41
Fla. L. Weekly D2064aTop of Form
Fla. L. Weekly D2064aTop of Form
Insurance
— Homeowners — Rescission of policy — Material misrepresentations in
application — Loss history — Determination that insured’s misrepresentations
on application were material and affected insurer’s decision to issue or renew
policy was supported by sufficient evidence, including insured’s admissions
during examination under oath and unrebutted testimony of assistant vice
president in insurer’s underwriting department — Because policy specifically
disclaimed coverage if one or more insureds intentionally concealed or
misrepresented any material fact or circumstance, applicant’s material misrepresentations
were properly imputed to co-owner — No error in ruling that rescission of
homeowners policy was proper
— Homeowners — Rescission of policy — Material misrepresentations in
application — Loss history — Determination that insured’s misrepresentations
on application were material and affected insurer’s decision to issue or renew
policy was supported by sufficient evidence, including insured’s admissions
during examination under oath and unrebutted testimony of assistant vice
president in insurer’s underwriting department — Because policy specifically
disclaimed coverage if one or more insureds intentionally concealed or
misrepresented any material fact or circumstance, applicant’s material misrepresentations
were properly imputed to co-owner — No error in ruling that rescission of
homeowners policy was proper
HESHAM
MOUSTAFA and HALA AHMED, Appellants, v. OMEGA INSURANCE COMPANY, Appellee. 4th
District. Case No. 4D15-1834. September 7, 2016. Appeal from the Circuit Court
for the Seventeenth Judicial Circuit, Broward County; Michael L. Gates, Judge;
L.T. Case No. 12-015324CA 12. Counsel: Susan W. Fox and Heather M. Kolinsky of
Fox & Loquasto, P.A., Orlando, and Matthew L. Baldwin and Rene Delombard of
Trujillo Vargas Ortiz Gonzalez LLP, Coral Gables, for appellants. Christina L.
Flatau and Elaine D. Walter of Gaebe, Mullen, Antonelli & DiMatteo, Coral
Gables, for appellee.
MOUSTAFA and HALA AHMED, Appellants, v. OMEGA INSURANCE COMPANY, Appellee. 4th
District. Case No. 4D15-1834. September 7, 2016. Appeal from the Circuit Court
for the Seventeenth Judicial Circuit, Broward County; Michael L. Gates, Judge;
L.T. Case No. 12-015324CA 12. Counsel: Susan W. Fox and Heather M. Kolinsky of
Fox & Loquasto, P.A., Orlando, and Matthew L. Baldwin and Rene Delombard of
Trujillo Vargas Ortiz Gonzalez LLP, Coral Gables, for appellants. Christina L.
Flatau and Elaine D. Walter of Gaebe, Mullen, Antonelli & DiMatteo, Coral
Gables, for appellee.
(KLINGENSMITH,
J.) Hesham Moustafa and Hala Ahmed (collectively, “Homeowners”) appeal from a
final summary judgment in favor of Omega Insurance Company. The trial court
ruled that Omega’s rescission of Homeowners’ insurance policy was proper in
light of Moustafa’s material misrepresentations in the policy application. We
affirm.
J.) Hesham Moustafa and Hala Ahmed (collectively, “Homeowners”) appeal from a
final summary judgment in favor of Omega Insurance Company. The trial court
ruled that Omega’s rescission of Homeowners’ insurance policy was proper in
light of Moustafa’s material misrepresentations in the policy application. We
affirm.
Homeowners
purchased their home in 2003. Between 2003 and 2007, they made two insurance
claims on the home. The first was made in 2005 for damage to the roof caused by
Hurricane Wilma. The second was made in 2007 after a leaking shower pan caused
water damage. Repairs for both claims were covered by prior insurers.
purchased their home in 2003. Between 2003 and 2007, they made two insurance
claims on the home. The first was made in 2005 for damage to the roof caused by
Hurricane Wilma. The second was made in 2007 after a leaking shower pan caused
water damage. Repairs for both claims were covered by prior insurers.
In
October 2007, Moustafa submitted a preliminary application for a homeowner’s
policy with Omega, and later signed a formal application in December 2007.
