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Fla. L. Weekly D203aTop of Form
Fla. L. Weekly D203aTop of Form
Insurance
— Homeowners — Ensuing loss provision — Trial court erred by entering
summary judgment against insurer for cost of a repair and replacement of slab
necessary to reach a broken pipe, because the insurance contract’s ensuing loss
provision provided coverage for such repairs where water damage had occurred,
and as the slab had not yet been opened at the time of summary judgment, it was
unknown whether water damage had occurred — No prejudice to homeowners’ filing
another claim of loss at a later date
— Homeowners — Ensuing loss provision — Trial court erred by entering
summary judgment against insurer for cost of a repair and replacement of slab
necessary to reach a broken pipe, because the insurance contract’s ensuing loss
provision provided coverage for such repairs where water damage had occurred,
and as the slab had not yet been opened at the time of summary judgment, it was
unknown whether water damage had occurred — No prejudice to homeowners’ filing
another claim of loss at a later date
HOMEOWNERS
CHOICE PROPERTY & CASUALTY, etc., Appellant, vs. MIGUEL MASPONS, et al.,
Appellees. 3rd District. Case No. 3D14-1310. L.T. Case No. 12-14183. Opinion
filed January 18, 2017. An Appeal from the Circuit Court for Miami-Dade County,
Darrin P. Gayles, Judge. Counsel: Groelle & Salmon P.A., and Robert C.
Groelle and Patrick J. Carleton (West Palm Beach), for appellant. Mintz
Truppman and Timothy H. Crutchfield, for appellees.
CHOICE PROPERTY & CASUALTY, etc., Appellant, vs. MIGUEL MASPONS, et al.,
Appellees. 3rd District. Case No. 3D14-1310. L.T. Case No. 12-14183. Opinion
filed January 18, 2017. An Appeal from the Circuit Court for Miami-Dade County,
Darrin P. Gayles, Judge. Counsel: Groelle & Salmon P.A., and Robert C.
Groelle and Patrick J. Carleton (West Palm Beach), for appellant. Mintz
Truppman and Timothy H. Crutchfield, for appellees.
(Before
EMAS and LOGUE, JJ., and SHEPHERD, Senior Judge.)
EMAS and LOGUE, JJ., and SHEPHERD, Senior Judge.)
(SHEPHERD,
Senior Judge.) This is an appeal by Homeowners Choice Property and Casualty Company
from an adverse final summary judgment under a homeowners’ insurance policy.
The dispositive question appears to be whether the undisputed facts of this
case support the judgment of the trial court that the homeowners are entitled
to indemnity under the “ensuing loss” provision of a homeowners’ insurance
policy for the cost of tearing up and replacing a portion of the foundation or
slab on which their home sits, necessary to reach and replace a sanitary drain
line, the repair and replacement of which is not covered under the policy. The
trial court found coverage to exist under this provision of the policy. We find
the decision of the trial court was premature.
Senior Judge.) This is an appeal by Homeowners Choice Property and Casualty Company
from an adverse final summary judgment under a homeowners’ insurance policy.
The dispositive question appears to be whether the undisputed facts of this
case support the judgment of the trial court that the homeowners are entitled
to indemnity under the “ensuing loss” provision of a homeowners’ insurance
policy for the cost of tearing up and replacing a portion of the foundation or
slab on which their home sits, necessary to reach and replace a sanitary drain
line, the repair and replacement of which is not covered under the policy. The
trial court found coverage to exist under this provision of the policy. We find
the decision of the trial court was premature.
FACTS
The
sanitary drain line in need of repair and replacement in this case is located
under the kitchen floor of a home owned by Miguel and Annette Maspons in
Miami-Dade County. The home was constructed in 1957 on a poured concrete slab.
The sanitary drain lines for the home are located under the slab and made of
cast iron pipe. No one questions that this was anything other than a usual
construction material or construction method for the era.
sanitary drain line in need of repair and replacement in this case is located
under the kitchen floor of a home owned by Miguel and Annette Maspons in
Miami-Dade County. The home was constructed in 1957 on a poured concrete slab.
