Florida Appeals Court Rebukes Citizens Property Insurance Over Roof Claim Denial

A recent decision by Florida’s Second District Court of Appeal has significant implications for how insurers handle all-risk homeowner claims with replacement-cost provisions. In 2021, Richard Brito and Pamela Garcia filed a roof damage claim under their Citizens Property Insurance policy, only to have it denied outright. Citizens then argued in trial court that, because the homeowners hadn’t completed repairs, it owed only the initial actual cash value—effectively blocking any claim for the balance.

The trial court accepted Citizens’ staged-payment interpretation and prevented the homeowners from presenting evidence of full repair costs, ending the case in the insurer’s favor. However, on June 18, the appellate panel reversed, finding that staged-payment clauses apply only when coverage has been acknowledged, not used to deny coverage entirely. By drawing a clear line between coverage denials and payment-schedule provisions, the court reopened the dispute, allowing Brito and Garcia to prove their full replacement-cost damages.

This ruling not only gives the homeowners another opportunity to seek full compensation but also serves as a warning to insurers: denying claims on technicalities may backfire if courts view payment clauses as contingent on recognizing coverage. As insurers increasingly rely on nuanced policy language to limit exposure, this decision underscores judicial willingness to scrutinize such tactics and reinforce policyholder rights under replacement-cost contracts.

With potential conflict among Florida’s appellate districts, the state Supreme Court may ultimately resolve the split. In the meantime, insurers operating in Florida—and possibly beyond—should review claim-handling guidelines to ensure that denials aren’t followed by enforcement of payment rules that presuppose acceptance of coverage.