Although Ahmed, Moustafa’s wife, did not sign either application, she was
listed as a co-applicant and a named insured on the policy.
October 2007, Moustafa submitted a preliminary application for a homeowner’s
policy with Omega, and later signed a formal application in December 2007.
Although Ahmed, Moustafa’s wife, did not sign either application, she was
listed as a co-applicant and a named insured on the policy.
Moustafa
did not disclose anything about the two prior claims of loss on the policy
applications. Specifically, in the “Loss History” section Moustafa checked “no”
to the question, “[h]ave you had any losses at this or any other location in
the last three years, whether paid by insurance or not?” He also checked “no”
to the question, “[h]ave you had previous water damage at the insured
location?” Additionally, Moustafa signed the portion of the formal application
indicating that, to the best of his knowledge and belief, there was not any
unrepaired damage to the property.1
did not disclose anything about the two prior claims of loss on the policy
applications. Specifically, in the “Loss History” section Moustafa checked “no”
to the question, “[h]ave you had any losses at this or any other location in
the last three years, whether paid by insurance or not?” He also checked “no”
to the question, “[h]ave you had previous water damage at the insured
location?” Additionally, Moustafa signed the portion of the formal application
indicating that, to the best of his knowledge and belief, there was not any
unrepaired damage to the property.1
At
the time Moustafa submitted his answers to the policy application questions,
Omega had no way to verify the veracity of those answers or ascertain the
existence of any prior claims; the most Omega could do was to request that
applicants provide truthful information.
the time Moustafa submitted his answers to the policy application questions,
Omega had no way to verify the veracity of those answers or ascertain the
existence of any prior claims; the most Omega could do was to request that
applicants provide truthful information.
In
reliance on Moustafa’s representations, Omega agreed to provide the requested
coverage. It then issued a policy containing the following provision:
reliance on Moustafa’s representations, Omega agreed to provide the requested
coverage. It then issued a policy containing the following provision:
2. Concealment or Fraud
a. Under Section I —
Property Coverages, with respect to all “insureds” covered under this policy, we
provide no coverage for loss under Section I — Property Coverages if,
whether before or after a loss, one or more “insureds” have:
Property Coverages, with respect to all “insureds” covered under this policy, we
provide no coverage for loss under Section I — Property Coverages if,
whether before or after a loss, one or more “insureds” have:
(1) Intentionally
concealed or misrepresented any material fact or circumstance;
concealed or misrepresented any material fact or circumstance;
(2) Engaged in fraudulent
conduct; or
conduct; or
(3) Made false statements;
relating to this insurance.
(Emphasis
added).
added).
In
April 2010, the home suffered additional water damage, which Omega paid to
repair according to the policy. During the course of processing this claim,
Omega’s adjuster was informed of the two previous claims made in 2003 and 2007,
but remained unaware that they were undisclosed on the policy application. The
following year, Omega’s general managing agency renewed the policy after again
failing to discover the misrepresentations on Moustafa’s applications during a
policy renewal review.
April 2010, the home suffered additional water damage, which Omega paid to
repair according to the policy. During the course of processing this claim,
Omega’s adjuster was informed of the two previous claims made in 2003 and 2007,
but remained unaware that they were undisclosed on the policy application. The
following year, Omega’s general managing agency renewed the policy after again
failing to discover the misrepresentations on Moustafa’s applications during a
policy renewal review.
One
week after a notice of renewal was sent to Homeowners in August 2011,
Homeowners discovered yet another water-related incident. During the course of
his inspection of the damage, Omega’s claim adjuster spoke with another
adjuster who had been assisting Homeowners with their claim. That adjuster told
Omega’s adjuster not to consider some of the damage found in the home because
it was caused by the 2005 incident.
week after a notice of renewal was sent to Homeowners in August 2011,
Homeowners discovered yet another water-related incident. During the course of
his inspection of the damage, Omega’s claim adjuster spoke with another
adjuster who had been assisting Homeowners with their claim. That adjuster told
Omega’s adjuster not to consider some of the damage found in the home because
it was caused by the 2005 incident.
