ALAN S. GOLD, District Judge.
THIS CAUSE is before the Court upon Defendant QBE Insurance Corporation's ("QBE") Motion for Summary Judgment
Upon review of the record, including QBE's Statement of Material Facts, the Plaintiffs Response, and the evidentiary materials offered by both sides, the following
Plaintiff was insured by Defendant QBE through a commercial property insurance policy, number QF2950-06 (the "Policy"), for a total of $31,861,000.00. (Pl. Statement, ¶ 1). The Policy was issued to Plaintiff for the twelve month period commencing February 2, 2005. [See DE 18, Ex. A]. The Policy contained the following provisions setting forth the insured's duties in the event of loss or damage:
[DE 18, Ex. A]. The Policy also contained the following provision governing the insured's right to bring legal action against the insurer:
(Id.)
Plaintiff alleges that Hurricane Wilma struck El Dorado on October 24, 2005. [See DE 18]. At some point shortly after the Hurricane, Plaintiff provided QBE with an initial notice of the loss. (Pl. Statement, ¶ 6). Thereafter, on November 21, 2005, QBE's insurance adjuster, Sanford Siegel ("Mr. Seigel"), in conjunction with the public adjuster retained by Plaintiff, Joseph Zevuloni ("Mr. Zevuloni"), inspected the loss location. (Id., ¶ 7). At that time, QBE's adjuster requested copies of records from Plaintiff's public adjuster, including preliminary damage surveys, invoices/estimates relating to the alleged damages, and any reports from Plaintiff's engineers and contractors.
In a letter dated May 25, 2006, after reviewing the records produced by Plaintiff, QBE requested an examination under oath of a designated corporate representative with the most knowledge of the damages sustained from Hurricane Wilma, the necessary repairs, and the insurance claim. (Def. Statement, ¶ 34). QBE also requested examinations under oath of six additional witnesses, including Plaintiff's property manager and current and former members of Plaintiff's Board of Directors ("Board Members"). (Id.). On August 9, 2006, QBE conducted examinations of Plaintiff's corporate representative and property manager. (Id., ¶ 35). Both of these individuals produced by Plaintiff deferred to Plaintiff's public adjuster on a number of issues. (Id., ¶ 36). For example, when asked about the estimates for the Hurricane repairs, Plaintiffs corporate representative deferred to the public adjuster stating "as far as that was concerned he took care of that." (Id.). Plaintiff's Property Manager also claimed to have no involvement in determining the extent of the Hurricane Wilma damages or obtaining bids or estimates. (Id.)
On August 13 and 31, 2006, QBE reiterated its request for the remaining examinations under oath, but Plaintiffs attorney advised that he would not produce any other individuals for examination. (Id. ¶ 37). On September 11, 2006, QBE again requested the additional examinations under oath; requested the examination of Plaintiffs public adjuster; and provided proposed dates for the examination of Plaintiffs public adjuster. (Id.). Plaintiff responded on October 3, 2006 by denying
QBE informed Plaintiff on October 30, 2006, that its failure to produce the records and the additional examinations under oath had impeded and delayed QBE's investigation, reiterated its offer of a confidentiality agreement for any unit member files, and attached a proposed confidentiality agreement. (Id., ¶ 38). With regard to the withheld documents referred to by Plaintiff's attorney as "solely limited to board meeting and minutes," QBE requested a list of the documents withheld and further requested that Plaintiff provide copies of the documents with allegedly privileged material redacted. (Id., ¶ 14). On December 14, 2006, QBE explained the purposes behind the policy conditions, again requested access to the unit owner files and withheld documentation, and informed Plaintiff that this was its final opportunity to comply and cooperate. (Id., ¶ 15). In the December 14, 2006 letter QBE also cited the Sworn Statement in Proof of Loss ("sworn proof of loss") provision of the Policy and provided a copy of the sworn proof of loss form. (Id., ¶ 49).
