Florida/Georgia Personal Injury & Workers Compensation

...e insolvent insurer as if the insurer had not become insolvent. § 631.57(1)(b). "`Covered claim' means an unpaid claim . . . which arises out of, and is within the coverage, and not in excess of, the applicable limits of an insurance policy. . . ." § 631.54(3)....

...§ 631.57, Fla. Stat. (1995) (emphasis supplied). In a similar manner, the concept of a "covered claim" is defined and limited by the statutory definitional phrase "is within the coverage, and not in excess of, the applicable limits of an insurance policy." § 631.54(3), Fla....

...Under Florida's statutory insurer liquidation system, when an insurer becomes insolvent, FIGA becomes obligated to respond to covered claims that arise prior to adjudication of the insurer's insolvency and within a specified period after insolvency. Jones v. Fla. Ins. Guar. Ass'n , 908 So.2d 435, 442 (Fla. 2005); see § 631.54(3), Fla....

...(2010) (stating that residential coverage includes both personal lines residential coverage, such as that provided by homeowner's and similar policies, and commercial lines residential coverage, such as that provided by condominium association and similar policies). Section 631.54(5), Florida Statutes (2010), part of the FIGA act, also defines "homeowner's insurance" to exclude commercial policies such as those covering condominium associations or homeowners' associations....

...men's Compensation Act, the policy involved in this case was a policy of "reinsurance", and being a policy of reinsurance it could not qualify as "direct insurance", nor could any claim thereunder meet the definition of "covered claim" as set out in Section 631.54(4), F.S., the last sentence of which reads as follows: "`Covered claim' shall not include any amount due any reinsurer, insurer, insurance pool, or underwriting association, as subrogation recoveries or otherwise." (emphasis supplied)...

...st a reinsurer would necessarily involve "an amount due an insurer". The decisive issue here, then, is whether Zinke-Smith, having elected to become a "self-insurer" (as defined in Section 440.38, F.S.) was thereby an "insurer" within the meaning of Section 631.54(4), F.S., so that the policy of insurance with Home Owners was simply a form of reinsurance rather than merely one of excess liability....

...ida Insurance Code, and Section 624.03 defines insurer as follows: "`Insurer' includes every person engaged as indemnitor, surety, or contractor in the business of entering into contracts of insurance or of annuity." When the legislature provided in Section 631.54(4), F.S....

...In summary, we hold that the policy of insurance involved in this case was "direct *510 insurance within the scope of the Florida Insurance Guaranty Association Act, and that Zinke-Smith was not an insurer such as would prevent any amount due it from qualifying as a "covered claim" under Section 631.54(4), F.S....

...e insurer had not become insolvent." Indeed, we did overlook the provisions of Section 631.57(1)(b), F.S. We agree with appellant that the effect of that statute is to make FIGA an "insurer" on the "covered claim", which latter term is defined under Section 631.54(4), F.S....

...Co. of New York, 250 So.2d 259 (Fla. 1971); Auto Mutual Indemnity Co. v. Shaw, 134 Fla. 815, 184 So. 852 (1938). [3] There is no question that the allegations of the complaint were otherwise sufficient to state a bad faith-excess cause of action. [4] § 631.54(4), Fla....

...entered.” Id. at 607 . Appellee contends that these cases involve claims for workmen’s compensation and do not apply in the context of fire insurance claims. The compensation sought in each of those cases was for a “covered claim,” Fla.Stat. § 631.54(3), which FIGA is obligated to pay under *1533 § 631.57(l)(a)....

...In addition, one recent decision, also not involving workmen’s compensation, specifically prohibited an award of pre-judgment interest upon claims against FIGA for unearned premiums, which are “covered claims” for which FIGA is obligated, Fla. Stat. § 631.54 (3)....

...ive at a fair value for the [covered loss] damage, while excluding payment for the repairs required by [other causes]”). . FIGA also expresses concern about the outcome of the case, including having to pay the insured directly, in contravention of section 631.54(3)(c); having to pay more than the "covered losses,” under a particular version of section 631.54; having to pay attorney’s fees for which it is not liable; and so on....

