A Florida circuit court has found that a condominium owner’s property policy did not include coverage for the “explosion” of an advanced decompose body since it did not fall under a name peril listed in the insured’s policy.
Florida’s Fourth District Court of Appeals recently handed down the ruling in the case of Rodrigo v. State Farm Florida (No. 4D12-3410, April 23, 2014), which had its genesis in a 2009 incident involving the death of a woman whose body was not discovered for weeks.
According to court records, the women’s body had gone unnoticed until neighbors complained to the condominium’s maintenance men about the odor coming from her residence.
By that time, the build-up of internal gases in the corpse had caused her abdomen to rupture, resulting in the leakage of bodily fluids into the walls and ceiling of Rodrigo’s condominium unit.
The resulting odor eventually caused the condominium association to gut the deceased’s residence. Rodrigo, however, claimed that State Farm Florida still owed her monies to repair her unit and to compensate her for damage to her personal property and for living expenses.
Rodrigo had argued the deceased woman’s ruptured corpse constituted an “explosion” and was covered under her policy.
State Farm Florida, however, denied the claim, saying a decomposed body was not a covered peril.
Judge Melanie May noted that Rodrigo’s policy did not define what constituted an explosion. However, she noted, that by precedent the courts have long held that a policy must be interpreted according to its most basic definition as understood by the “man-on-the-street.”
As a result, May wrote, Rodrigo’s policy did not cover the damage caused by her neighbor’s death.
“The plain meaning of the term “explosion does not include a decomposing body’s cells explosively expanding, causing leakage of bodily fluids,” opined May. “In short, although novel in her attempt to do so, the insured could not establish that the decomposing body was tantamount to an explosion.”
May also denied Rodrigo’s claim on the basis that she failed to provided a sworn proof of loss as required within 60 days of filing a claim.
Rodrigo’s policy specified that once State Farm received the sworn proof of loss, State Farm Florida had 60 days to reimburse her for damages under one of three conditions. The two parties had reached a mutual agreement on the amount of the claim, the entry of a legal final judgment or the filing of an appraisal award.
State Farm Florida did send an adjuster to Rodrigo’s condominium unit and obtained an appraisal for repairing her damage. The insurer then offered to pay her to repair unit, but denied liability for her personal property damage.
Rodrigo rejected the offer and although she sent State Farm Florida invoices with a list of damages, she did not make a sworn proof of loss. She argued that since State Farm Florida did make an offer to repair her condominium, the requirement for the sworn proof of loss did not apply.
The court said the failure to file the sworn proof of loss violated the terms of Rodrigo’s policy even if State Farm Florida had offered a settlement.
“Because the insurer and insured never reached an agreement, no final judgment was enter, and no valid appraisal award existed, there was no coverage for the claims,” wrote May.
Was this article valuable?
Here are more articles you may enjoy.