One
month later, in September 2011, Omega’s Special Investigation Unit (“SIU”)
started looking into prior claims filed on the home, and sent Homeowners a
letter requesting additional information. In November 2011, Omega received
SIU’s report about the prior losses, which detailed Homeowners’ unreported
claims from 2005 and 2007. This prompted Omega to send Homeowners a letter
informing them of the ongoing investigation and reserving “each and every right
that it has under and pursuant to the policy of insurance in question.” Omega
then had its underwriting department investigate whether those claims were
disclosed on the policy applications.
month later, in September 2011, Omega’s Special Investigation Unit (“SIU”)
started looking into prior claims filed on the home, and sent Homeowners a
letter requesting additional information. In November 2011, Omega received
SIU’s report about the prior losses, which detailed Homeowners’ unreported
claims from 2005 and 2007. This prompted Omega to send Homeowners a letter
informing them of the ongoing investigation and reserving “each and every right
that it has under and pursuant to the policy of insurance in question.” Omega
then had its underwriting department investigate whether those claims were
disclosed on the policy applications.
As
part of its investigation, Omega asked Moustafa to submit to an examination
under oath (“EUO”). During the EUO, Moustafa admitted to inaccurately stating
on the application that there were not any losses regarding the home in the
prior three years, and that the home did not have any previous water damage. He
also admitted that there were water stains throughout the home that he had not
repaired, but simply painted over sometime between 2008 and 2011. Moustafa
acknowledged that he signed the application, including the statement of
condition and applicant’s statement,2 and conceded he understood that by
signing he approved what was stated therein.
part of its investigation, Omega asked Moustafa to submit to an examination
under oath (“EUO”). During the EUO, Moustafa admitted to inaccurately stating
on the application that there were not any losses regarding the home in the
prior three years, and that the home did not have any previous water damage. He
also admitted that there were water stains throughout the home that he had not
repaired, but simply painted over sometime between 2008 and 2011. Moustafa
acknowledged that he signed the application, including the statement of
condition and applicant’s statement,2 and conceded he understood that by
signing he approved what was stated therein.
Shortly
thereafter, Omega rescinded the policy due to Moustafa’s material
misrepresentations on his application about the prior claims, water damage, and
unrepaired damage, stating in a letter to Homeowners that it would not have
issued the policy if it “had known the true facts surrounding [Homeowners’]
application for insurance.” Homeowners then sued Omega for failing to provide
coverage and payment for their losses.
thereafter, Omega rescinded the policy due to Moustafa’s material
misrepresentations on his application about the prior claims, water damage, and
unrepaired damage, stating in a letter to Homeowners that it would not have
issued the policy if it “had known the true facts surrounding [Homeowners’]
application for insurance.” Homeowners then sued Omega for failing to provide
coverage and payment for their losses.
Omega
moved for summary judgment, asserting that it properly rescinded the policy due
to Moustafa’s material misrepresentations within the applications. While
Homeowners did not deny that the applications contained numerous
misrepresentations in their opposition to the motion for summary judgment, they
claimed that a number of issues precluded summary judgment, including: 1)
whether Omega could rescind the policy when Ahmed did not sign the application;
2) whether the alleged misrepresentations were material to Omega’s decision to
insure the home; and 3) whether Omega waived its right to rescind the policy.
During the course of the litigation both parties also filed the deposition
transcript of an assistant vice president in the underwriting department, who
testified that the rescission was based on the misrepresentations regarding the
loss claims, water damage, and unrepaired damage, as the policy would not have
been renewed had those misrepresentations been known.
moved for summary judgment, asserting that it properly rescinded the policy due
to Moustafa’s material misrepresentations within the applications. While
Homeowners did not deny that the applications contained numerous
misrepresentations in their opposition to the motion for summary judgment, they
claimed that a number of issues precluded summary judgment, including: 1)
whether Omega could rescind the policy when Ahmed did not sign the application;
2) whether the alleged misrepresentations were material to Omega’s decision to
insure the home; and 3) whether Omega waived its right to rescind the policy.