...3d DCA 1987), we reverse the trial court's order granting summary judgment and entering final judgment in favor of Upper Keys Marine Construction, Inc. Mistakenly treating appellant's indemnity claims as subroation claims, the court granted summary judgment in favor of Upper Keys, basing its conclusions upon section 631.54(3), Florida Statutes (1979), which prohibits subrogation actions by one insurer against the insured of another insolvent insurer....

...Essentially, Moody and MasTec took the position that because Federated is a member of FIGA, and Moody and MasTec’s insurer, Reliance Insurance Company 3 (“Reliance”), is both a FIGA member and insolvent, Fla. Stat. § 631.54 bars Federated’s claims. Section 631.54(3)(b) provides that “[m]ember insurers shall have no right of subrogation, contribution, indemnification, or otherwise, sought directly or indirectly through a third party, against the insured of any insolvent member.”1 It is un...

...Exch. v. R.D. Moody & Assocs., Inc., 391 F. Supp. 2d 1228 (M.D. Ga. 2005). After acknowledging that he was bound to apply Georgia’s choice of law rules in this diversity case, the district judge 1 Prior to its amendment in 2004, § 631.54(3)(b) provided that member insurers had “no right of subrogation against the insured of any insolvent member.” 4 proceeded to discuss those rules. Id. at 1230-31. Then, without explicitly stating why Florida law applied, the district court determined that Federated’s subrogation claim was a “covered claim” under FIGA and it was barred by Fla. Stat. § 631.54(3)(b)....

...In addition, under section 631.57(1)(b), FIGA shall "[b]e deemed the insurer to the extent of its obligation on the covered claims." Thus, FIGA is responsible for the damages otherwise owed by Reliance only if those damages constitute a covered claim as defined by chapter 631. Section 631.54(3) defines covered claim: "Covered claim" means an unpaid claim, including one of unearned premiums, which arises out of, and is within the coverage, and not in excess of, the applicable limits of an insurance policy to which this part...

...ainst Reliance in bankruptcy court. While we agree with Vernay that this result may seem unfair, we are powerless to rewrite either chapter 631 or the insurance policy provisions to provide reimbursement for these breach of contract damages. Because section 631.54(3) and the provisions of the insurance policies make it clear that Vernay's damages do not constitute a covered claim, we reverse both judgments for attorney's fees and costs against FIGA....

...thstanding Travelers' lien for medical benefits it paid for claimant's benefit under a medical insurance policy covering claimant. The principal issue is whether the deputy commissioner had jurisdiction to determine whether Travelers is precluded by section 631.54(3), Florida Statutes (1983), from recovering any sums from FIGA....

...After the court's decision, and presumably in compliance with the affirmed order, FIGA sent Feuer a check for $78,759.82, the amount of Sitko's medical bills which FIGA estimated remained unpaid. Attached to the check was a letter stating that, as FIGA interpreted it, section 631.54(3), Florida Statutes (1983), [1] authorized FIGA to pay only "covered claims," i.e....

...l case, only the employer/carrier and the claimant will be "interested parties." In any event we hold, for the reasons stated below, that the deputy did not have jurisdiction to decide the issue of FIGA's liability or lack thereof to Travelers under section 631.54(3), and we need not reach the question of the deputy's possible jurisdiction over Travelers had a different issue been involved....

...Travelers has no lien on the funds paid to Feuer's trust account for the unpaid medical providers; therefore, its chapter 440 remedy must be asserted in circuit court. Accordingly, that portion of the deputy's order of modification which purports to determine FIGA's liability to Travelers under section 631.54(3) is invalid and vacated....

...At the time of the accident, the City of Tampa maintained liability insurance through Integrity Insurance Company with limits of coverage of $3,000,000 per occurrence. Integrity became insolvent and pursuant to chapter 631, Florida Statutes (1985), FIGA became obligated to pay Integrity's "covered claims," as defined by section 631.54(3), [2] Florida Statutes (1985)....

...1988). The concept of "an unpaid claim ... which arises out of, and is within the coverage, and [is] not in excess of the applicable limits of an insurance policy ...," is a helpful definition, but it does not truly define the nature of a "claim." § 631.54(3), Fla....

...Guaranty Ass’n v. Soto, 979 So.2d 964 *315 (Fla. 3d DCA 2008). 1 Because Petty’s attorney’s fee award pursuant to section 627.428(1), Florida Statutes (2008), is not within the coverage of her insurance policy, it is not a covered claim under section 631.54(3), Florida Statutes (2008), that the Florida Insurance Guaranty Association (FIGA) must pay....

