Experienced Public Adjusters · Florida property claims
Garcia: Causation and Insurance Appraisal in Context
A disagreement about why damage occurred can affect both coverage and the amount of loss. The appraisal clause, insurer’s actual position and governing law determine which issues can be submitted to appraisal.
Reviewed November 3, 2026. General information; policy wording, dates and applicable law matter.
What the 2019 decision addressed
In People’s Trust Insurance Co. v. Garcia, 263 So. 3d 231 (Fla. 3d DCA January 23, 2019), the dispute followed a roof leak. The insurer acknowledged interior water-damage coverage but disputed roof damage and elected to repair under a preferred-contractor endorsement.
The appellate court reversed the denial of the insurer’s motion to compel appraisal. Because coverage had not been wholly denied in that case, the disputed causation issue was treated as part of the amount-of-loss appraisal. The court distinguished that situation from a complete denial of a covered loss, where coverage issues are for the court.
What the decision does not promise
The ruling sent the dispute to appraisal; it did not automatically award a new roof or every requested repair. It should not be summarized as allowing appraisers to decide every legal coverage dispute. The policy, endorsement, demand and the insurer’s letters were important to the case.
This is a historical summary of the opinion, not a complete review of later appellate treatment or legal advice about a current claim. A Florida insurance attorney should evaluate whether and how the decision applies before you accept or resist an appraisal demand.
Assemble the actual record
- The complete policy, including appraisal and repair-option endorsements.
- Written coverage decisions identifying accepted and disputed damage.
- The appraisal demand, response and applicable dates.
- Inspection findings, photographs and estimates supporting each disputed item.
- Any election-to-repair correspondence, mediation notices or court orders.
Separate the observed physical damage from a legal conclusion about coverage. A professional report should explain its findings and limitations. Keep competing scopes organized by room, assembly or component so differences can be evaluated clearly.
Related Florida claim guidance
Read our appraisal and mediation overview and guide to appraiser qualifications and conflicts. Do not ignore response deadlines while gathering information.
Experienced Public Adjusters can help prepare and communicate the documented property loss within our licensed role. Legal interpretation, litigation and appraisal-enforcement disputes require counsel. Request an initial claim review to discuss your damage records and the insurer’s estimate.
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David Dwyer, designated primary adjuster: Florida license W391016. Experienced Public Adjusters, LLC: firm license W807213. We are not a law firm and do not guarantee coverage or a settlement result.