I was taught that insurance coverage could never be created by estoppel, but insurers waive exclusions and conditions precedent by payment. So, when an insurance company pays a claim and then later changes its mind, can it sue its policyholder to get that money back?
That question came squarely before a Florida federal court in Scott A. Saveraid Trust v. QBE Specialty Insurance Company. 1 The dispute began, as so many have in recent years, with Hurricane Ian. The policyholder, the Saveraid Trust, owned a beachfront property and carried surplus lines coverage through QBE. After the storm, QBE paid over $300,000 for dwelling damage and another $20,600 for loss of use. Months later, and after the policyholder filed a lawsuit to obtain more benefits, the insurer claimed it had made a mistake. It claimed that the damage was actually excluded flood or storm surge damage. QBE filed a counterclaim seeking to recover the payments through a theory of unjust enrichment.
The policyholder moved to dismiss, arguing that Florida law simply doesn’t allow an insurer to transform a contract claim into an equitable refund case. The Trust pointed out that QBE’s own pleadings admitted that the payments were made under the insurance policy, following an investigation and coverage determination. That, the Trust said, made this a contractual dispute, not a case of unjust enrichment.
Florida law has long held that equity cannot be invoked when an express contract governs the subject matter. The policyholder also relied on a recent Eleventh Circuit case, MONY Life Insurance Company v. Perez, where the court rejected an insurer’s attempt to use unjust enrichment to claw back benefits, even when the policy lacked a reimbursement clause. The Trust’s message was simple: if QBE wanted a contractual right to recoup payments, it should have written one into its policy.
QBE countered that this was not a typical coverage dispute. It had paid for a loss it now believed was clearly excluded. The insurer argued that the policy did not address how to handle mistaken overpayments, leaving restitution in equity as its only avenue for relief. It relied on decisions like Pinewood Condominium Apartments v. Scottsdale Insurance Company, in which a court allowed an unjust enrichment claim for overpayments made outside the scope of a policy. QBE warned that denying its claim would create an unfair windfall for the insured, who would keep money it never had a right to receive.
The judge wasn’t persuaded. The court dismissed QBE’s unjust enrichment claim with prejudice, meaning it cannot be refiled. The judge acknowledged that some prior cases had permitted insurers to seek restitution of overpayments, but she held that the Eleventh Circuit’s recent MONY Life decision foreclosed QBE’s theory. The court emphasized that even when a policy is silent on repayment or overpayment, those issues still fall within the “same subject matter” as the insurance contract. QBE’s payments were made as part of its contractual obligations, and calling them a mistake did not transform them into an equitable claim. The court also noted that QBE could have included a clawback clause in its policy, but chose not to, and that equity would not step in to rewrite the bargain.
This ruling sends an important signal to insurers tempted to walk back coverage decisions after the fact. This scenario often arises when insurance defense attorneys cleverly look for ways to raise the stakes for the policyholder. They often allege some type of fraud as well.
However, once an insurer makes a coverage determination and then payment under its policy, it cannot simply sue its policyholder in equity to undo that decision. If it wants the ability to recoup payments it later deems excessive or mistaken, it must place that right in the policy. For policyholders, the decision reinforces a principle as old as the insurance promise itself: when an insurer makes a deliberate coverage determination and issues payment, it must stand by its word unless fraud or some contractual basis exists to do otherwise.
Thought For The Day
“Equity will not relieve a party from the consequences of its own deliberate choice.”
– Justice Benjamin Cardozo
1 Scott A. Saveraid Trust v. QBE Specialty Ins. Co., No. 2:25-CV-394 (M.D. Fla. Nov. 7, 2025) (See also, QBE’s Counterclaims; Saveraid Trust’s Motion to Dismiss Counterclaim; and QBE’s Response to Motion to Dismiss Counterclaims).