Court Reverses Summary Judgment, Finding Insurer Failed to Prove Policy Exclusion

The Fourth District Court of Appeal reversed the trial court’s order granting summary judgment in favor of the insurance carrier, finding the carrier did not satisfy its burden of proving an exclusionary provision of the policy, thereby holding a genuine issue a material fact to exist.

The Belizaires sued Citizens after the carrier denied their claim for windstorm damage to their roof. In its denial, Citizens cited the policy’s wear and tear and deterioration exclusion, and claimed that a covered peril did not create the opening in the roof through which rain entered. Citizens defended the lawsuit on these exclusionary bases. In moving for summary judgment, Citizens argued the burden of proof never shifts to itself if the insureds cannot meet their original burden of proof on the initial issue of coverage. Thus, Citizens claimed it was not required to prove the damages were caused by an exception or exclusion under the policy as an initial matter. In support of its motion, Citizens submitted only an affidavit of its corporate representative, field adjuster photographs and its denial letter.

In opposing the summary judgment, the homeowners filed an affidavit of a certified building and roofing contractor, opining the claimed damage was caused by a windstorm, and an affidavit from themselves, specifically detailing the exact date of the windstorm event during the policy period. Notwithstanding the insureds’ affidavits, the trial court entered summary judgment in Citizens’ favor.

On appeal, the Fourth District Court of Appeal disagreed with the trial court and held that the Belizaires met their initial burden of proof, thus, shifting the burden to Citizens to prove the damage was caused by an exclusionary provision in the policy. In doing so, the district court held that Citizens had not met its burden as it did not file an affidavit competent to establish any fact entitling it to summary judgment. The court held that a denial letter was not competent proof of the facts Citizens used to justify its denial.

Accordingly, the district court found a genuine dispute of material fact remained as to the cause of loss and reversed the final summary judgment, remanding the case to the trial court for further proceedings.