The sanitary drain lines for the home are located under the slab and made of
cast iron pipe. No one questions that this was anything other than a usual
construction material or construction method for the era.
In
December 2010, the Maspons noticed their kitchen sink was draining slowly. On
February 8, 2011, the Maspons hired Water Leak Detectors, which determined,
through the use of underground videography, that there was a break or failure
in the sanitary drain line under the kitchen floor in need of repair. On March
21, 2011, a public adjuster, retained by the Maspons, reported to Homeowners
Choice that the drain line under the floor of the property was “broken” and was
causing the sink to drain slowly. On March 28, 2011, Homeowners Choice
inspected the property. Using a similar non-destructive technology, Homeowners
Choice’s inspector, My Plumbing Company, found a large hole in the “bottom
sweep fitting” of the sanitary drain pipe that serves the kitchen, turning it
toward the hall bathroom. My Plumbing Company also found a second hole in the
line, and “scale” and “detritus” in other drain lines it examined. There has
never been a claim that the broken drain pipe caused any water damage to the
interior of the home and, despite speculation and argument of counsel, no
evidence that water seepage from the pipe has caused any damage under the slab
of the house. As Ms. Maspons testified in her deposition, “I won’t know what
other damages there are until the broken pipe is dug up.”
December 2010, the Maspons noticed their kitchen sink was draining slowly. On
February 8, 2011, the Maspons hired Water Leak Detectors, which determined,
through the use of underground videography, that there was a break or failure
in the sanitary drain line under the kitchen floor in need of repair. On March
21, 2011, a public adjuster, retained by the Maspons, reported to Homeowners
Choice that the drain line under the floor of the property was “broken” and was
causing the sink to drain slowly. On March 28, 2011, Homeowners Choice
inspected the property. Using a similar non-destructive technology, Homeowners
Choice’s inspector, My Plumbing Company, found a large hole in the “bottom
sweep fitting” of the sanitary drain pipe that serves the kitchen, turning it
toward the hall bathroom. My Plumbing Company also found a second hole in the
line, and “scale” and “detritus” in other drain lines it examined. There has
never been a claim that the broken drain pipe caused any water damage to the
interior of the home and, despite speculation and argument of counsel, no
evidence that water seepage from the pipe has caused any damage under the slab
of the house. As Ms. Maspons testified in her deposition, “I won’t know what
other damages there are until the broken pipe is dug up.”
Based
upon this state of the record, the trial court found there was no coverage
under the insurance policy for the repair and replacement of the pipe, but that
Homeowners Choice was responsible for the greater cost of tearing out and
replacing the slab to make the repair. Homeowners Choice appeals the latter
decision.
upon this state of the record, the trial court found there was no coverage
under the insurance policy for the repair and replacement of the pipe, but that
Homeowners Choice was responsible for the greater cost of tearing out and
replacing the slab to make the repair. Homeowners Choice appeals the latter
decision.
ANALYSIS
In
Florida, the insured has the burden of proving facts that bring its claim
within an insurance policy’s affirmative grant of coverage. E. Fla. Hauling,
Inc. v. Lexington Ins. Co., 913 So. 2d 673, 678 (Fla. 3d DCA 2005). In
order to meet this burden under a policy of property damage insurance, the
insured must prove (1) that the property harmed or damaged falls within the
“insuring clause” of the policy, and (2) the loss claimed falls within a
second, “covered perils” provision contained in each policy. See 10 Couch
on Insurance § 148:2 (3d ed. 2013). The property in this case is
uncontestably insured property under the Homeowners Choice insurance policy.
Thus, the first prong of the coverage analysis is satisfied. It is the second
coverage prong that produces the question for resolution in this case, whether
the Maspons suffered a loss that also falls within the “covered perils”
provision of the insurance policy. Only then might compensation be due, and
then only if there is no applicable exclusion from coverage that might apply.
