Do policyholders have to comply with post-loss obligations anew when submitting new or different claims that materially differ in scope or value from the original claim submission? I reframed the issues to better discuss an important and recent Florida decision. These issues come up on a routine basis, usually because damage is often hidden or policyholders do not fully investigate for all damage, and insurers have little incentive to do so. There has not been a great deal of discussion about the rules to be followed when these types of claims issues arise. Treasure Cay Condominium and Frontline Insurance Company have been litigating these exact issues for years following a 2017 loss. Frontline appears to have won the day based on a recent appellate ruling that upholds a trial court victory. 1
The trial court concluded there was no dispute that, after submitting a roughly $3 million supplemental claim almost two years after Frontline issued its coverage position, Treasure Cay refused to sit for an examination under oath, declined re-inspection, and failed to produce records requested by Frontline. The trial court found that these post-loss duties under its policy are conditions precedent to suit and are reinforced by the “Legal Action Against Us” clause. Because those duties were not satisfied, the court ruled that appraisal was not ripe and Frontline was relieved of further obligations on the supplemental claim.
What the trial court actually found matters because the Florida Third District Court of Appeal (DCA) affirmed. After Treasure Cay submitted a roughly $3 million package two years after the storm and after Frontline found that the loss was less than the deductible, the insurer treated this as a “supplemental claim” under Florida law. The trial court ruled that the insured’s demand for appraisal did not erase its post-loss duties. The trial court found there was no dispute that the insured refused to sit for an examination under oath, to allow re-inspection, and to produce records related to the supplement, and that this refusal materially breached the policy and prejudiced the insurer. On that basis, the trial court granted summary judgment and entered final judgment for the insurer. 2
The policyholder’s core argument was that appraisal was ripe and mandatory once a genuine dispute over the amount of loss existed. By the time appraisal was invoked, the insurer had inspected, adjusted below the deductible, and there were no unmet post-loss obligations; the later document requests and EUO demand were characterized as belated and excessive. From that view, the trial court should have compelled appraisal, or at least held an evidentiary hearing on substantial compliance because Treasure Cay said it had cooperated to a meaningful extent, and any remaining compliance questions were fact issues for trial.
The insurer’s response was blunt, seeking a ruling where its client paid nothing. It argued that invoking appraisal does not end post-loss duties. Instead, the insurer claimed that the insured openly refused to comply after presenting a multimillion-dollar “supplemental claim” under Florida law.
The insurer argued that under Florida’s Third DCA’s prejudice framework, a complete refusal triggers a presumption of prejudice that the insured must overcome, and Treasure Cay offered no competent rebuttal of this presumed prejudice. Because the dispute was legal rather than factual on this matter, no evidentiary hearing was required. It argued that the breach relieved the insurer of any further obligations, including appraisal, and warranted summary judgment and no payment.
On appeal, the Florida Third DCA affirmed the trial court’s Order in a per curiam fashion and without full explanation of its reasoning. In doing so, the appellate court pointed directly to prior case precedent and noted rules to be followed. It noted that an insured’s failure to comply with post-loss duties can relieve the carrier of obligations on supplemental claims. It noted that trial courts can err by compelling appraisal before those post-loss duties are satisfied. It seemed to highlight that an Examination Under Oath is part of those material post-loss duties. Significantly, it also noted precedent that requires a meaningful exchange of information before a true disagreement exists for appraisal to start. Those seem to be the practical rules the appellate panel chose to highlight in affirming the trial court’s Order.
There are practical lessons for policyholders and their representatives. When you file a new or materially expanded claim in scope or value, and especially if you are filing a “supplemental claim” under Florida law, it is better to treat it as a restart of the adjustment process. Expect and prepare for renewed requests for examinations under oath, fresh site inspections, and new requests for books and records tailored to the new scope or value. Do not condition cooperation on appraisal or litigation positions. Instead, cooperate in good faith while preserving rights. If necessary, seek protective limits rather than refusing outright.
Some insurance companies are simply going to argue prejudice and will use the presumption of prejudice even if it does not exist. They will also take forever-lasting investigations and bait frustrated policyholders into litigation. Be cautious about filing a lawsuit too soon. I would suggest that policyholders and their representatives catalog all rebuttal evidence to the prejudice presumption in real time. This means keeping and finding as much contemporaneous evidence and documentation of conditions, repairs, and timelines so you can show, not just say, that the insurer’s ability to investigate has not been impaired. I would assume that courts will apply the presumption of prejudice rule precedent to require post-loss compliance before appraisal, and that a refusal to cooperate and aid the insurer in its investigation risks forfeiture.
It’s a tough ending. This was high-risk litigation, expertly briefed and argued on both sides, that ultimately resulted in the forfeiture of a $3 million claim because the refusal to comply with post-loss duties after a supplemental presentation was deemed a material breach with presumed, unrebutted prejudice. The law the Third DCA chose to emphasize tells you why the outcome held—and what future policyholders must do differently to avoid the same fate.
This case is a hard read because everyone lawyering it did strong work. I know, and have genuine respect for, both the policyholder’s counsel and the insurer’s counsel. The briefing was thoughtful, the arguments were crisp, and the stakes were enormous. The result shows how quickly a high-dollar claim can be lost when cooperation becomes the bargaining chip in an insurance claim dispute.
I have written many articles about post-loss obligations. The one on my mind most relevant to this post is “What is The Upside To Refusing To Appear At an Examination Under Oath?” where I stated:
I am writing this because I routinely field questions asking if policyholders can refuse to go to an examination under oath or asking for reasons which can defeat the insurer’s demand. While policyholders may win the legal argument for avoidance, policyholders should not place themselves in that position if they can avoid it. Unless there are criminal implications by giving the testimony, it is an ‘everything to lose and nothing to be gained’ from refusing to attend an examination under oath.
For some insurance companies and their counsel, this “you jump and I will tell you how high or you lose your right to bring a claim” position results in never-ending claims investigations and refusals to take a claims position because there is always something more that has to be provided and requested. The courts and insurance regulators should be wary of this abuse as well and make certain there are significant remedies for claims delays caused by these types of actors.
Thought for the Day
“By failing to prepare, you are preparing to fail.”
— Benjamin Franklin
1 Treasure Cay Condominium Association v. Frontline Ins. Unlimited Co., No. 3D-24-1196 (Fla. 3d DCA Oct. 1, 2025).
2 Treasure Cay Condominium Association v. Frontline Ins. Unlimited Co., No. 19-CA-000269 (Fla. Cir. Ct. – 16th Judicial Cir. June 7, 2024).