During the course of the litigation both parties also filed the deposition
transcript of an assistant vice president in the underwriting department, who
testified that the rescission was based on the misrepresentations regarding the
loss claims, water damage, and unrepaired damage, as the policy would not have
been renewed had those misrepresentations been known.
After
a hearing, the trial court entered final summary judgment in favor of Omega.
The court found that Omega properly rescinded the policy because: 1) the
misrepresentations were material as a matter of law (as they would not enable a
reasonable insurer to accurately estimate the nature of the risk); and 2) the
indisputable evidence showed that Omega would not have issued the policy if it
had known the truth about the prior claims. This appeal followed.
a hearing, the trial court entered final summary judgment in favor of Omega.
The court found that Omega properly rescinded the policy because: 1) the
misrepresentations were material as a matter of law (as they would not enable a
reasonable insurer to accurately estimate the nature of the risk); and 2) the
indisputable evidence showed that Omega would not have issued the policy if it
had known the truth about the prior claims. This appeal followed.
We
review “orders granting summary judgment de novo.” Wells Fargo Bank, N.A. v.
Palm Beach Mall, LLC, 177 So. 3d 37, 45 (Fla. 4th DCA 2015).
review “orders granting summary judgment de novo.” Wells Fargo Bank, N.A. v.
Palm Beach Mall, LLC, 177 So. 3d 37, 45 (Fla. 4th DCA 2015).
“When reviewing a ruling on
summary judgment, an appellate court must examine the record in the light most
favorable to the non-moving party.” [Corya v. Sanders, 76 So. 3d 31, 33
(Fla. 4th DCA 2011)]. “ ‘If the record reflects the existence of any genuine
issue of material fact, or the possibility of any issue, or if the record
raises even the slightest doubt that an issue might exist, summary judgment is
improper.’ ” Shaw v. Tampa Elec. Co., 949 So. 2d 1066, 1069 (Fla. 2d DCA
2007) (quoting Snyder v. Cheezem Dev. Corp., 373 So. 2d 719, 720 (Fla.
2d DCA 1979)).
summary judgment, an appellate court must examine the record in the light most
favorable to the non-moving party.” [Corya v. Sanders, 76 So. 3d 31, 33
(Fla. 4th DCA 2011)]. “ ‘If the record reflects the existence of any genuine
issue of material fact, or the possibility of any issue, or if the record
raises even the slightest doubt that an issue might exist, summary judgment is
improper.’ ” Shaw v. Tampa Elec. Co., 949 So. 2d 1066, 1069 (Fla. 2d DCA
2007) (quoting Snyder v. Cheezem Dev. Corp., 373 So. 2d 719, 720 (Fla.
2d DCA 1979)).
Dennis
v. Kline, 120 So. 3d 11, 20 (Fla. 4th DCA 2013).
v. Kline, 120 So. 3d 11, 20 (Fla. 4th DCA 2013).
Additionally,
the construction given to the terms of an insurance policy is also subject to
de novo review. Kattoum v. N.H. Indem. Co., 968 So. 2d 602, 604 (Fla. 2d
DCA 2007) (“The interpretation of an insurance contract is a question of law;
accordingly we review de novo the trial court’s rulings.”).
the construction given to the terms of an insurance policy is also subject to
de novo review. Kattoum v. N.H. Indem. Co., 968 So. 2d 602, 604 (Fla. 2d
DCA 2007) (“The interpretation of an insurance contract is a question of law;
accordingly we review de novo the trial court’s rulings.”).