...Because Petty’s section 627.428(1) fee award was not based upon a coverage provision of Petty’s underlying insurance policy, the Second District held that the fee award was not within the coverage of Petty’s policy and was not a covered claim that FIGA must pay under section 631.54(3), Florida Statutes. Id. The Second District certified conflict with the Third District’s decision in Soto, 979 So.2d at 966 , which held that a section 627.428(1) fee was a covered claim under section 631.54(3) because the insurance policy at issue, as a matter of law, was subject to the obligations of section 627.428(1)....

...Acquisition Co., 734 So.2d 403 , 411 n. 10 (Fla.1999)). Section 631.57(l)(a), Florida Statutes (2008) (emphasis added), provides that FIGA shall “[b]e obligated to the extent of the covered claims existing” prior to an insurer’s adjudication of insolvency. Section 631.54(3) defines a covered claim as: an unpaid claim, including one of unearned premiums, which arises out of, and is within the coverage, and not in excess of, the applicable limits of an insurance policy to which this part applies, issued...

...an insurer, if such insurer becomes an insolvent insurer and the claimant or insured is a resident of this state at the time of the insured event or the property from which the claim arises is permanently located in this state. A plain reading 2 of section 631.54(3) indicates that a covered claim must meet two distinct requirements: (1) it must arise, or originate, from an insurance policy and (2) it must be within the coverage of, or be included within the risks taken on and losses protected against in, an insurance policy....

...3 The parties do not contest that Petty’s section 627.428(1) fee award arose from her underlying insurance policy. In order to recover from FIGA, however, Petty’s claim for fees must also be within the coverage of her underlying insurance policy. See § 631.54(3), Fla....

...laim. It does not alter the coverage provisions of the insurance contract itself. 4 III. Conclusion Because Petty’s underlying insurance policy does not expressly provide coverage for a section 627.428(1) fee award, it is not a covered claim under section 631.54(3) that FIGA must pay....

...r statutory construction is not necessary. Id. . Petty argues that a claim for unearned premiums would not be covered unless a policy expressly included a coverage provision guaranteeing that the insured could recover any unearned premiums. However, section 631.54(3) expressly includes claims for unearned premiums in the definition of a covered claim....

...t it was amenable, as Consolidated's replacement, to the petition for a rule nisi. We next hold, despite its argument to the contrary, that the attorney's fee awards in the compensation proceedings are "covered claims" for which FIGA is responsible. Section 631.54(4), Florida Statutes (1979) provides: (4) `Covered claim' means an unpaid claim ......

...The applicable statute defines "covered claim" as: [A]n unpaid claim, including one of unearned premiums, which arises out of, and is within the coverage, and not in excess of, the applicable limits of an insurance policy to which this part applies. .. . § 631.54(3), Fla....

...ed. Based on the errors and omissions of the insurance agent as alleged in this case, [4] we do not think there is a sufficient basis to find a "covered claim" under Chapter 631. [5] AFFIRMED. DAUKSCH and COBB, JJ., concur. NOTES [1] §§ 631.51(1), 631.54(3), Fla....

...e law, we find only one issue which warrants discussion: whether the trial court's award of pre-insolvency court costs is erroneous. Apparently, the trial court believed that the pre-insolvency court costs were "covered claims" within the meaning of section 631.54(4), Florida Statutes (1981). Kenilworth Insurance Company, pursuant to its contractual duty to defend Price, incurred the $44.60 in court costs through the Piper firm. As Price did not incur the costs, they are not covered claims under section 631.54(4)....

...(FIGA), appeals the final summary judgment ordering it to pay approximately $237,000 directly to Tammy Bernard for sinkhole loss to her home. FIGA argues that the trial court erred in determining that its liability for this loss was governed by the 2010 definition of “covered claim” in section 631.54(3), Florida Statutes, rather than the more restrictive definition in the 2011 version of the statute....

...ory definition of “covered claim” applied. The court rejected FIGA’s argument that the 2011 definition applied and instead found “as a matter of law that [Bernard] is entitled to payment of amounts due on a ‘covered claim,’ as defined by Section 631.54(3), Fla....

