Roy Jossfolk owned a home which was insured by United Property & Casualty Insurance Company (“United”).   Hurricane Wilma caused damage to the insured’s property in 2005 and a subsequent claim for damages was asserted against United.  United determined that there was no wind related damages, but paid for other damages.  Jossfolk did not agree with the amount of damages and subsequently demanded an appraisal of the loss.  The umpire increased the amount of damages and determined that two squares of roof tile were damaged as a result of Hurricane Wilma.  The award specifically stated that “Ordinance and Law” was “not appraised”.  When Jossfolk’s contractor applied to the City of Weston for a roofing repair permit to repair all damage to the roof (including the 2% wind damage), the City denied the permit because the repair was greater than 25% of the total roof.  The rejection of the permit triggered ordinance and law coverage.  Jossfolk requested that United pay for the entire roof repair under Ordinance and Law coverage.  United argued that the appraisers and umpire appraised the entire loss (including Ordinance and Law), therefore, the claim was closed.  The circuit court agreed with United and granted their motion for summary judgment, entered an order in favor of United and granted United’s entitlement to attorney fees based on a proposal for settlement.

Jossfolk, through his attorneys James Ligman and Michael Seward, appealed the judgment to the Fourth District Court of Appeal.  The Appellate Court reversed the lower court’s ruling and found that Ordinance and Law coverage was “not appraised”.  The Court relied on Ceballo v. Citizens Prop. Ins. Corp.. 967 So. 2d 811 (Fla. 2007) and reasoned that Ordinance and Law coverage is not recoverable until it is incurred.  The appraisal panel could not have appraised Ordinance and Law because Jossfolk had not applied for roof repairs, prior to the claim being submitted to appraisal.

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Universal Property and Casualty Insurance Co. gets slammed by the State of Florida

On May 30, 2013 the Office of Insurance Regulation for the State of Florida issued an Order as to improper marked conduct examination of Universal Property and Casualty Insurance Company:

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Unconstitutional ban of fees for Public Adjusters lifted.

This week, the governor signed SB 1770 which repeals the unconstitutional ban of fees for public adjusters.  Beginning July 1, 2013 the fee ban and fee cap pertaining to Citizens Property Insurance claims will be lifted. Public adjusters will once again be able to adjust Citizens claims at all stages of the investigation process.  The fee cap will remain at 20% for insurance claims (all insurance claims declared a state of emergency will still be capped at 10% for the first year).    

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The Florida House and Senate have approved legislation which will repeal the public adjuster fee ban as it relates to initial Citizens insurance claims.  The legislation must be signed by the Governor before it becomes law.  It appears that when signed, the legislation will take effect June 1, 2013.  Finally, some good news out of Tallahassee.

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Floor Tile Damage – Do I Have Coverage?

Question:  I have a bronze statue in my home that fell when I was moving and cracked several floor tiles.  I cannot match the tile and must replace all of the floor tile throughout my house.  This will cost thousands of dollars.  Is this covered under my insurance policy?

Answer:  Prior to April 24, 2013, I would have advised you that you most likely had coverage.  However, Florida’s Fourth District Court of Appeal has recently determined that damage to floor tile caused by dropped objects is considered “marring” and is not covered under your insurance policy.  This decision directly affects homes in Broward, Palm Beach, St. Lucie, Indian River, Martin and Okeechobee counties, but may cause problems in all Florida counties.  In the case of Benjamin Ergas and Beth Ergas v. Universal Property and Casualty Insurance Company, the Appellate Court stated that the dropping of a hammer, which caused damage to floor tile, constituted marring and was not covered under the “all risk” insurance policy. 

The question arises as to what amount of damage constitutes marring.  Is the 4th DCA’s opinion limited to small insignificant blemishes to tiles or does it eliminate coverage for any and all damage to tile floors?  In a footnote, the Court suggested that the meaning of marring may be ambiguous when used in an “all risk” policy, thereby leaving the door open to tile claims that consist of more extensive damage. 

Is the damage to your floor covered?  No one can answer that question with absolute certainty.  If you do have damage to your floor, contact one of our attorneys to review your insurance policy and discuss your options.  

Is the damage to your floor covered?  No one can answer that question with absolute certainty.  If you do have damage to your floor, contact one of our attorneys to review your insurance policy and discuss your options.  

Posted in Floor Tile Claims | 1 Response

Citizens Property Insurance Withdraws Motion to Add $15,000 Cap for Water Losses

We are pleased to report that the recent proposal to cap non weather related water damage claims for Citizens Insurance Company policyholders has been dropped, thanks in part to FAPIA’s efforts to call attention to the matter through our membership as well as targeted media relations.

After hearing public testimony during the Citizens Board of Governors meeting on Friday, July 27th, the motion to reduce coverage for policyholders who suffer from water losses to a $15K special limit of liability was withdrawn. The decision came one day after Florida’s Insurance Consumer Advocate Robin Westcott spoke out, during a meeting of the Citizens Consumer Services Committee, against the cap in water loss coverage, increasing rates and the mitigation inspection process. The vote also followed publication of letters to the editor in the Palm Beach Post and Tallahassee Democrat from policyholders secured and interviewed by our public relations firm, Moore Communications Group.

FAPIA first became aware of the proposal to limit all non-weather related water loss claims to a special limit of liability because of our participation in a claims committee meeting on July 13th. We immediately reported this to the public adjusting community with an email call to action.