“Florida
law . . . gives an insurer the unilateral right to rescind its insurance policy
on the basis of misrepresentation in the application of insurance.” Gonzalez
v. Eagle Ins. Co., 948 So. 2d 1, 2 (Fla. 3d DCA 2006). Indeed, section
627.409, Florida Statutes, provides in pertinent part:
law . . . gives an insurer the unilateral right to rescind its insurance policy
on the basis of misrepresentation in the application of insurance.” Gonzalez
v. Eagle Ins. Co., 948 So. 2d 1, 2 (Fla. 3d DCA 2006). Indeed, section
627.409, Florida Statutes, provides in pertinent part:
(1) Any statement or
description made by or on behalf of an insured or annuitant in an application
for an insurance policy or annuity contract, or in negotiations for a policy or
contract, is a representation and is not a warranty. A misrepresentation,
omission, concealment of fact, or incorrect statement may prevent recovery
under the contract or policy only if any of the following apply:
description made by or on behalf of an insured or annuitant in an application
for an insurance policy or annuity contract, or in negotiations for a policy or
contract, is a representation and is not a warranty. A misrepresentation,
omission, concealment of fact, or incorrect statement may prevent recovery
under the contract or policy only if any of the following apply:
(a) The misrepresentation,
omission, concealment, or statement is fraudulent or is material either to the
acceptance of the risk or to the hazard assumed by the insurer.
omission, concealment, or statement is fraudulent or is material either to the
acceptance of the risk or to the hazard assumed by the insurer.
(b) If the true facts had
been known to the insurer pursuant to a policy requirement or other
requirement, the insurer in good faith would not have issued the policy or
contract, would not have issued it at the same premium rate, would not have
issued a policy or contract in as large an amount, or would not have provided
coverage with respect to the hazard resulting in the loss.
been known to the insurer pursuant to a policy requirement or other
requirement, the insurer in good faith would not have issued the policy or
contract, would not have issued it at the same premium rate, would not have
issued a policy or contract in as large an amount, or would not have provided
coverage with respect to the hazard resulting in the loss.
§
627.409(1), Fla. Stat. (2007) (emphasis added); see also United Auto. Ins.
Co. v. Salgado, 22 So. 3d 594, 599 (Fla. 3d DCA 2009) (“[W]here a
misstatement or omission materially affects the insurer’s risk, or would have
changed the insurer’s decision whether to issue the policy and its terms,
[section 627.409] may preclude recovery.”).
627.409(1), Fla. Stat. (2007) (emphasis added); see also United Auto. Ins.
Co. v. Salgado, 22 So. 3d 594, 599 (Fla. 3d DCA 2009) (“[W]here a
misstatement or omission materially affects the insurer’s risk, or would have
changed the insurer’s decision whether to issue the policy and its terms,
[section 627.409] may preclude recovery.”).
We
have stated that “[a] misrepresentation is material if it does not enable a
reasonable insurer to adequately estimate the nature of the risk in determining
whether to assume the risk.” Singer v. Nationwide Mut. Fire Ins. Co.,
512 So. 2d 1125, 1128-29 (Fla. 4th DCA 1987). Regarding the difference between
the grounds for rescission based on misrepresentations that are material as a
matter of law, and misrepresentations that lead an insurer to issue a policy
that it otherwise would not have issued if it had known the true facts, we have
explained:
have stated that “[a] misrepresentation is material if it does not enable a
reasonable insurer to adequately estimate the nature of the risk in determining
whether to assume the risk.” Singer v. Nationwide Mut. Fire Ins. Co.,
512 So. 2d 1125, 1128-29 (Fla. 4th DCA 1987). Regarding the difference between
the grounds for rescission based on misrepresentations that are material as a
matter of law, and misrepresentations that lead an insurer to issue a policy
that it otherwise would not have issued if it had known the true facts, we have
explained:
While several of the
decisions finding that a misrepresentation was material as a matter of law also
address the issue of whether the insurer would have actually issued the policy
under the same terms and same premium had it known the true facts, the
consideration of that issue [is] not required in making a determination that a
misrepresentation was material to the risk or the hazard assumed by the
insurer.
decisions finding that a misrepresentation was material as a matter of law also
address the issue of whether the insurer would have actually issued the policy
under the same terms and same premium had it known the true facts, the
consideration of that issue [is] not required in making a determination that a
misrepresentation was material to the risk or the hazard assumed by the
insurer.
