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Exceeding policy limits for reasonable emergency measures: Measures to preserve the right to receive payment | Property Insurance Law Team Blog



There are countless circumstances immediately following a loss that require urgent action. Common examples of so-called “reasonable emergency measures” include dropping a roof to prevent further water intrusion, performing dehydration services or any number of temporary repairs aimed at preventing further loss or damage. Although policyholders have an obvious interest in ensuring that these measures are implemented (they want to protect their home / property), it is also consistently required under home insurance. This is largely due to virtually all policies that contain one or another version of the following provision:

IN THE EVENT OF LOSS OF PROPERTY, YOU MUST TAKE REASONABLE EMERGENCY MEASURES ONLY TO PROTECT THE PROPERTY FROM FURTHER DAMAGE IN ACCORDANCE WITH THE POLICY PROVISIONS. EXCEPT FOR REASONABLE EMERGENCY MEASURES, THERE IS NO COVERAGE FOR REPAIRS BEGINING BEFORE THE PREVIOUS: (A) 72 HOURS AFTER WE ARE ANNOUNCED FOR THE LOSS, (B) THE PERIOD IS RELEASED.

This does not come as a surprise to most individuals. Policyholders want to protect their property and insurance companies want to limit their exposure. However, problems arise when the costs of implementing these reasonable emergency measures become significant. This is directly attributable to the relatively low political limits of such measures. This was precisely the case in All Insurance Restoration Services, Inc. v. Citizens Property Insurance Corporation.1

In this case, the insured received water damage when the plumbing source for their refrigerator leaked. At the time of the loss, the property was insured by a homeowner issued by the citizens. According to the insurance, after a loss, the insured had an obligation to “[t]take reasonable emergency measures necessary to protect the covered property from further damage, in accordance with the provisions of Additional Coverage. “2 With regard to reasonable emergency measures, the policy of the insured’s homeowners stated the following:

F. Additional coverage [**2]. . . .

Reasonable emergency measures

a. We will pay up to the higher of $ 3,000 or 1% of your coverage. A limit of liability for the reasonable costs you have incurred for necessary measures taken solely to protect covered property from further damage, when the damage or loss is caused by a risk-insured Mot.

b. We will not pay more than the amount in a. above, unless we give you approval within 48 hours of your request to us to exceed the limit of one. above. In such cases, we only pay up to the additional amount for the measures we approve.

If we do not respond to you within 48 hours of your request to us and the damage or loss is caused by a risk insured against, you may exceed the amount in one. above only up to the cost you incurred for reasonable emergency measures required to protect the covered property from further damage.

The insured then hired All Insurance Restoration Services (AIRS) to perform water reduction services, and the insured allocated their benefits under the homeowner policy to AIRS. AIRS completed the services and notified citizens of their claim on the same day.

Subsequently, AIRS sent an e-mail to Citizens and attached AIRS ‘”water reduction package”, which included the award of benefits and an invoice of $ 7,238.75 for water reduction services. Citizens then sent a letter to AIRS attaching a $ 3,000 check against the reasonable emergency limit for the liability portion of the loss. Unsurprisingly, the letter referred AIRS to the insurance terms in Additional Coverage, in particular the requirement that notice be given before the insurance limit for reasonable emergency measures is exceeded.

Citizens then refused to comply with AIRS ‘request for full payment of the water reduction package and brought an action. Citizens requested a summary judgment, arguing that AIRS never made a request to exceed the policy limit for reasonable emergency measures, and therefore the undisputed facts precluded judgments by law. The district court’s decision was direct and uncomplicated, and approved the citizens’ motion and stated the following:

Defendant has fully complied with his obligations under the insurance policy by paying the $ 3,000.00 limit for reasonable emergency measures. The plaintiff failed to meet his burden of proving that the defendant had violated the terms of the insurance.

The court finds that the plaintiff failed by law to make a request for the defendant’s approval to exceed the $ 3,000.00 limit for reasonable emergency action. There was nothing in the email to the defendant on November 29, 2017, requesting approval to perform work over $ 3,000.00. Under the usual meaning of the insurance provision, a claim for payment in excess of $ 3,000.00 via an invoice for services that have already been completed is not a request to exceed the policy limit for reasonable emergency measures.3

AIRS appealed the ruling. The Third Court of Appeal upheld the district court’s judgment and justified:

AIRS e-mail and submission of invoices are nothing more than a requirement for payment for services already performed. Requesting payment of an invoice for services already performed is not the same as requesting permission to exceed the $ 3,000 limit. Therefore, even if Citizen must respond within 48 hours to a request to exceed the $ 3,000 reasonable emergency limit, it is not required to respond to a claim for payment of a reasonable emergency invoice that has already been made to an insured. As such, the trial court rendered a final summary judgment in favor of Citizens and against AIRS, since, according to the clear language of the insurance contract, Citizens fulfilled its contractual obligations when submitting the $ 3,000 check to AIRS. Looks Certified Priority Restoration v. Universal Ins. Co. by N. (which addresses the same policy language as in the present case, and concludes that the record shows that the insurer was entitled to a final summary judgment in which Certified Priority Restoration (‘CPR’) ‘failed to request that the insurer allow it to exceed the $ 3 limit 000 before submitting the invoice for the finished product [water [**9] relief]work “, and where” the insurer paid USD 3,000 to CPR “); see also Certified Priority Restoration v. Citizens Prop. Ins. Corp., 2021 Fla. App. LEXIS 9878, 46 Fla. L. Weekly D1546, * 2 (Fla. 4th DCA June 30, 2021). Consequently, we confirm the final summary judgment in favor of the citizens.

The moral of the story is simple: the policy requires that reasonable emergency measures be taken to protect the property. Policyholders have an interest in making it independent of this obligation. Reasonable emergency measures can be a significant cost, and most policies provide opportunities to obtain coverage beyond the stated limits. If you or someone you know has met these requirements and the insurance company still refuses to cover the full cost of these emergency measures, contact Merlin Law Group.
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1 All Ins. Restoration Servs. v. Citizen Prop. Ins. Corp., 328 So. 3d 1057 (Fla. 3d DCA 2021).
2 Id. at 1058.
3 Id. at 1060.


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