Insurer Can't Prove Fraudulent Intent on Summary Judgment

Published: Oct. 10, 2022, 3:34 p.m.

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Lies During Litigation do not Violate Policy\'s Fraud Provision  

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Mariana Gracia appealed the trial court\'s grant of final summary  judgment in favor of Security First Insurance Company ("Security  First"). The trial court found Gracia had made affirmative  misrepresentations regarding the pre-loss condition of her property,  warranting forfeiture of coverage under the concealment or fraud  provision of her homeowner\'s insurance policy. 

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Mariana Gracia v.  Security First Insurance Company, No. 5D21-1456, Florida Court of  Appeals, Fifth District (September 9, 2022)  FACTS  Security First insured Gracia for the risks of loss to her home located  in Orlando, Florida. Gracia reported a loss due to roof damage allegedly  caused by a storm. Security First investigated the claim and extended  approximately $11,000 in coverage for damages. However, Gracia then  submitted a sworn proof of loss, claiming more damages than what  Security First had covered.  

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After Security First denied the supplemental claim, Gracia sued alleging  breach of contract and seeking additional damages to cover roof repairs  and interior water damage. During her deposition, Gracia revealed that a  home inspection had been performed in 2015, prior to her purchasing the  property. When asked the results of the inspection, she stated,  "Everything was good" and that the "roof was in good condition."  After Security First obtained the 2015 inspection report, it amended its  affirmative defenses to include the concealment or fraud provision of  the policy, as the inspection report indicated that the property had  roof and interior ceiling damage in 2015. The inspection report  contained photographs revealing the damage and specifically noted roof  leaks around the chimney, water damage in the attic, and interior  ceiling damage caused by water-areas consistent with those noted by  Gracia in her instant claim.  Security First moved for summary judgment on several grounds but focused  exclusively on its concealment or fraud defense at the summary judgment  hearing. The trial court agreed with Security First. To obtain summary  judgment Security First was required to establish that Gracia\'s  statements regarding the pre-loss condition of her property were made  with the intent to mislead. Because this case was decided under the new  Florida Rule of Civil Procedure 1.510, summary judgment is appropriate  when "the evidence is such that a reasonable jury could not return a  verdict for the nonmoving party."

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 In re Amends. to Fla. R. Civ. P.  1.510, 317 So.3d 72, 75 (Fla. 2021) (citing Anderson v. Liberty Lobby,  Inc., 477 U.S. 242, 248 (1986)).  The trial court interpreted this new standard as allowing it to weigh  and judge the credibility of the evidence. Credibility determinations  and weighing the evidence are jury functions, not those of a judge, when  ruling on a motion for summary judgment.  ANALYSIS  The Court of Appeal found it important to highlight the distinction  between misrepresentation during the insurance application

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