Policy Terms Control Right to Return of Overpayments
Post 5226
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An Insurer that Claims it Paid More than it Owed Admits to an Incompetent Claims Staff
In Scott A. Saveraid Trust for Scott A. Saveraid Revocable Trust v. QBE Specialty Insurance Company 2:25-cv-394-SPC-DNF, United States District Court for the Middle District of Florida, Fort Myers Division, Judge: Sheri Polster Chappell, U.S. District Judge (Date: November 7, 2025)
Key Facts
The plaintiff, Scott A. Saveraid Trust (the “Trust”), owns real property in Fort Myers Beach, FL. The Trust purchased a homeowners insurance policy (the “Policy”) from defendant QBE Specialty Insurance Company (“QBE”). In September 2022, the property sustained damage from Hurricane Ian, a covered peril under the Policy.
The Trust filed a claim with QBE, which investigated and paid $307,622.32 for dwelling coverage and $20,600 for loss of use. QBE alleges the damage was primarily water-related (e.g., flood damage), which is excluded under the Policy, and that it “mistakenly opened coverage” leading to these payments. The Trust contends QBE underpaid and owes additional benefits under the Policy.
Procedural History
The Trust filed suit against QBE for breach of contract, seeking additional Policy benefits. QBE filed a two-count counterclaim:
Count I:
Declaratory judgment under 28 U.S.C. § 2201, seeking a declaration that the VPL does not apply to the Policy (i.e., QBE is not obligated to pay the full Policy limit for a total loss).
Count II:
Unjust enrichment, seeking repayment of the $328,222.32 allegedly overpaid to the Trust.
Legal Issues
1. Does QBE’s request for a declaration that the VPL does not apply to the Policy state a valid claim under 28 U.S.C. § 2201, or is it duplicative of the Trust’s breach of contract claim and QBE’s affirmative defenses, or merely a factual dispute unsuitable for declaratory relief?
2. Can QBE pursue an equitable claim for recovery of alleged overpayments under the Policy when an express insurance contract governs the parties’ relationship and the subject matter of the payments?
Motion to Dismiss Granted in Part and Denied in Part:
Count I (Declaratory Judgment):
Denied. The claim survives as it presents a valid actual controversy, is not impermissibly duplicative, and involves a legal (not purely factual) issue.
Count II (Unjust Enrichment):
Granted with prejudice. The claim is barred under Florida law because the alleged overpayments fall within the subject matter of the express insurance contract.
Reasoning
Actual Controversy Requirement:
The claim satisfies 28 U.S.C. § 2201 and Article III because there is a substantial, immediate controversy over the VPL’s applicability to the Policy — adverse legal interests between the parties on whether QBE must pay the full Policy limit for a total loss. This is a legal interpretation, not a mere “factual allocation dispute” as argued by the Trust.
Even if redundant, redundancy alone does not warrant dismissal under Rule 12(b)(6), which tests validity, not necessity. Substantively, the claims differ: the Trust’s breach claim seeks benefits “pursuant to the terms of the Policy itself,” while the declaratory claim addresses whether the VPL independently mandates full payment.
Courts permit declaratory claims alongside overlapping defenses because defenses are negative (relieving liability) while declaratory relief is affirmative (seeking a binding interpretation). Dismissing at the pleading stage is premature, as overlap may not moot the claim, and litigation costs are minimal. The Court exercises discretion to retain it.
Unjust Enrichment Claim
Unjust enrichment requires: (1) conferral of a benefit; (2) defendant’s knowledge; (3) acceptance/retention; and (4) inequity in retention without payment. However, it is unavailable where an express contract covers the same subject matter. Here, the Policy governs all claims, payments, and coverage disputes, including the overpayments QBE made in response to the Trust’s claim.
The Eleventh Circuit’s recent decision in MONY Life Ins. Co. v. Perez, 146 F.4th 1018 (11th Cir. 2025), is dispositive. There, an insurer’s unjust enrichment claim for overpayments failed because the payments — even if mistaken or unauthorized— arose from the insured’s claim under the contract’s terms. The court held such claims “fall squarely within the ambit of the express contract” regardless of policy provisions for recovery or the reason for overpayment (e.g., mistake vs. misrepresentation). Payments were made pursuant to contractual obligations, not outside the Policy’s scope.
