Third District Court reversed and remanded order granting insured’s motion for summary judgment based on insured’s failure to comply with policy conditions.

In the underlying matter, LFC Medical Center (LFC) filed for summary judgment, which was granted by the trial court. United Automobile Insurance Company (United) appealed the decision and argued, in pertinent part, the trial court erred because the insured failed to submit to an examination under oath (EUO), which is a condition precedent under the policy. 

Florida’s Third District Court of Appeal found the trial court erred in granting summary judgment in favor of the insured as United put forward sufficient evidence that the insured breached the policy by not attending the EUO. The district court based its findings on its previous decision in Am. Integrity Ins. Co. v. Estrada, which held “when an insurer has alleged, as an affirmative defense to coverage, and thereafter has substantially established, that an insured has failed to substantially comply with a contractually mandated post-loss obligation, prejudice to the insurer from the insured’s material breach is presumed, and the burden then shifts to the insured to show that any breach of post-loss obligations did not prejudice the insurer.” 

Based on its finding, the Third District Court of Appeal reversed and remanded for further proceedings as genuine issues of material fact remained regarding whether United was prejudiced due to LFC’s non-compliance with a post-loss obligation. 

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