On the turnpike, near Sample Road, there were several car accidents and a semi trucks that were flipped over due to the nearly 100 miles per hour winds. The tornado also made its way through Pompano Beach where it caused significant structural damage to at least one industrial building and left some residents fearing for their lives.

The third and final touchdown lasted no more than 15 seconds, but still ripped shingles from the roof of the Wyndmoor Retirement Community and uprooted tress before dissipating. The American Red Cross has been dispatched and is helping residents of the community.

During tornados and other severe weather, it is recommended, to stay inside and near an internal room to avoid and debris that may be flying due to the heavy winds.

If you think your property sustained any sort of storm damage, contact The Mineo Salcedo Law Firm for a consultation.  Call (954) 463-8100.



Insurance Claims Process Holding up Recovery of Cape Coral

cape coral tornado blog postAs the city of Cape Coral begins coming to terms with the loss and damage of their belongings and homes, many residents are growing frustrated of not being able to begin the healing process.

The $1.2 million in aid money from the Cape Coral emergency fund can help clean up debris, but most families are waiting on their insurance companies to repair their homes. Many of these residents are stating their insurance companies are still conducting estimates and not allowing them to begin the repair process until the insurance company completes their procedures.

As water continues leaking into homes and damage accumulates, many are waiting several days to speak with their adjuster. Of those who have had an adjuster visit their home, many are stating there are several days between the adjuster’s visit and an estimate being provided, all while the homes continue being battered by the elements. This gap is making an already catastrophic situation even more frustrating for the displaced families.

While insurance companies have agreed to assist with the cost of a hotel, residents are displaced for an unknown amount of time and having a tough time finding a longer-term rental property to live in during this especially busy rental season, causing additional heartache. The sooner these families can begin hiring contractors and putting their homes back the way they were, prior to the storm, the sooner they can get back their normal lives back.

Insurance Rates Still Rising In Spite of A Decade of Zero Hurricanes! Why?

The hurricane season has ended and in Florida, this means a decade of zero hurricanes in spite of the fact that the country has had a few devastating hurricanes since 2000. Florida though has had around 63 subtropical or tropical cyclones from 2000 up to 2013 causing over $64 billion in damages, 69 deaths, and 82 injuries. The strongest hurricane to hit Florida happened in 2004, Hurricane Charley. That hurricane alone cost $5.4 billion in property damages, $285 million in agricultural loss and damages, 24 deaths, and almost 800 injuries. In some areas, about 95% of the buildings were damaged. But that’s all part of Florida’s past and seeing that no hurricane has hit the state at all, it begs the question: Why does Florida have one of the highest rates in home insurance in the country?

Insurance experts have the answer. According to them, insurance providers are pointing the blame on construction materials. They say the cost of repairing or rebuilding has increased dramatically over the years, not even including the cost of labor. There is a domino effect that ends with the consumer paying higher rates.

Based on this logic, other states with few to no hurricanes should also have high insurance rates while states that have been hit by hurricanes in the past 10 years should have higher insurance rates than Florida because of more damages. According to Sean Shaw, a slightly controversial consumer advocate, insurance companies are just using this as an excuse to charge high rates. He adds that the higher rates consumers are paying is all part of corporate earnings especially for top executives. Shaw, who is a lawyer and son of a retired Supreme Court Justice, Leander Shaw ran for representative of the House District 61 but lost to Edwin Narain by a mere 774 votes.

Shaw remains determined to fight for the rights of consumers and whatever reasons insurance companies throw at those who dare complain can all be rebutted be it sink holes (Florida experiences the most number of sinkholes in the country) or insurance fraud.

Let’s look at sinkholes.

