MIAMI – Florida's 3rd District Court of Appeal has ruled in the case of a medical center in Miami Beach that sought to appeal a trial court's decision in favor of an insurance company.
The appeal centers on an incident that took place at Kendall South Medical Center at 2013. Maintenance staff were working on the sprinkler system in the center when a leak occurred, which caused water damage to the walls and flooring of the area, according to court documents. The medical center had an insurance policy with the defendant, Insurance Nation. The insurance plan was renewed between 2011 and 2013 and covered $100,000 in damages on the property and contained a $1,000 deductible and 90 percent coinsurance clause.
The leak cost an estimated $260,000 in damages to the Kendall South property. The medical center made an insurance claim, expecting to receive the $100,000 payout listed in its policy but only received $16,562.67. Insurance Nation claimed it sent that amount because of the policy’s coinsurance clause.
Kendall South immediately filed a negligence claim against the management company that runs the property that it is housed in, Equity One Realty & Management, FL. Inc., which allegedly did the work on the sprinkler system. The management company claimed that Kendall South failed to keep up with its insurance policy, which was in violation of its lease.
Kendall South proceeded to add Countryside Power Sweeping Inc. to the lawsuit, alleging that it performed the work on the sprinkler system.
In January and July 2015, Kendall South filed a Second and Third Amended Complaint to add claims against Insurance Nation, alleging more negligence. Kendall South alleged that the insurance company was responsible for providing the coverage requested and explaining the policy. The medical center claimed duty was breached when the insurance agent "'failed to advise and or inform and or adequately and or properly explain to [Kendall South] the 90% coinsurance clause' where the agent 'knew or should have known that the policy written by [Insurance Nation] with the 90% coinsurance clause would not cover and pay [Kendall South’s] property as requested by [Kendall South] in the event' of a covered claim," according to court documents.
The appeals concluded that Kendall South had a right in claiming negligence on Insurance Nation's part. The court reversed the final order made by the trial court, dismissing Kendall South’s Fourth Amended Complaint. The case is remanded for further proceedings.