Courts May not Rewrite Clear & Unambiguous Policy
Post 4844
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In Universal Property & Casualty Insurance Company v. Irma Qureshi and George Guerrero, No. 4D2023-1338, Florida Court of Appeals, Fourth District (July 24, 2024) the Court of Appeals was required to address the measure of damages recoverable for the breach of a replacement cost property insurance policy.
BACKGROUND
A jury awarded the insureds $57,836.83 in damages on their claim that Universal Property & Casualty Insurance Company (“Universal”) breached some but not all of the coverage terms of the insureds’ property insurance policy by paying them only the $10,000 policy limit for damage caused by mold without including payment for the damage caused by the water leak at the property that resulted in the mold.
The insureds never repaired the damaged items described in an estimate they had submitted for reimbursement from Universal prior to selling their property or at any time after the loss.
The policy required actual replacement before an insured was entitled to replacement value after a loss, provided that Universal would not pay, “any amount for ‘diminution in value,'” defined in the policy as “any reduction in value of any covered property prior to or following repair or replacement as compared to the value of that property immediately before the loss.”
ANALYSIS
Universal argued that the trial court reversibly erred by allowing the insureds to introduce into evidence at trial the estimated repair costs for work that was never performed.
Courts have almost uniformly held that an insurance company’s liability for replacement cost does not arise until the repair or replacement has been completed.
In addition, courts, without dispute, are not authorized to rewrite clear and unambiguous contracts. The Court of Appeals concluded the insureds’ policy is clear and unambiguous. The insureds are not entitled to their repair costs unless and until work is performed and expenses are incurred.
Well established Florida law rejects an expansion of insurance coverage to include payment for estimated but not yet incurred repair costs because it would improperly create insurance coverage by waiver or estoppel.
CONCLUSION
Because the trial court impermissibly allowed the jury to consider evidence of estimated but not yet incurred repair costs in determining recoverable damages, the Court of Appeals reversed and remanded the case for a new trial on the issue of damages. On remand, the trial court was directed to confine the proof at the new trial on damages to only those damages for which recovery is permitted under the policy’s clear and unambiguous terms.
ZALMA OPINION
Courts often have sympathy for insured’s who incurred damage but were not paid in full because – as with Irma Qureshi and George Guerrero – because they sold the house without completing or expending any money to do the repairs for which they had submitted an estimate. The policy, and the law, required that the insured’s only receive replacement cost funds if they actually spend the money. They did not and the court had no right to change the policy terms to allow them to obtain funds from their insurer to which they were not entitled.
(c) 2024 Barry Zalma & ClaimSchool, Inc.
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Insurance Expert May Not Testify to Speculative and Contains Unsupported Conclusions.
Posted on September 18, 2026 by Barry Zalma
See the full video at and at https://rumble.com/v7fmifw-expert-may-only-testify-to-what-experience-supports.html
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The operative dispute concerned State Farm Auto’s motion to exclude or limit opinions from plaintiffs’ insurance-industry expert, Aaron Castillo. Castillo.
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The proponent of expert testimony must establish by a preponderance of the evidence that an expert is qualified and that the opinions are helpful, sufficiently grounded, and reliably derived and applied. Experience-based opinions must explain how the...
150 Months in Prison for Tax Fraud
Post 4846
Posted on September 17, 2026 by Barry Zalma
See the full video at https://lnkd.in/g8rh3JBX and https://lnkd.in/gmkdy-9C, In United States Of America v. Thomas Addaquay, Nos. 25-10609, 25-10611, United States Court of Appeals, Eleventh Circuit (September 9, 2026) the Eleventh Circuit affirmed all challenged convictions, the 150-month aggregate sentence, and the challenged $4,123,474.55 restitution award.
FACTS
In United States Of America v. Thomas Addaquay, United States Of America v. Thomas Addaquay, Nos. 25-10609, 25-10611, United States Court of Appeals, Eleventh Circuit (September 9, 2026) the Eleventh Circuit affirmed all challenged convictions, the 150-month aggregate sentence, and the challenged $4,123,474.55 restitution award.
FACTS
Thomas Addaquay controlled United Consolidated Accounting and Business Services (UC), nominally a check-cashing business.
The government proved a three-stage tax-refund scheme that converted the resulting refund checks into usable funds through ...
Major Fraud Perpetrator Asserts Fifth Amendment Privilege to Avoid Prosecution
Post 5489
Posted on September 14, 2026 by Barry Zalma
Fraudster Refuses to Answer Questions About His Alleged Fraud
See the full video at https://lnkd.in/gvicAMDr and at https://lnkd.in/gvicAMDr
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Luis Manuel Garcia Salcedo, resulted in a $6 million settlement. Non-party Jose Hernandez allegedly worked as an assistant manager at Subin, operated Hernandez Associates, and owned litigation-funding companies that shared office space with Subin and provided services to its clients.
After Great American ...
Insured’s Ordered to Pay Insurer for Fraud by the Insureds
Post 4573
Posted on November 3, 2026 by Barry Zalma
In The Prudential Insurance Company Of America v. Carol Gardina and George Gardina, No. 6:23-cv-1125-JSS-DCI, United States District Court, M.D. Florida, Orlando Division (October 22, 2026).
THE JURY TRIAL AND VERDICT
Plaintiff sued Defendants for numerous causes of action stemming from its allegations that Defendants fraudulently collected benefits under their long-term care insurance policies. Plaintiff's case proceeded to a nine-day jury trial, after which the jury found Defendants liable for fraudulent misrepresentation, fraudulent concealment, and civil conspiracy.
The jury also found Defendant Carol Gardina liable to Plaintiff for $1,930,129 in compensatory damages and Defendant George Gardina liable to Plaintiff for $12,496 in compensatory damages and $20 in punitive damages. Thereafter, the court entered judgment in Plaintiff's favor and awarded Plaintiff $1,930,129 in compensatory damages from...
ZIFL – Volume 30, Issue 21
Posted on November 2, 2026 by Barry Zalma
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
Zalma’s Insurance Fraud Letter (ZIFL) continues its 30th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma. It is provided FREE to anyone who visits the site at http://zalma.com/zalmas-insurance-fraud-letter-2/
DOJ, ATF, Law Enforcement Partners Conclude Operation Show Me Justice
435 Dangerous Offenders Arrested, 166 Illegal Firearms Seized, 81 Kg Illicit Drugs off the streets in St. Louis
The Department of Justice, BATF, U.S. Marshals Service (USMS), US Attorney Missouri announced the ...
ZIFL – Volume 30, Issue 21
Posted on November 2, 2026 by Barry Zalma
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
Zalma’s Insurance Fraud Letter (ZIFL) continues its 30th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma. It is provided FREE to anyone who visits the site at http://zalma.com/zalmas-insurance-fraud-letter-2/
DOJ, ATF, Law Enforcement Partners Conclude Operation Show Me Justice
435 Dangerous Offenders Arrested, 166 Illegal Firearms Seized, 81 Kg Illicit Drugs off the streets in St. Louis
The Department of Justice, BATF, U.S. Marshals Service (USMS), US Attorney Missouri announced the ...