Id.
at
1128; see also Salgado, 22 So. 3d at 604 (holding that “the ‘law is well
settled that if the misrepresentation of the insured were material to the
acceptance of the risk by the insurer or, if the insurer in good faith would
not have issued the policy under the same terms and premium, then rescission of
the policy by the insurer is proper’ ” (emphasis added) (quoting N.Y. Life
Ins. Co. v. Nespereira, 366 So. 2d 859, 861 (Fla. 3d DCA 1979))).
at
1128; see also Salgado, 22 So. 3d at 604 (holding that “the ‘law is well
settled that if the misrepresentation of the insured were material to the
acceptance of the risk by the insurer or, if the insurer in good faith would
not have issued the policy under the same terms and premium, then rescission of
the policy by the insurer is proper’ ” (emphasis added) (quoting N.Y. Life
Ins. Co. v. Nespereira, 366 So. 2d 859, 861 (Fla. 3d DCA 1979))).
The
determination of materiality under section 627.409(1)(a) is generally a
question of law based on “an objective view of what is material.” Singer,
512 So. 2d at 1129 (discussing an earlier version of section 627.409, but
concluding that materiality in this context should be based on an objective
standard); see also de Guerrero v. John Hancock Mut. Life Ins. Co., 522
So. 2d 1032, 1033 (Fla. 3d DCA 1988) (“Where the evidence is clear and
uncontradicted the materiality of the misrepresentation shall be decided as a
question of law.”).
determination of materiality under section 627.409(1)(a) is generally a
question of law based on “an objective view of what is material.” Singer,
512 So. 2d at 1129 (discussing an earlier version of section 627.409, but
concluding that materiality in this context should be based on an objective
standard); see also de Guerrero v. John Hancock Mut. Life Ins. Co., 522
So. 2d 1032, 1033 (Fla. 3d DCA 1988) (“Where the evidence is clear and
uncontradicted the materiality of the misrepresentation shall be decided as a
question of law.”).
In
contrast, the determination to be made under section 627.409(1)(b) regarding
how an insurer would have acted had it known the true facts is “one of fact
requiring testimony by the insurer’s representatives” that implicates “the
subjective view of what a particular insurer would or would not have deemed
material if it had known the true facts.” Singer, 512 So. 2d at 1129
(discussing the earlier version of section 627.409 but concluding that this
determination is subjective in nature and thus requires witness testimony).
contrast, the determination to be made under section 627.409(1)(b) regarding
how an insurer would have acted had it known the true facts is “one of fact
requiring testimony by the insurer’s representatives” that implicates “the
subjective view of what a particular insurer would or would not have deemed
material if it had known the true facts.” Singer, 512 So. 2d at 1129
(discussing the earlier version of section 627.409 but concluding that this
determination is subjective in nature and thus requires witness testimony).
Florida
courts have granted summary judgment in favor of insurers where an insured’s
misrepresentation on an insurance application was “of that character which the
court can say would reasonably have affected the insurer’s judgment as to the
nature of the risk and amount of premium.” Id. at 1128 (citation
omitted); see also Salgado, 22 So. 3d at 596-97, 604 (holding that
insured’s failure to list his brother as a member of the household was a
material misrepresentation that “provided [the insurance company] with grounds
to rescind the policy”); Kieser v. Old Line Life Ins. Co. of Am., 712
So. 2d 1261, 1262-64 (Fla. 1st DCA 1998) (affirming summary judgment because
misrepresentations on a life insurance application about recent hospital stays
and medical treatment were material); de Guerrero, 522 So. 2d at 1032-33
(affirming summary judgment and agreeing with the trial court that
misrepresentations about medical history on an application for life insurance
indisputably “affected the insurer’s willingness to accept the risk or issue
the policy on the same terms”).
courts have granted summary judgment in favor of insurers where an insured’s
misrepresentation on an insurance application was “of that character which the
court can say would reasonably have affected the insurer’s judgment as to the
nature of the risk and amount of premium.” Id. at 1128 (citation
omitted); see also Salgado, 22 So. 3d at 596-97, 604 (holding that
insured’s failure to list his brother as a member of the household was a
material misrepresentation that “provided [the insurance company] with grounds
to rescind the policy”); Kieser v. Old Line Life Ins. Co. of Am., 712
So. 2d 1261, 1262-64 (Fla. 1st DCA 1998) (affirming summary judgment because
misrepresentations on a life insurance application about recent hospital stays
and medical treatment were material); de Guerrero, 522 So. 2d at 1032-33
(affirming summary judgment and agreeing with the trial court that
misrepresentations about medical history on an application for life insurance
indisputably “affected the insurer’s willingness to accept the risk or issue
the policy on the same terms”).