...“Covered claim” shall not include: (a) Any amount due ... as subrogation, contribution, indemnification, or otherwise; or (b) Any claim that would otherwise be a covered claim under this part that has been rejected by any other state guaranty fund .... § 631.54(3), Fla....

...r public adjuster’s fees in connection with a sinkhole loss or pay the policyholder. The association may pay for actual repairs to the property but is not liable for amounts in excess of policy limits. Ch. 2011-39, § 30, Laws of Fla. (codified at § 631.54(3)(c), Fla....

...Phillips, 134 So.3d 505 (Fla. 5th DCA 2014) (reversing order requiring insurer to pay subsurface repair costs because the policy gave the insurer the authority to withhold payment for such costs until the insured contracted for the repairs). . The creation of section 631.54(3)(c) was one of a number of provisions in chapter 2011-39 intended to ensure that sinkhole insurance claim proceeds are actually used to remediate the sinkhole damage and repair the property....

...Dixie Lloyds Ins. Co., 655 So.2d 303 (La.1995). . The Texas Guaranty Act uses the term "impairment” rather than “insolvency,” but the terms appear to have the same meaning. Compare § 462.004(5), Tex. Ins. Code (defining "impaired insurer”) with § 631.54(6), Fla....

...The purposes of this statute, as stated in § 631.51 are as follows: "(1) Provide a mechanism for the payment of covered claims under certain insurance policies to avoid excessive delay in payment and to avoid financial loss to claimants or policyholders because of the insolvency of an insurer;" § 631.54(4) provides: "`Covered claim' means an unpaid claim, including one of unearned premiums, which arises out of and is within the coverage, and not in excess of, the applicable limits of an insurance policy to which this part applies, issued b...

...that the claimant or policyholder be a resident of this state is to require that FIGA only guarantee payment to Florida residents who would otherwise suffer loss through the insolvency of an insurer authorized to transact business in this state. See § 631.54(5). Here the claimant Dolan qualifies under § 631.54(4), above quoted, as a resident of this state but his claim is not a covered claim because it is not an unpaid claim....

...f Main's assets located in Florida. The trial court's order of insolvency and liquidation is of concern to FIGA because the order triggered FIGA's statutory obligation to pay the covered claims of Main's Florida insureds and creditors under Sections 631.54(4), (5) and 631.57(1), Florida Statutes (1979)....

...ainst delay in payment and financial loss occasioned by the insolvency of an insurer. Section 631.511, Florida Statutes. [2] Funds for FIGA's payment of covered claims are raised by assessments levied by the Department against all "member insurers" (Section 631.54(6)) which are then remitted to and administered by FIGA's board of directors. Section 631.57(3)(a). FIGA's liability for claims is governed by the statutes. Section 631.57(1), Florida Statutes, imposes the obligation upon FIGA to pay "covered claims," defined in Section 631.54(4) as claims arising out of insurance policies issued by an insolvent insurer. The term "insolvent insurer" is defined in Section 631.54(5), Florida Statutes (1979) as follows: (5) "Insolvent insurer" means a member insurer authorized to transact insurance in this state, either at the time the policy was issued or when the insured event occurred, and against which an or...

...sessions just ended) have come and gone without amendments to the law which would have allowed the Department to demand action by FIGA toward payment of covered claims without further delay. Thirdly, we note the enactment in 1979 of an amendment to Section 631.54(5) [5] which imposed the additional requirement *818 of a court order of liquidation (which we have discussed in this opinion), in addition to a finding of insolvency, as a prerequisite to FIGA's obligation to pay claims against insolvent insurers. Absent the 1979 amendment referred to the trial court's order herein, finding Main insolvent, would have been sufficient to trigger FIGA's obligation to pay claims. This is so because, prior to the 1979 amendment, Section 631.54(5) defined "insolvent insurer" as an insurer "adjudicated to be insolvent by a court of competent jurisdiction, if such adjudication has become final by the exhaustion of appellate review." There formerly existed no requirement of an "...

...iation. New Jersey Property & Liability Insurance Guaranty Association v. Sheeran, 137 N.J. Super. 345, 349 A.2d 92 (1975). [6] In conclusion, it is our opinion that the change in the law governing FIGA's liability, effected by the 1979 amendment to Section 631.54(5), presents issues not adjudicated by the trial court's order, and which have not been briefed or argued in this appeal....