QBE received no communication for the next six months. (Id., ¶ 16). Then, on June 26, 2006, QBE received a letter of representation from Plaintiffs second attorney, Hugh Lumpkin ("Mr. Lumpkin"). (Id.). On July 17, 2007, QBE reiterated its request for the examinations under oath; stated that it was prejudiced by Plaintiffs failure to provide a sworn proof of loss; and provided another copy of the sworn proof of loss form. (Id., ¶ 40). On July 20, 2007, Mr. Lumpkin advised that he was searching for someone with similar knowledge to Plaintiffs public adjuster to produce for an examination under oath because Mr. Zevuloni was no longer the public adjuster for Plaintiff. (Id.; Pl. Statement ¶ 40). Moreover, in the same correspondence, Mr. Lumpkin advised that he was reviewing the unit owner files and meeting minutes for the possible production of additional documentation. (Id., ¶ 18). The letter also reminded QBE that it had already copied over eleven thousand pages of documents belonging to Plaintiff, and that QBE failed to produce QBE's estimate of damage, engineering reports,
No further communication was received for several months, and QBE sent a followup letter on January 7, 2008. (Id., ¶ 19). That same day, QBE received notice that Plaintiff was represented by its third attorney. (Id., ¶ 220). QBE then received a letter of representation from Merlin Law Group on February 26, 2008, claiming that Plaintiff had complied with all policy conditions and demanding appraisal. (Id.). QBE also received a sworn proof of loss on February 26, 2008, alleging damages from Hurricane Wilma totaling $21,381,343.02, but the sworn proof of loss was not on the form provided by QBE. (Id., ¶ 54).
On March 20, 2008, QBE informed Plaintiff that its sworn proof of loss was untimely as it was received over fourteen
On September 23, 2008, QBE notified Plaintiff that it had failed to produce minutes of meetings from the year 2005 just prior to Hurricane Wilma.
On December 5, 2008, QBE requested confirmation that all meeting minutes and withheld documents were provided. (Id., ¶ 32). On January 9, 2009, QBE scheduled the six remaining examinations under oath for February 9 and 10, 2009. (Id., ¶ 44). Plaintiff's position in response was that the additional examinations under oath were not required under the terms and conditions of the Policy, and, thus, Plaintiff filed this lawsuit on January 8, 2009. (Pl. Statement, ¶ 44)
Plaintiff asserts two counts against QBE. Count I of the Amended Complaint seeks a declaratory judgment requesting that this Court determine Plaintiff and QBE's duties and obligations under the policy. [DE 18, pp. 2-5]. Count II is for breach of contract for failure to tender insurance proceeds allegedly due under the Policy. [Id., pp. 5-9]. QBE has
Rule 56(c) of the Federal Rules of Civil Procedure authorizes summary judgment when the pleadings and supporting materials show that there is no genuine issue as to any material fact and that the moving party is entitled to judgment as a matter of law. See Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986). A fact is "material" if it hinges on the substantive law at issue and it might affect the outcome of the nonmoving party's claim. See id. ("Only disputes over facts that might affect the outcome of the suit under the governing law will properly preclude the entry of summary judgment."). The court's focus in reviewing a motion for summary judgment is "whether the evidence presents a sufficient disagreement to require submission to a jury or whether it is so one-sided that one party must prevail as a matter of law." Anderson, 477 U.S. at 252, 106 S.Ct. 2505; Bishop v. Birmingham Police Dep't, 361 F.3d 607, 609 (11th Cir.2004).
The moving party bears the initial burden under Rule 56(c) of demonstrating the absence of a genuine issue of material fact. Allen v. Tyson Foods, Inc., 121 F.3d 642, 646 (11th Cir.1997). Once the moving party satisfies this burden, the burden shifts to the party opposing the motion to go beyond the pleadings and designate "specific facts showing that there is a genuine issue for trial." Celotex v. Catrett, 477 U.S. 317, 324, 106 S.Ct. 2548, 91 L.Ed.2d 265 (1986). A factual dispute is genuine only if the evidence is such that a reasonable fact finder could return a verdict for the nonmoving party. Anderson, 477 U.S. at 248, 106 S.Ct. 2505; Denney v. City of Albany, 247 F.3d 1172, 1181 (11th Cir.2001). In assessing whether the movant has met its burden, the court should view the evidence in the light most favorable to the party opposing the motion and should resolve all reasonable doubts about the facts in favor of the nonmoving party.