Florida, the insured has the burden of proving facts that bring its claim
within an insurance policy’s affirmative grant of coverage. E. Fla. Hauling,
Inc. v. Lexington Ins. Co., 913 So. 2d 673, 678 (Fla. 3d DCA 2005). In
order to meet this burden under a policy of property damage insurance, the
insured must prove (1) that the property harmed or damaged falls within the
“insuring clause” of the policy, and (2) the loss claimed falls within a
second, “covered perils” provision contained in each policy. See 10 Couch
on Insurance § 148:2 (3d ed. 2013). The property in this case is
uncontestably insured property under the Homeowners Choice insurance policy.
Thus, the first prong of the coverage analysis is satisfied. It is the second
coverage prong that produces the question for resolution in this case, whether
the Maspons suffered a loss that also falls within the “covered perils”
provision of the insurance policy. Only then might compensation be due, and
then only if there is no applicable exclusion from coverage that might apply.
The
“covered perils” section of the Homeowners Choice insurance policy in this case
reads in pertinent part:
“covered perils” section of the Homeowners Choice insurance policy in this case
reads in pertinent part:
SECTION 1 — PERILS INSURED
AGAINST —
AGAINST —
COVERAGE A — DWELLING and
COVERAGE B —
COVERAGE B —
OTHER STRUCTURES
We insure against risk of direct
loss to property described in Coverages A and B only if that loss is a physical
loss to property. We do not insure, however, for loss:
loss to property described in Coverages A and B only if that loss is a physical
loss to property. We do not insure, however, for loss:
. . . .
2. Caused by:
. . . .
e. Any of the following:
(1) Wear and tear, marring,
deterioration;
deterioration;
. . . .
If any of these cause water
damage, not otherwise excluded, from a plumbing, heating, air
conditioning or automatic fire protection sprinkler system or household
appliance, we cover loss caused by the water including the cost of tearing
out and replacing any part of the building necessary to repair the system
or appliance. We do not cover loss to the system or appliance from which
this water escaped.
damage, not otherwise excluded, from a plumbing, heating, air
conditioning or automatic fire protection sprinkler system or household
appliance, we cover loss caused by the water including the cost of tearing
out and replacing any part of the building necessary to repair the system
or appliance. We do not cover loss to the system or appliance from which
this water escaped.
(Emphases
added.)
added.)
Any
analysis must begin with the language of the insurance contract. We give the
undefined words of an insurance contract their ordinary meaning, just as we
would with any other type of contract. See State Farm Fire & Cas.
Co. v. Castillo, 829 So. 2d 242, 244 (Fla. 3d DCA 2002) (“[T]erms utilized
in an insurance policy should be given their plain and unambiguous meaning as
understood by the ‘man-on-the-street.’ ”). A “loss” is the diminution of value
of something, and in this case, the ‘something’ is the insureds’ house or
personal property. Loss, Black’s Law Dictionary (10th ed. 2014).
“Direct” and “physical” modify loss and impose the requirement that the damage
be actual. Examining the plain language of the insurance policy in this case,
it is clear that the failure of the drain pipe to perform its function
constituted a “direct” and “physical” loss to the property within the meaning
of the policy.1
analysis must begin with the language of the insurance contract. We give the
undefined words of an insurance contract their ordinary meaning, just as we
would with any other type of contract. See State Farm Fire & Cas.
Co. v. Castillo, 829 So. 2d 242, 244 (Fla. 3d DCA 2002) (“[T]erms utilized
in an insurance policy should be given their plain and unambiguous meaning as
understood by the ‘man-on-the-street.’ ”). A “loss” is the diminution of value
of something, and in this case, the ‘something’ is the insureds’ house or
personal property. Loss, Black’s Law Dictionary (10th ed. 2014).