Moustafa
admitted during his EUO that: 1) he inaccurately stated on the applications
that there were not any losses at the home in the prior three years, and that
the home did not have any previous water damage; 2) there were water stains
throughout the home that he had not repaired, but simply painted over sometime
between 2008 and 2011; and 3) he understood that by signing the application,
including the statement of condition and applicant’s statement, he approved
what was stated therein. These admissions, as well as the unrebutted testimony
of an assistant vice president in the underwriting department, were sufficient
to prove that Moustafa’s misrepresentations were material and affected Omega’s
decision to issue or renew the policy. See Kieser, 712 So. 2d at 1262-64
(holding that misrepresentations were material based in part on the affidavit
of an insurance company’s senior vice president of underwriting).
admitted during his EUO that: 1) he inaccurately stated on the applications
that there were not any losses at the home in the prior three years, and that
the home did not have any previous water damage; 2) there were water stains
throughout the home that he had not repaired, but simply painted over sometime
between 2008 and 2011; and 3) he understood that by signing the application,
including the statement of condition and applicant’s statement, he approved
what was stated therein. These admissions, as well as the unrebutted testimony
of an assistant vice president in the underwriting department, were sufficient
to prove that Moustafa’s misrepresentations were material and affected Omega’s
decision to issue or renew the policy. See Kieser, 712 So. 2d at 1262-64
(holding that misrepresentations were material based in part on the affidavit
of an insurance company’s senior vice president of underwriting).
The
evidence also showed that it was only after the conclusion of its investigation
(which included the EUO verifying that Moustafa made the misrepresentations on
the application) that Omega formally rescinded the policy. This was entirely
appropriate, as “an insurance company has the right to rely on an applicant’s
representations in an application for insurance and is under no duty to further
investigate.” Salgado, 22 So. 3d at 601 (citation omitted); Indep.
Fire Ins. Co. v. Arvidson, 604 So. 2d 854, 856 (Fla. 4th DCA 1992) (“An
insurer is entitled, as a matter of law, to rely upon the accuracy of the
information contained in the application and has no duty to make additional
inquiry.”).
evidence also showed that it was only after the conclusion of its investigation
(which included the EUO verifying that Moustafa made the misrepresentations on
the application) that Omega formally rescinded the policy. This was entirely
appropriate, as “an insurance company has the right to rely on an applicant’s
representations in an application for insurance and is under no duty to further
investigate.” Salgado, 22 So. 3d at 601 (citation omitted); Indep.
Fire Ins. Co. v. Arvidson, 604 So. 2d 854, 856 (Fla. 4th DCA 1992) (“An
insurer is entitled, as a matter of law, to rely upon the accuracy of the
information contained in the application and has no duty to make additional
inquiry.”).
Here,
the trial court correctly held that Moustafa’s misrepresentations were material
as a matter of law because the “clear and uncontradicted” evidence, de
Guerrero, 522 So. 2d at 1033, established that those misrepresentations
objectively prevented Omega from “adequately estimat[ing] the nature of the
risk in determining whether to assume the risk.” Singer, 512 So. 2d at
1128-29. Furthermore, the evidence supported the trial court’s conclusion that
Omega would not have issued the policy if it had known about the unrepaired
damage.
the trial court correctly held that Moustafa’s misrepresentations were material
as a matter of law because the “clear and uncontradicted” evidence, de
Guerrero, 522 So. 2d at 1033, established that those misrepresentations
objectively prevented Omega from “adequately estimat[ing] the nature of the
risk in determining whether to assume the risk.” Singer, 512 So. 2d at
1128-29. Furthermore, the evidence supported the trial court’s conclusion that
Omega would not have issued the policy if it had known about the unrepaired
damage.