FAPIA leadership has worked ever since to make consumer groups and the media aware of the proposal to reduce coverage, reaching out to lawmakers and other leaders and collecting policyholder accounts of water damage claims provided by public adjusters statewide. We secured testimonials from teachers, attorneys and even a former Supreme Court Justice who was represented by a public adjuster for his water damage claim. We have also collected water loss damage photographs — dozens of which were delivered to Citizens’ new President, Barry Gilway, at the beginning of the July 27 meeting. The assistance of each PA that reached out to us was invaluable in our efforts. Some of those policyholder stories and photos can be found at, where we welcome and urge you to share your success stories and those of your policyholder clients.

There were a number of policyholder advocates present for the Citizens meeting as well as FAPIA members, supporting attorneys and consumer groups. At the request of members of the public, Citizens Chairman of the Board Carlos Lacasa, opened the meeting up for the public to voice their concerns.

The following statement was made by FAPIA Managing Director, Nancy Dominguez on behalf of the Florida Association of Public Insurance Adjusters:

“In establishing Citizens Property Insurance, the Legislature set out to create an affordable and comprehensive insurance option for property owners that have otherwise been locked out of the private insurance market. Florida Statute 627.351 regarding CPI states that “Florida has a compelling interest to ensure Florida property owners have access to insurance at affordable rates that facilitate the remediation, reconstruction and replacement of damaged property.” 

“This cap effectively violates that law because it is too low to facilitate the necessary reconstruction and replacement in some of the most typical types of plumbing losses.’ “Moreover, in his consumer guide to properly insuring a home, Chief Financial Officer Jeff Atwater states that in order to be adequately covered, “your home must be insured for the amount it will take to rebuild the home at current prices for building materials and labor costs, including the amount necessary to bring it into compliance with current building codes.” “Having given much discussion and debate to the insurance crisis in Florida and the need to shrink CPI’s liability, we understand the need for changes and policies that will protect the state’s costs and losses in the event of a major damaging event.’ “But to do so at the expense of hardworking Floridians insured by Citizens is not the answer. Policyholders who face significant water damage will be unable to recover if they are limited to recovering only $15,000. CPI owes it to its more than 1.5 million policyholders, who have already been rejected by private insurers, to maintain coverage that protects them in the event of a catastrophic water loss. As policyholder advocates, we urge you and Citizens leadership to reject this proposed cap. We realize solutions must be found that are fair and equitable to Florida’s taxpayers as well as Citizens policyholders. This is not the solution. Thank you.”

After hearing from at least five members of the public including FAPIA members Hector Chinea and Raul Rivero, the original motion to pass the special limit of liability was withdrawn and was not further considered. This cap could be proposed again in the future, so FAPIA will be monitoring the proposals considered by the Citizens Board at all public meetings and will keep FAPIA membership informed.

I’d like to take this opportunity to thank you for all of your letters and phone calls of support. The policyholders in Florida have won a major victory in the state’s ongoing efforts to water down insurance coverage.

Sincerely, Harvey Wolfman, President Florida Association of Public Insurance Adjusters

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Victory for Insureds!

The Appellate court rejects State Farm’s attempt to block insureds from pursuing a late reported Hurricane Wilma Claim.

Click here to read the complete decision.



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Florida Supreme Ct Ruling: 48 Hour Ban is Unconstitutional

Florida Supreme Court Ruling Declared a ‘Major Win’ for Consumers

TALLAHASSEE- The Florida Association of Public Insurance Adjusters (FAPIA) today applauded the Florida Supreme Court ruling that declared unconstitutional the state law banning public insurance adjusters from soliciting policyholders 48 hours after a damaging event – calling it a victory for consumers throughout Florida.

“FAPIA has always been committed to working with the Legislature, the Cabinet and state insurance officials to promote policies and legislation that protect consumers,” said FAPIA President Harvey Wolfman. “On behalf of FAPIA and the policyholders we serve, I am grateful that the Supreme Court ruled in our favor, agreeing with our position that the ban on solicitation is a violation of public adjusters’ free speech rights – and more importantly, an unfair rule that put policyholders at a disadvantage. This is a victory for consumers in Florida.”

Today’s ruling marks the end of a lengthy court battle, which began in 2008 when the Legislature approved the ban which was to be implemented and enforced by the Florida Department of Financial Services. The state law bars public adjusters from initiating contact directly or indirectly with policyholders during the first 48 hours after an event such as a hurricane, tornado or sinkhole that triggers a claim.

An Oviedo-based public adjuster sued the state Department of Financial Services, maintaining that the first 48 hours after a damaging event are the most critical for a policyholder because it is the window when damage photos, paperwork and other important actions must be taken to protect evidence and make sure that the policy holder complies with all policy conditions.

Public adjusters handle the preparation, presentation and adjustment of a policyholder’s claim – and are the only insurance professional that prepares comprehensive building damage estimates and personal property inventories on behalf of policyholders. Immediately after a damaging event, the Public Adjuster provides immediate claims handling assistance to the insured, helping the policyholder fulfill all obligations placed upon them by the insurance policy conditions.

“FAPIA and its nearly 400 member public adjusters are committed to helping policyholders receive full and fair compensation following damage to their property,” said Wolfman. “Thanks to this ruling, we can help more policyholders in those critical first hours when they need it most.”

We would like to take this opportunity to thank everyone who made this victory for insured Floridians possible.  FAPIA member Fred Kortum, Mark Boardman, all of the attorneys who represented this case, particularly  Wilbur Brewton who successfully argued the case in front of the Supreme Court.  We would also like to thank all of those FAPIA members who went above and beyond when asked, to help fund this lawsuit.  Without all of you, this victory would not have been possible.

IMPORTANT NOTICE TO PUBLIC ADJUSTERS – The state has 15 days from the date of this ruling to request a re-hearing from the Supreme Court.  During that time, the solicitation ban is STILL IN EFFECT.  We will keep you informed as soon as the stay is lifted.  Until that time, please remember to continue to observe the 48 hour solicitation ban.

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