“Direct” and “physical” modify loss and impose the requirement that the damage
be actual. Examining the plain language of the insurance policy in this case,
it is clear that the failure of the drain pipe to perform its function
constituted a “direct” and “physical” loss to the property within the meaning
of the policy.1
However,
the last paragraph of the “perils insured” provision of the insurance policy,
often referred to as the “ensuing loss” provision of the policy, cautions that
we not prematurely abort our inquiry. That clause provides the homeowner with
coverage for an “ensuing” loss that is not specifically excluded. Thus, while
the exclusion for “[w]ear and tear” or “deterioration” might mean, and in this
case does mean by virtue of the Maspons’ concession that Homeowners Choice is
not obligated to compensate the Maspons for their corroded drain pipe, if the
Maspons suffered consequential loss as a result of the corroded pipe and that
consequential or “ensuing” loss is not excluded under another provision of the
policy, the loss is covered. See Liberty Mutual Fire Ins. Co. v.
Martinez, 157 So. 3d 486, 488 (Fla. 5th DCA 2015); Murray v. State Farm Fire
& Cas. Ins. Co., 219 Cal App. 3d 58, 64 (Cal. Ct. App. 1990).
the last paragraph of the “perils insured” provision of the insurance policy,
often referred to as the “ensuing loss” provision of the policy, cautions that
we not prematurely abort our inquiry. That clause provides the homeowner with
coverage for an “ensuing” loss that is not specifically excluded. Thus, while
the exclusion for “[w]ear and tear” or “deterioration” might mean, and in this
case does mean by virtue of the Maspons’ concession that Homeowners Choice is
not obligated to compensate the Maspons for their corroded drain pipe, if the
Maspons suffered consequential loss as a result of the corroded pipe and that
consequential or “ensuing” loss is not excluded under another provision of the
policy, the loss is covered. See Liberty Mutual Fire Ins. Co. v.
Martinez, 157 So. 3d 486, 488 (Fla. 5th DCA 2015); Murray v. State Farm Fire
& Cas. Ins. Co., 219 Cal App. 3d 58, 64 (Cal. Ct. App. 1990).
Happily
for us, we can quickly conclude the interpretive gymnastics in which we are
engaged at this point. At the time of the summary judgment proceeding, the slab
had not been opened. There was no evidence that the water exiting the pipe had
caused any damage to its surroundings. See Cheetham v. Southern Oak
Ins. Co., 114 So. 3d 257 (Fla. 3d DCA 2013) (reversing a judgment for
insurer where there was evidence of damage caused by water backing into the
residence up through a blocked pipe). Thus, the trial court erred by entering
judgment against Homeowners Choice for the cost of the repair and replacement
of the slab necessary to reach the broken pipe at this time. On the other hand,
it is not inconceivable that such evidence may surface in the future. For this
reason, we reverse and remand this case for entry of judgment in favor of
Homeowners Choice Insurance Company, but without prejudice to the Maspons’
filing another claim of loss at a later date, if appropriate.
for us, we can quickly conclude the interpretive gymnastics in which we are
engaged at this point. At the time of the summary judgment proceeding, the slab
had not been opened. There was no evidence that the water exiting the pipe had
caused any damage to its surroundings. See Cheetham v. Southern Oak
Ins. Co., 114 So. 3d 257 (Fla. 3d DCA 2013) (reversing a judgment for
insurer where there was evidence of damage caused by water backing into the
residence up through a blocked pipe). Thus, the trial court erred by entering
judgment against Homeowners Choice for the cost of the repair and replacement
of the slab necessary to reach the broken pipe at this time. On the other hand,
it is not inconceivable that such evidence may surface in the future. For this
reason, we reverse and remand this case for entry of judgment in favor of
Homeowners Choice Insurance Company, but without prejudice to the Maspons’
filing another claim of loss at a later date, if appropriate.
Reversed
and remanded with directions.
and remanded with directions.
__________________
1We
pause to note that unlike some policies, this insuring clause language does not
require the loss to be either “sudden” or “accidental.”
pause to note that unlike some policies, this insuring clause language does not
require the loss to be either “sudden” or “accidental.”
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