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Fourth DCA Rules on Late Notice and Proof of Loss Issues

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Just today, the 4th DCA ruled in Kramer v. State Farm Florida Insurance Company, ____ So.3d ____ (Fla. 4th DCA 2012), where an insured homeowner gave late notice and proof of loss concerning a wind damage claim.

Ultimately, the insurance company in this case won on summary judgment.  But, the important part of this case (especially for me) is that the 4th DCA confirmed that the analysis in this situation is controlled by the Supreme Court’s decision in Bankers Insurance Company v. Macias, 475 So.2d 1216 (Fla. 1985).

This is important for me because we just recently won a jury trial involving this same situation.  In my case, the trial court followed the Macias decision.  The insurance company has appealed and is arguing that the Court should not have followed Macias.

Under Macias, if the insured violates a condition precedent, like late notice, or failing to file a proof of loss, the insured can still win if the insured proves that the insurance company was not prejudiced by failing to comply with the condition precedent.  In my case, that is exactly what happened.  The Jury concluded that the insurance company was not prejudiced by the insureds’ failure to provide a proof of loss form.  We were able to show that there was no prejudice because, although the insureds did not provide a proof of loss form, they had provided all of the information that would be contained on the form, and more.

The proper thing for the insurance company to have done in this situation was to ask for a stay of the case while the insureds provided them with a proof of loss form.


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