Breach of Contract: Florida Jury Awards Woman $28k For Denial Of Valid Insurance Claim

Dania Leal v Universal Property & Casualty Insurance Company

On July 11, 2024, the Florida jury returned the verdict in favor of the Plaintiff and awarded her $28,000 in a breach of contract lawsuit. The cause of action arose when the Defendant Insurance Company denied reimbursement of a covered loss under the valid insurance policy.

Case Background

On  April 26, 2022, Dania Leal filed the instant breach of contract lawsuit before the Florida State, Miami-Dade County, Eleventh Circuit Court. Judge Barbara Areces presided over this case. [Case number: 2022-007692-CA-01]

Cause

Dania Leal, residing in Miami-Dade County, Florida, and of legal age, brought forth a lawsuit against Universal Property Casualty Insurance Company, a Florida corporation authorized to operate in the state, conducting business in Miami-Dade County, Florida. During the relevant period, Universal Property Casualty Insurance Company issued an insurance policy to Dania Leal upon receipt of a premium payment.

Dania Leal purchased and paid for a homeowner’s insurance policy, Policy Number 1501-1806-0918 (the “Policy”), covering her property located at 16609 NW 71st Avenue, Miami Lakes, Florida 33014 (the “Property”). Under the terms of the Policy, Universal Property Casualty Insurance Company agreed to insure Dania Leal against property losses.

On or around May 9, 2020, while the Policy was in effect, the Property suffered a covered water loss (the “Loss”). Dania Leal reported the Loss to Universal Property Casualty Insurance Company, which assigned claim number FL21-0109600 to it. However, Universal Property Casualty Insurance Company later denied coverage for this covered loss.

Despite demands, Universal Property Casualty Insurance Company refused to acknowledge coverage or compensate Dania Leal for the full value of her damages, as required by the Policy and Florida law. As a result of Universal Property Casualty Insurance Company’s breach of the Policy, Dania Leal suffered damages.

Damages

Dania Leal prayed that the Court enter a judgment stating:

• that Plaintiff was entitled to insurance benefits for all losses sustained as a result of the covered insurance claim at issue herein;
• that Defendant’s actions constituted material breaches of the Policy and violations of Florida law;
• that Plaintiff was entitled to costs and attorneys’ fees under sections 627.428 and 57.041, Fla. Stat.; and
• that Plaintiff was entitled to such further relief as the Court deemed fair and just.

Dania Leal also demanded a trial by jury on all matters that were triable as a matter of right.

Key Arguments and Proceedings

Legal Representation

• Plaintiff(s): Dania Leal
  • Counsel for Plaintiff(s): Randy M Weber | Quintana Brittany L
  • Experts for Plaintiff(s): Michael Saxe, P.E. | Peter Vargas

• Defendant(s): Universal Property Casualty Insurance Company
  • Counsel for Defendant(s): Bathche Fils-Aime | Mengjun Qiu
  • Experts for Defendant(s): Kang Li, P.E.

Claims

The Plaintiff and Defendant had entered into a written contract, the Policy, wherein the Plaintiff agreed to pay a premium and the Defendant agreed to insure the Property. The Plaintiff fulfilled her obligation by paying all due and owed premiums as stipulated in the Policy. The Policy contractually obligated Defendant to fully cover Plaintiff for the damage suffered by the insured Property. The Policy covered the losses sustained by the insured Property. Consequently, Defendant had a duty to provide insurance coverage and to fully compensate Plaintiff to restore the insured Property and Plaintiff to their pre-loss state. However, Defendant failed to recognize coverage for the covered loss in question and did not fully compensate Plaintiff for the incurred Loss, thereby breaching the agreement.

Defense

Universal claimed that according to the Policy, the Plaintiff could not recover matching costs or replacement expenses for undamaged property. Under the Policy and relevant Florida laws, Universal’s responsibility for covered losses was limited strictly to actual damages. On April 12, 2021, an inspection revealed no visible damage to the shower wall tile or floor tile of the property in question. Since replacing undamaged property does not constitute a direct physical loss, the Plaintiff cannot seek compensation for alleged damages to undamaged property.

During the inspection, stains were observed on the ceilings of the living and dining room areas, apparently due to a lack of upkeep. Therefore, Universal argued that it was justified in denying part of the Plaintiff’s claim based on the property’s maintenance issues.

Additionally, Plaintiff did not promptly provide Universal with a pre-purchase home inspection, plumbing receipts, appraisal report, or invoices and photographs for emergency mitigation services. This delay significantly hindered Universal’s investigation into the claim. They claimed that since the Plaintiff did not adhere to all the stipulations outlined in the policy, she, therefore, could not recover any portion of the claim.

Furthermore, the Plaintiff’s delay in reporting the alleged loss unfairly prejudiced Universal’s ability to conduct an independent inspection of the purported damages. Consequently, Defendant asserted that Plaintiff should be precluded from seeking any form of compensation.

Expert Testimony

Jury Verdict

On July 11, 2024, the Florida jury returned the verdict in favor of the Plaintiff. The jury found that the Plaintiff had sustained a physical loss to her property.

The jury was also of the opinion that Defendant had not been able to prove that Plaintiff had failed to comply with the post-loss conditions of the Policy. Accordingly, the jury awarded $28,000 as fair and adequate compensation for the damage to her house.

Court Documents:

Complaint

Answer

Verdict