The
Homeowners also assert that Omega could not rescind the policy’s coverage as it
applied to Ahmed because her failure to sign the application means that she
personally did not make any material misrepresentations. We find this argument
to be meritless.
Homeowners also assert that Omega could not rescind the policy’s coverage as it
applied to Ahmed because her failure to sign the application means that she
personally did not make any material misrepresentations. We find this argument
to be meritless.
The
definitions section of Omega’s policy defines the “insured” as not only the
named insured shown in the declarations section (i.e., Moustafa), but also the
insured’s spouse if he or she resides in the same household. Here, it was not
disputed that Ahmed lived with Moustafa in the home. Additionally, the Omega
policy specifically disclaimed coverage if one or more insureds either:
1) intentionally concealed or misrepresented any material fact or circumstance;
2) engaged in fraudulent conduct; or 3) made false statements relating to the
insurance. Thus, since Moustafa admitted that he misrepresented the history of
the damage to the home in the policy application, his material
misrepresentations were properly imputed to Ahmed, thereby entitling Omega to
rescind her coverage as well.
definitions section of Omega’s policy defines the “insured” as not only the
named insured shown in the declarations section (i.e., Moustafa), but also the
insured’s spouse if he or she resides in the same household. Here, it was not
disputed that Ahmed lived with Moustafa in the home. Additionally, the Omega
policy specifically disclaimed coverage if one or more insureds either:
1) intentionally concealed or misrepresented any material fact or circumstance;
2) engaged in fraudulent conduct; or 3) made false statements relating to the
insurance. Thus, since Moustafa admitted that he misrepresented the history of
the damage to the home in the policy application, his material
misrepresentations were properly imputed to Ahmed, thereby entitling Omega to
rescind her coverage as well.
In
sum, there was no genuine issue of material fact regarding whether Moustafa
concealed or misrepresented the prior damage to the home. His
misrepresentations were material as a matter of law, and would have affected
Omega’s decision to insure the home. Accordingly, we affirm the final summary
judgment rendered in this case.
sum, there was no genuine issue of material fact regarding whether Moustafa
concealed or misrepresented the prior damage to the home. His
misrepresentations were material as a matter of law, and would have affected
Omega’s decision to insure the home. Accordingly, we affirm the final summary
judgment rendered in this case.
Affirmed.
(GROSS
and FORST, JJ., concur.)
(GROSS
and FORST, JJ., concur.)
__________________
1This
court has held that “summary judgment is rarely proper in ‘knowledge and
belief’ cases because the issue usually ‘turns on the axis of the circumstances
surrounding the complete transaction, including circumstantial evidence of
intent and knowledge.’ ” Casamassina v. U.S. Life Ins. Co., 958 So. 2d
1093, 1100-01 (Fla. 4th DCA 2007) (quoting Cohen v. Kravit Estate Buyers,
Inc., 843 So. 2d 989, 991 (Fla. 4th DCA 2003)). However, Homeowners did not
preserve this issue for appellate review, and summary judgment was granted on
other grounds in addition to Moustafa’s misrepresentation about the damage to
the home.
court has held that “summary judgment is rarely proper in ‘knowledge and
belief’ cases because the issue usually ‘turns on the axis of the circumstances
surrounding the complete transaction, including circumstantial evidence of
intent and knowledge.’ ” Casamassina v. U.S. Life Ins. Co., 958 So. 2d
1093, 1100-01 (Fla. 4th DCA 2007) (quoting Cohen v. Kravit Estate Buyers,
Inc., 843 So. 2d 989, 991 (Fla. 4th DCA 2003)). However, Homeowners did not
preserve this issue for appellate review, and summary judgment was granted on
other grounds in addition to Moustafa’s misrepresentation about the damage to
the home.
2These
statements were included as part of the application, and included additional
representations regarding the history of the home to assist Omega in making its
various underwriting decisions, including policy coverage and premium cost.
statements were included as part of the application, and included additional
representations regarding the history of the home to assist Omega in making its
various underwriting decisions, including policy coverage and premium cost.
* *
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