...ary state. Thus the trial court's order runs contrary to these statutory provisions, which are a part of the Uniform Act. [5] According to Florida House and Senate Staff Reports the Department of Insurance apparently encouraged the 1979 amendment to Section 631.54(5)....

...694 Committee files, Senate Commerce Committee Office, The Capitol; House Committee on Insurance Staff Report, April 20, 1979, HB 1430, Committee files, State Archives Building, Cartons 475-478, and 478T. [6] FIGA suggests that the 1979 amendment to Section 631.54(5), Florida Statutes, was motivated by the desire to avoid, in Florida, the same result as occurred in the Sheeran case....

...(1989) (State may recover investigative costs, court costs, and attorney's fees incurred to protect State's water resources); § 489.132(3), Fla. Stat. (1989) (violation of licensing provisions may result in fine and assessment for investigative and legal costs); § 631.54(5), Fla....

...After a hearing and argument before the court resulting in the trial court's announcement of a ruling in favor of Empire for the full amount of its damages, FIGA filed a motion for reduction of its liability for any judgment rendered on the contribution claim, basing its motion on the provisions of section 631.54(3), Florida Statutes (1985), which states in part that a "covered claim" does not include any amount owed an insurer, a reinsurer, or an underwriting association as subrogation recoveries or otherwise....

...is issue takes a rather novel turn as presented by McKenzie. Based upon the distinctions between the rights of a party entitled to recovery by way of subrogation, as opposed to contribution, [2] and relying upon provisions found in the FIGA statute, section 631.54(3), McKenzie argues that since Empire's right to contribution fails, its right to full recovery of its judgment against McKenzie and FIGA also fails. Pursuing this argument, McKenzie first points to the definition of "covered claim," under section 631.54(3), which states, in part: (3) "Covered claim" means an unpaid claim, ......

...or policy holders because of insolvency of an insurer, and the assessment of the cost of such protection of claimants and policy holders among insurers. Section 631.51(1), (4). Next, we agree, as stated by the trial judge in the final judgment, that section 631.54(3), excluding from the definition of "covered claim" any "amount due any reinsurer, insurer, insurance pool, or underwriting association, as subrogation recoveries or otherwise," does not exclude the claim of Empire because Empire does not fall into any of these categories....

...District Court of Appeal of Florida, Fourth District. April 1, 1981. Jeffrey F. Berin, Palm Beach, for appellant. *1277 G. William Bissett of Preddy, Kutner & Hardy, P.A., Miami, for appellee. LETTS, Chief Judge. Involved here is the question of whether a solvent member insurer under Section 631.54(4), Florida Statutes (1977) has a right of subrogation against the individual insured of another insolvent carrier member of F.I.G.A....

...Meanwhile upon the adjudication of Roulis' carrier as insolvent, the Florida Insurance Guaranty Association (FIGA) assumed Roulis' defense and filed a motion to dismiss the solvent carrier's subrogation claim on the grounds that such claim was precluded under Section 631.54(4), Florida Statutes (1977) which concludes with the following sentence: Member insurers shall have no right of subrogation against the insured of any insolvent member....

...Chelton, 388 So.2d 1281 (Fla. 3d DCA 1980), we adhere to our conclusion that it is. Segal v. Garrigues, 320 So.2d 475 (Fla. 4th DCA 1975). The solvent carrier argues first that since the accident occurred prior to the adoption of the 1977 version of Section 631.54(4) then the previous 1970 version is applicable....

...See Government Employees Insurance Co. v. Wheelus, 319 So.2d 181 (Fla. 4th DCA 1975). It is undisputed that the underinsured benefits were paid subsequent to the enactment of the 1977 version of the statute. The solvent carrier next argues that this is not a "covered claim" under Section 631.54(4) because a covered claim is the equivalent of an unpaid claim....

...A "covered claim" is "an unpaid claim, including one of the unearned premiums, which arises out of, and is within the coverage, and not in excess of, the applicable limits of an insurance policy to which this part applies, issued by an insurer, if such insurer becomes an insolvent insurer." § 631.54(3), Fla....