According to experts, sinkholes are not increasing but attention to it is growing because of the Internet and the shock value of seeing images of sink holes. In fact, insurance companies in Florida begun questioning claims on sinkhole damages so much so that in 2011, the state’s insurance law was overhauled. The new law actually devalues a property because it shuts the door on certain claims from the “sinkhole alley” of Florida which is Pasco and Hernando counties. This law makes it harder for property owners to qualify for damage claim so property owners are stuck with having to shoulder the cost should any part of their property be damaged by a sinkhole. Other lawyers say it is almost impossible to qualify under sinkhole damage because insurance companies are allowed to pick the engineers who will decide on claims. In addition, sinkhole is a separate insurance from the basic homeowner’s property insurance.

Let’s look at insurance fraud.

The Florida Division of Insurance Fraud gets over 10,000 alleged cases of insurance fraud with about 1,000 cases presented for prosecution. However, even if Florida ranks 3rd in the country for cases presented for prosecution and second in number of arrests for insurance fraud, the Florida’s Division of Insurance Fraud is highest in recovery of losses from insurance fraud. In 2009, restitution amounted to over $34 million.

Shaw insists, “At a certain point you have to tell the insurance agency we don’t care what the excuse is.” He insists that electing someone who will be pro-consumer is the best way to stop the rates from increasing.

Right now consumers have options to getting lowered insurance rates aside from electing pro-consumer leaders:

  1. Ask current state representatives and leaders to get tough on insurance
  2. Shop for insurance well in advance so you don’t get stuck with having to make fast decisions just to get it “over and done with”
  3. Invest in additional security and hurricane items like roof straps to get additional discounts

If you have an insurance claim or want to have our attorneys review your policy of insurance, please call The Mineo Salcedo Law Firm for a free consultation.  (954) 463-8100.

The Grinch Is Alive In Miami Gardens: Arrest Warrants Out

The 1957 children’s classic from Dr. Seuss, “How The Grinch Stole Christmas” has heartbreakingly happened in Miami Gardens. Four men broke into a home and stole all the presents under the tree plus family jewels and other valuables.

Police have issued photos of the 4 men who were caught by the family’s surveillance cameras while in the act of being inside the home. The owner of the house, Toni (last name and photo withheld) said she got an alert around 10 in the morning from her ADT alarm while she was at work. The alert notified her that someone had gone into her home. Fortunately, Toni and her husband has the foresight to buy the cameras and install them immediately.

According the police reports and the videos from the surveillance cameras, the men entered the house through a bedroom window. The videos captured the faces and vital details about the men like their face features, what they were wearing, and arm tattoos. One man saw the camera and tried to hide his face.

The valuables that were taken included a necklace and earrings Toni’s husband bought for her which has significant sentimental value and all the Christmas gifts under the tree estimated  to be worth several thousands of dollars. One of the gifts was for her son and was a computer.

Not long after the house alarm sounded, armed police came into the scene with a K-9 unit but the men had already disappeared apparently leaving hurriedly after they saw the surveillance cameras. Toni calls the break-in heartless because it took away Christmas for the family including the presents that had “From Santa” on them. The Miami-Dade Crime Stoppers are offering a reward of $1,000 for any legitimate tip on the men or their whereabouts. Calls can be made to 305-471-TIPS. Callers can stay anonymous and still be eligible for the reward money.

If you have an insurance claim or want to have our attorneys review your policy of insurance, please call The Mineo Salcedo Law Firm for a free consultation.  (954) 463-8100.

Citizens Seeks to Limit Coverage for Water Related Claims

226ASP6179944780Citizens Property Insurance Corporation’s Board of Governors on Wednesday approved a slate of policy changes to bolster oversight of water loss claims while continuing to protect policyholders who need immediate emergency repair to water loss claims, according to a statement from the state-backed insurer. The move was in response to what the company calls “skyrocketing” water loss claims, particularly in South Florida.

By unanimous vote, Citizens board agreed to modify policy language in response to a surge of questionable water loss claims by limiting initial payouts for emergency services and clarifying ambiguous policy language relating to coverages typically affected by water loss claims. The recommended changes will be forwarded to the Florida Office of Insurance Regulation for approval.

