Certified Priority Restoration A/A/O Cheryl Coakley v. Universal Ins. Co. of North America, 2021 Fla. App. LEXIS 12096 (Fla. 4th DCA, Aug. 18, 2021)
Fourth DCA affirms summary judgment in favor Universal after payment of $3,000 reasonable emergency measures limit as the assignee failed to request prior authorization to exceed the $3,000 limit.
In Certified Priority, the Court upheld an Order granting Summary Judgment in favor of Universal, finding that the Appellant failed to abide by the policy condition requiring prior authorization from the insurer before proceeding with emergency measures in excess of $3,000 or 1% of the Coverage A policy limits. The insured property sustained damage by water leading the Insured to retain the services of Certified Priority Restoration (CPR) and assign the right to recover insurance benefits under the policy. CPR subsequently performed emergency measures on the property and submitted an invoice to Universal for $8,710.84. Universal provided a check in the amount of $3,000, citing the policy provision requiring prior authorization by the insurer for emergency measures in excess of $3,000 or 1% of the Coverage A policy limits.
After CPR filed suit, Universal moved for summary judgment on two grounds: 1) That Plaintiff failed to make a request to exceed the available limits of coverage for reasonable emergency measures under the subject policy of insurance; and, 2) CPR’s claims are barred by Section 673.3111, Florida Statutes (accord and satisfaction by instrument). The lower court granted the Motion for Summary Judgment on both grounds, and Universal appealed the decision.
Since neither the $3,000 check nor the accompanying written communication contained a “conspicuous statement” as outlined by the statute, the Court found that the facts did not allow for entry the summary judgment on the accord and satisfaction defense asserted by Universal. However, the Court also held that CPR failed to request that the insurer allow CPR to exceed the $3,000 limit before submitting the invoice for the completed work. Specifically, the Court found that even if the AOB contained language that requested to exceed the cap, CPR sent the AOB and invoice after it had already completed the services, thus not providing the carrier an opportunity to object to CPR’s request. Since Universal paid the $3,000 limit as outlined in the policy, the Court found that summary judgment was proper.
Takeaway: In order to exceed the reasonable emergency measures, the assignee must request prior written authorization before it completes services or the damages are capped at $3,000.