QBE argues that it is entitled to summary judgment based upon its affirmative defenses of non-compliance with the policy conditions and failure to fulfill conditions precedent to recovery under the Policy. More specifically, QBE argues as follows:
(1) Plaintiff denied QBE's request to conduct additional examinations under oath;
(2) Plaintiff failed to provide its sworn proof of loss for fourteen months after QBE's initial request, and failed to provide the sworn proof of loss on the form provided by QBE for sixteen months after QBE's initial request; and (3) Plaintiff failed to produced all requested records relating to its claim.
In support of its summary judgment motion, QBE points to a wide variety of cases, all of which stand for the proposition that where an insured fails to comply with policy conditions and conditions precedent to filing suit under an insurance contract, the insured has materially breached its contract and may not prevail in a law suit against the insurer. See, e.g., Goldman v.
QBE argues that Plaintiff failed to comply with the post-loss policy conditions by refusing to submit to additional examinations under oath. The policy states, in relevant part, as follows:
[DE 18, Ex. A]. On May 25, 2006, QBE requested examinations under oath of a designated corporate representative, Plaintiff's property manager, and current and former Board Members. Thereafter, QBE conducted examinations under oath of Plaintiff's designated corporate representative and property manager on August 9, 2006. However, both of these individuals deferred to Plaintiff's public adjuster on a number of key issues. Thus, on September 11, 2006, QBE reiterated its request for the examinations under oath originally sought on May 25, 2006, and also requested to examine Plaintiffs public adjuster. QBE argues that Plaintiff breached the Policy because QBE requested additional examinations under oath, but Plaintiff proceeded to file this action instead of complying
Plaintiff relies on Goldman v. State Farm Fire General Ins. Co., 660 So.2d 300, 303 (Fla. 4th DCA 1995), for the proposition that an "insured's refusal to comply with the demand for an [examination under oath] is a willful and material breach of an insurance contract, which precludes the insured from recovery under the policy." For purposes of my analysis, Vision I Homeowners Ass'n, Inc. v. Aspen Specialty Ins. Co., 674 F.Supp.2d 1333 (S.D.Fla.2009), is particularly instructive. There, the defendant argued that it was entitled to summary judgment because the plaintiff had failed to comply with its request to provide additional examinations under oath. As in the present case, the plaintiff in Vision I had submitted a corporate representative for examination and provided the defendant with numerous documents prior to the examination under oath. The Court noted that there was no provision in the policy that required that the insured subject itself to more than one examination under oath, despite the fact that the policy stated that the insurer was entitled to examine "any insured." See Vision I Homeowners Ass'n, Inc., 674 F.Supp.2d at 1340-41. Based on established Florida law set forth in Haiman v. Fed. Ins. Co., 798 So.2d 811 (Fla. 4th DCA 2001), the Court in Vision I concluded that "at most, [the] evidence [presented] creat[ed] a disputed issue of material fact regarding Vision I's compliance with the terms of the contract." See Vision I Homeowners Ass'n, Inc., 674 F.Supp.2d at 1341; see also Haiman, 798 So.2d 811 at 812 (where insured cooperates to some degree or provides an explanation for its noncompliance, a fact question is presented regarding the necessity or sufficiency of compliance).
Similarly, under the instant facts, I am persuaded that the issue of whether Plaintiff complied with the Policy's examination under oath requirement is a question of fact for the jury precluding summary judgment. QBE argues that it was entitled to request examinations under oath of Board Members who were unit owners considered to be "additional insureds" under the terms of the Policy. [See DE 42-2, p. 22]. Even assuming that QBE was entitled to examine unit owners as "additional insureds," as the Court did in Vision I, I decline to conclude as a matter of law that Plaintiff failed to sufficiently comply with the policy's examination under oath requirement thereby forfeiting all of its rights under the Policy.