The recommended changes are the first steps, board members were told, to better control costs without jeopardizing customer service following a spike in the frequency, severity and litigation of water claims particularly in South Florida, which last year accounted for 72 percent of all water loss claims. Recent data shows that the claim activity is spreading to other regions of the state, according to Citizens.

The board action comes as lawmakers continue discussions to create a framework governing the use of post-loss assignment of benefits to ensure that customers remain in control of their own claims. Citizens’ contract changes would complement these legislative initiatives, the insurer said.

“The bottom line is these policy changes and clarifications are necessary first steps to keep premiums as low as possible while protecting our policyholders who have legitimate claims,” said Barry Gilway, Citizens president, CEO and executive director. “However, they in no way fix the assignment of benefits cost-driver that must be addressed by statute.”

“Without these changes, Citizens would be forced either to take more draconian measures to curb costs or continue to raise rates,” Gilway continued.

Citizens said water loss claims now account for more than half of every premium dollar collected in Miami-Dade County. The issue, though concentrated in South Florida, appears to be spreading throughout the state.

One result of ambiguous language has been an increase in litigated water claims, Citizens said in its statement. In 2014, 38.4 percent of water loss claims in South Florida (Palm Beach, Broward and Miami-Dade) were litigated, more than double the frequency of litigated claims originating in the region in 2010, according to data from the insurer.

On Dec. 8, the board approved changes to:

Limit initial payouts for emergency services and temporary repairs prior to a report of loss to Citizens. Additional coverage for emergency services will be available following Citizens approval.
Exclude coverage of permanent repairs completed prior to a Citizens inspection of the damage.
Require that claims be reported within 72 hours of when policyholder knew or should have known that a loss had occurred.
Set a limit for additional coverage to restore uniformity of appearance by matching repairs with adjacent undamaged areas.
Clarify language relating to the replacement of plumbing systems following collapse, blockage or deterioration.
In 2014, Citizens said 39.2 percent of policyholders filing water loss claims in Palm Beach, Broward and Miami-Dade counties hired attorneys or public adjusters before filing an initial claim with Citizens. Elsewhere in the state, 4.2 percent of policyholders were retaining attorneys or public adjusters before reporting claims to Citizens. More than 98 percent of all litigated water claims initiate in the three county South Florida region.

Costs of litigated claims are nearly three times higher than non-litigated claims. In 2014, the average litigated claims costs $27,631 compared to $9,028 for non-litigated claims. Citizens said it must pay those costs by premiums collected by all policyholders within the territory where the loss occurs.

“With these changes, Citizens is attempting a surgical approach to protect policyholders and contain costs,” Gilway said.

If approved by OIR, the policy language changes would take effect in mid-2016 for new policies and existing Citizens policyholders when they come up for renewal.

Source: Citizens

Source: Insurance Journal:

The Dangers of Using a Turkey Fryer

TurkeyFrierFireMiami-Dade Fire Rescue joined Broward Sherriff’s Fire Rescue to host a demonstration on how to safely deep fry a turkey this Thanksgiving holiday.

The event was held on Monday November 23, at the Broward Fire AcaPropane.

The use of turkey fryers for Thanksgiving turkey were a focus at the event. Turkey fryers are often an accessible and inexpensive option for Thanksgiving, but according to the National Fire Protection Association, they are very unsafe.

Some of the dangers of using a turkey fryer include having the turkey fryer tip over, spilling hot cooking oil over a large area; having an overfilled cooking pot that can cause cooking oil to spill when the turkey is put in; and putting in a partially frozen turkey in the pot, causing cooking oil to splatter. Also, without thermostat controls, deep fryers can overheat oil to the point of starting a fire.

According to U.S. Fire Administration, even a small amount of cooking oil spilling on a hot burner can lead to a large fire.

Since the use of turkey-fryers often times can lead to very painful burns, other injuries, and damage of property; it is important to consider alternatives.

The National Fire Protection Association discourages the use of oil-containing turkey fryers except by properly trained professionals, who are using professional-level equipment.

Alternatively, oil-less outdoor units are also available and are a safer choice to oil-containing fryers.