QBE’s claim that overpayments are a distinct “subject matter” is unpersuasive post-MONY. MONY applies broadly, not limited to misrepresentation cases, and dismissal is with prejudice as amendment would be futile.
Broader Implications
This ruling reinforces the Eleventh Circuit’s strict bar on quasi-contract claims in insured-insurer disputes, prioritizing contract law over equity for payment recoveries. It highlights courts’ reluctance to dismiss declaratory claims early, especially in insurance cases involving statutory interpretation like the VPL, which mandates full payment for total losses from covered perils but may not apply to flood exclusions. The decision aligns with post-Hurricane Ian litigation trends in Florida, emphasizing efficient resolution of coverage disputes without redundant equitable remedies.
ZALMA OPINION
The insurer, proving it maintained an incompetent claims staff and alleged it erroneously paid $328,222.32 more than they owed. Its attempt to get its mistaken payment back from the insured failed when judge Sheri Polster Chappell found the payments were made under the terms of the contract of insurance.
(c) 2025 Barry Zalma & ClaimSchool, Inc.
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Post number 5289
In Great West Casualty Co. v. Nationwide Agribusiness Insurance Co., and Conserv FS, Inc., and Timothy A. Brennan, as Administrator of the Estate of Pat- rick J. Brennan, deceased, Nos. 24-1258, 24-1259, United States Court of Appeals, Seventh Circuit (February 11, 2026) the USCA was required to resolve a dispute that arose when a tractor-trailer operated by Robert D. Fisher (agent of Deerpass Farms Trucking, LLC-II) was involved in a side-impact collision with an SUV driven by Patrick J. Brennan, resulting in Brennan’s death.
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Post number 5288
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Insurers Exclude Damages Due to Insured’s Products
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Passover for Americans
Posted on February 19, 2026 by Barry Zalma
“The Passover Seder For Americans”
For more than 3,000 years Jewish fathers have told the story of the Exodus of the enslaved Jews from Egypt. Telling the story has been required of all Jewish fathers. Americans, who have lived in North America for more than 300 years have become Americans and many have lost the ability to read, write and understand the Hebrew language in which the story of Passover was first told in the Torah. Passover is one of the many holidays Jewish People celebrate to help them remember the importance of G_d in their lives. We see the animals, the oceans, the rivers, the mountains, the rain, sun, the planets, the stars, and the people and wonder how did all these wonderful things come into being. Jews believe the force we call G_d created the entire universe and everything in it. Jews feel G_d is all seeing and knowing and although we can’t see Him, He is everywhere and in everyone.We understand...
Passover for Americans
Posted on February 19, 2026 by Barry Zalma
Read the full article at https://www.linkedin.com/pulse/passover-americans-barry-zalma-esq-cfe-5vgkc.
“The Passover Seder For Americans”
For more than 3,000 years Jewish fathers have told the story of the Exodus of the enslaved Jews from Egypt. Telling the story has been required of all Jewish fathers. Americans, who have lived in North America for more than 300 years have become Americans and many have lostthe ability to read, write and understand the Hebrew language in which the story of Passover was first told in the Torah.
Passover is one of the many holidays Jewish People celebrate to help them remember the importance of G_d in their lives. We see the animals, the oceans, the rivers, the mountains, the rain, sun, the planets, the stars, and the people and ...
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Post number 5275
Posted on January 30, 2026 by Barry Zalma
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Facts and Background
Lido Hospitality, Inc. operates the Lido Motel in Franklin Park, Illinois. In November 2020, a windstorm caused one of the motel’s brick veneer walls to collapse. At the time, Lido was insured under a policy issued by AIX Specialty Insurance Company which provided coverage for windstorm damage. However, the policy contained an exclusion for any loss or damage directly or indirectly resulting from ...