QBE further argues that Plaintiff materially breached a policy condition precedent by failing to timely submit a signed sworn proof of loss after it was requested. The Policy requires Plaintiff to send QBE a sworn proof of loss within sixty days after the insurer's request. [See DE 18, Ex A]. In the instant case, the record reflects that the deadline for Plaintiff to provide the sworn proof of loss was February 14, 2007. However, QBE did not receive Plaintiffs sworn proof of loss until February 26, 2008, fourteen months after QBE's request. Moreover, because Plaintiff's initial sworn proof of loss was not on QBE's form, it was rejected by QBE as unsatisfactory. Subsequently, on May 8, 2008, Plaintiff submitted a revised sworn proof of loss on the form provided by QBE, albeit sixteen months after QBE's request.
Taking into account the required element of materiality, I conclude that there are genuine issues of fact as to whether Plaintiffs breach was material enough to preclude the insured from recovery under the policy. See Haiman, 798 So.2d 811 at 812 (where insured cooperates to some degree or provides an explanation for its noncompliance, a fact question is presented regarding the sufficiency of compliance). In so finding, I have considered the reasoning set out in the recent unpublished Eleventh Circuit decision, Swaebe v. Federal Ins. Co., 374 Fed.Appx. 855, 855-56, 2010 WL 785995, *1 (11th Cir. March 10, 2010). There, the Court stated that the materiality standard set forth in Haiman did not aide the plaintiff's argument on appeal because the plaintiff had breached the policy's "no action" provision by failing to submit a signed sworn proof of loss prior to filing suit. Id. at 858-59, at *3. In the present case, Plaintiff provided a sworn proof of loss fourteen months after QBE's initial request, and subsequently complied with QBE's request to re-submit the sworn proof of loss on the form provided by QBE. Importantly, the sworn proofs of loss were provided by Plaintiff prior to the filing of this lawsuit. Cf. Starling v. Allstate Floridian Ins. Co., 956 So.2d 511, 513 (Fla. 5th DCA 2007) (concluding that where plaintiff did not submit a sworn proof of loss until three months after she filed suit there was no genuine issue of fact that plaintiff materially breached the policy conditions precedent, and thus, the insurance company was
QBE also argues that it is entitled to summary judgment because Plaintiff failed to satisfy the Policy's post-loss conditions by not permitting QBE "to examine its books and records as often as may reasonably be required." [DE 41, p. 5]. In response, Plaintiff argues that it has satisfied the requirement and has sufficiently provided relevant, non-privileged information. To that end, Plaintiff claims that it has provided over eleven thousand documents to QBE during its investigation of Plaintiffs claim, including a report prepared by Plaintiffs public adjuster consisting of a "two thousand nine hundred and thirty nine page (2,939) line item estimate of damages" sustained by Plaintiff. [See DE 58, p. 3]. Plaintiff also notes that it informed QBE on several occasions that the reason certain documents were being withheld was that they were privileged or confidential. On October 3, 2006, Plaintiff further informed QBE that it could not comply with its request to produce unit owner files because unit owners were informed that their files would be kept confidential. [DE 57, ¶ 13]. Moreover, Plaintiffs attorney finally did agree to permit inspection of the requested unit owner files, and on July 8-9, 2008 the inspection was conducted. Although the requested unit owner files and other documents alleged to be relevant to QBE's investigation were not produced until months and at times years after QBE's repeated requests, as I have previously noted, under Florida law "cooperation to some degree" or "an explanation for [] noncompliance" presents a dispute of fact appropriate for resolution by a jury. See Haiman, 798 So.2d 811 at 812 (failure to produce certain documents did not entitle insurance company to judgment as a matter of law when the claimant produced "volumes of documents" for the insurance company); see also Paulucci v. Liberty Mut. Fire Ins. Co., 190 F.Supp.2d 1312, 1328 (M.D.Fla. 2002) (question of fact existed as to whether plaintiff breached its obligation under insurance policy by failing to produce relevant documents where plaintiff had provided over one thousand two hundred documents to insurer). Accordingly, QBE has failed to show as a matter of law that Plaintiff materially breached the Policy's records inspection provision, and, thus, summary judgment is unwarranted.
In light of the foregoing, I conclude that issues of unresolved fact remain precluding summary judgment in favor of QBE. Accordingly, it is hereby