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Home / Insurance / Sebo Claims Practice Case Moves to Trial | Property Insurance Law Team Blog

Sebo Claims Practice Case Moves to Trial | Property Insurance Law Team Blog



The case of Sebo simultaneous causal protection created significant insurance laws in Florida. It is now on its way to trial for its first-instance lawsuit in Collier County.

Coverage case Sebo has been discussed in this blog several times. We noted the effects of its holding in the Florida Supreme Court clarifies the rule to be applied when there are multiple causes of loss under an all-risk policy :

The Florida Supreme Court then discussed the application of concurrent causation to Wallach . In Walach the Rosenberg family suffered a loss after Wallach's sea wall collapsed, causing part of Rosenburg's sea wall to fall apart. The Rosenburg family's claim was rejected because their policy included an exception for loss due to soil movement or water damage. The Rosenburg family's insurer claimed that "where simultaneous causes unite to cause a loss and one of the causes is a risk that is excluded under the insurance, then no coverage is available to the insured." The third district sided with Rosenburg and found for reporting. The Court Wallach stated, "where weather hazards are combined with human negligence to cause a loss, it seems logical and reasonable to find the loss covered by an all-risk policy even if one of the causes is excluded from coverage. & # 39; [1

9659004] Looking at the facts about Sebo the home was destroyed due to the combination of design defects, rainwater and hurricane winds.While Sebo's policy specifically excludes damage due to design defects, rainwater and wind damage were covered. "the rain and construction defects acted in concert to create the destruction of Sebo's home … it would not be possible to apply the doctrine of effective proximate cause." And since none of the provisions of Sebo's policy prevented the application of the doctrine of simultaneous cause, the court found that the clear language of the policy did not preclude recycling.

This rule helps to restore what it means to have an all-risk policy. If you buy a full risk insurance and suffer a covered loss, you may be able to recover, even if a significant portion of the damage was due to an excluded cause.

Insurance companies generally try to hide claims and other internal documents. material showing how a claim was handled. Furthermore, internal documents showing the company's damage directive and culture are often not submitted without court intervention. Sebo 's lawsuit was thwarted by such silence and resulted in a reported appeals decision last year. 1

this basic question:

[H] whether an insurance company has processed, analyzed or tried a claim for a fair, straightforward and in good faith if access is completely denied to underlying archive material that reflects how the case was handled and contains direct evidence of whether the claim was processed in "good" or "bad" faith?

The Court of Appeal noted that underlying claims must be submitted even if there are objections based on the "work product" privilege of the underlying litigation:

The Court Ruiz noted that section 624,155, Florida Statutes (2005), is a "legislation" [1945901] considered an insurance the donor's obligation to act in good faith and act fairly in cases where an insured person seeks first-party protection or benefits under an insurance policy. . . Therefore, "protection of work products that may otherwise be given to documents prepared pending litigation on the underlying coverage dispute does not work automatically to protect such documents from detection in the subsequent or accompanying action in bad faith." … The Supreme Court held

& # 39; that in connection with the assessment of the obligation to process claims in good faith. . . , all materials, including documents, memoranda and letters, contained in the underlying claim and related litigation material created up to and including the date of resolution of the underlying disputed case and which in any way relate to coverage, benefits, liability, or damages , should also be presented in a first-party action in bad faith. ”

. . . the General Magistrate correctly established that the requested documents were not protected by the labor product doctrine, as the claim material is needed to determine whether the AHAC acted in bad faith.

convey it to our readers.

Thought for the day

The principle of acting in good faith is at the heart of decent work.
—Richard Eyre
_______________________________________ [19659018] 1 Am. At home Assur. Co. v. Sebo 324 So.3d 977 (Fla. 2d DCA 2021).


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