NFPA advises that people who want to have a deep-fried turkey, buy it cooked from a grocer, food retailer, or restaurant that prepares them using professional equipment.

The Thanksgiving holiday is the top day for cooking fires to happen. According to a recent report published by U.S. Fire Administration, an estimated 2,000 Thanksgiving Day fires occur annually in the U.S. in residential buildings, and the leading cause of these fires is cooking.

If you are looking forward to a deep fried turkey this Thanksgiving, it is important to consider your options with safety in mind.

It’s official: This is the biggest El Niño on record, and a killer La Niña is coming

ElNinoOn Wednesday morning, NOAA released its data for the Pacific Ocean temperatures for the week of November 9. We hit a record — the current El Niño is the strongest in recorded history.

Before 2015, the largest recorded weekly reading of El Niño occurred during the week of November 26 in 1997. We passed that milestone last week. In 1997, the El Niño index set a record of 2.8:

Screen Shot 2015 11 18 at 11.50.42 AMBruce Krasting

As of last week the Pacific Ocean in region 3.4 (where El Niño is measured) hit a record of 3.0:

Screen Shot 2015 11 18 at 11.56.07 AMBruce Krasting

So another weather record has been set. What does it mean? In the very short term it means that there will be some hellacious weather in the US Pacific West/Texas in the next 90 days. It also means there will be a drought in Australia and Indonesia. Other parts of the globe will feel the consequences of the mega Niño.

Another consequence of this year’s El Niño, however, is virtually a sure thing to happen within the next half year. A very rapid change in El Niño water temperatures will follow — in nine months we will have gone 180 degrees in the opposite direction and we will be dealing with a very strong La Niña.

The following plots the changes from El Niño (red) to La Niña (blue). Note the rapid change that occurred from November 1997 to the fall of 1998. A very big La Niña followed the record El Niño:

The numbers:

Screen Shot 2015 11 18 at 11.56.54 AMBruce Krasting

A chart of the 1998 event:

Screen Shot 2015 11 18 at 11.57.30 AMBruce Krasting

This chart from Wednesday’s NOAA report is a synopsis of the computer forecasts for the collapsing El Niño and soon-to-be La Niña:

Screen Shot 2015 11 18 at 11.58.11 AMBruce Krasting

What will the coming La Niña bring us? If history is the gauge, then we should be preparing for a record hurricane season in the summer and fall of 2016 and a return to the crushing droughts in the Pacific West. This is what NOAA reports for the hurricane season of 1998:

Screen Shot 2015 11 18 at 11.58.55 AMBruce Krasting

In March of this year, the Australian Meteorology department issued its first warning that a big El Niño was in our future. I wrote about it, and in the blog I made some predictions of what it meant. Many of those things have now proved correct. So I’ll go out on a limb with some deep thoughts on the coming La Niña:

— If you live anywhere along the US coast from Virginia all the way to Texas (especially Florida), make some preparations.

— If you’re thinking of putting your house up on stilts to avoid flood damage, do it now. By March, the “Coming La Niña story will be in the media — too late to hire the construction crews to raise the house.

— To the extent possible, increase flood and wind insurance protection.

— Short the stocks of those insurance companies that have large risk exposure to the US east coast.

— If you’re thinking of buying that dream house on the ocean in the Sunbelt, wait a year — there will be some bargains. If you’re a seller, call the broker soon …

The La Niña will result in a resumption of drought conditions in the West. So consider:

— Enjoy the West Coast skiing this year — the next two years will suck.

— Don’t buy a vegetable farm (or heaven forbid a grape grower) in California just yet.

— Pot growers in California (huge biz) will get squeezed, as these growers use a ton of water.

I wonder about Phoenix and Las Vegas (more than San Francisco or Los Angeles). These cities are highly dependent on the Colorado River/Lake Mead. In a year the headline will be “Drought Returns — Lake Mead Level Resumes Drop.” What might be the implications of that? I can’t think of anything to be “long” of in that scenario — including casinos …