...Florida Statutes (1981). As potential creditors of Iowa National, both DeFourny and the carrier filed claims with FIGA pursuant to section 631.181, Florida Statutes (1981). FIGA denied the carrier's claim as not being a "covered claim" as defined by section 631.54(3), Florida Statutes (1981)....

...statute. Deltona Corp. v. Florida Public Service Commission, 220 So.2d 905 (Fla. 1969). Since the clear legislative intent behind the section 440.39(3)(a) lien is to avoid a double recovery, we see no reason why the definition of "covered claim" in section 631.54(3) and the prohibition against subrogation claims contained therein should operate to nullify that intent....

...Finally, in construing two statutes courts have a duty, whenever possible, to preserve the force of both without destroying their evident intent. See Markham v. Blount, 175 So.2d 526 (Fla. 1965). Since we have determined that the definition of "covered claims" in section 631.54(3) applies to claims filed pursuant to the provisions of chapter 631 and not to workmen's compensation liens filed pursuant to section 440.39(3), both statutes can be given effect without destroying the evident intent of either statute....

...ien is neither a subrogation claim nor a claim of any other type filed against the receiver of the insolvent insurer under the provisions of chapter 631. We, accordingly, hold that although the prohibition against subrogation recoveries contained in section 631.54(3) justified FIGA's denial of the carrier's claim filed directly with FIGA pursuant to section 631.181, the prohibition cannot properly be applied to justify striking the carrier's lien filed pursuant to section 440.39(3)(a)....

...rt applies, issued by an insurer, if such insurer becomes an insolvent insurer and the claimant or insured is a resident of this state at the time of the insured event or the property from which the claim arises is permanently located in this state. § 631.54(3) (emphasis added)....

...Id. Thus, "the statutory language defines the extent of FIGA's obligations. FIGA is not responsible for claims against an insurer that do not fall within FIGA's statutory obligations." Id. at 1130. In addressing the definition of "covered claim" in section 631.54(3), this court stated, "Under the plain language of the statute, to be a covered claim, the claim must both `arise out of' the insurance policy and be `within the coverage of' the insurance policy." Id....

...to the settlement agreement. Id. In reaching its conclusion to affirm the award of fees, the Third District stated that a covered claim was "an unpaid claim arising out of and covered by a policy issued by the insolvent insurer." Id. at 966 (citing section 631.54(3), Florida Statutes (2001))....

...The court then recognized that "section 627.428 is an implicit part of all insurance policies of the kind involved here." Id. (citing State Farm Fire & Cas. Co. v. Palma, 629 So.2d 830, 832 (Fla. 1993)). The Third District then concluded that Soto's stipulated but unpaid attorney's fee judgment was a "covered claim" under section 631.54(3)....

...legislature limited FIGA's obligation to the express terms of the policy." Notably, the parties have not pointed to any language in the applicable insurance policy that provides coverage for fees awarded under section 627.428. Thus, we conclude that section 631.54(3) does not impose coverage for fees claimed under section 627.428 when such fees are not within the insurance policy's coverage provisions....

..."It should be noted that the definition of `insolvency' as contained in Section 631.011 of the Florida Statutes was not incorporated in the 1971 uninsured motorists statute, being Section 627.727 of the Florida Statutes, but rather the definition as set forth in Section 631.54(5) was incorporated in the uninsured motorists statute. Section 631.54(5) of the Florida Statutes in defining `insolvent insurer' says: "Insolvent insurer" means an insurer authorized to transact insurance in this State either at the time the policy was issued or when the insured event occurred and adjudi...

...tion, and is therefore of little assistance in reaching a determination in the instant case. "The defendants rely upon the 1973 Florida Uninsured Motorist Statute, Section 627.727, which defines `insolvent insurer' by referring to Florida Statute Subsection 631.54(5), which has been referred to hereinabove....

...ind need to add little to the foregoing opinion of the trial court, which we hold correctly decided the question involved. The appellants argue that while the trial court's decision of the question may be in accordance with § 627.727(3) and (4) and § 631.54(5) Fla....

...ees, and expert witness fees. FIGA answered the amended complaint on July 30, 2012, and alleged that it had not denied coverage to the Hunnewells and that it was ready to pay the Hunnewells for “actual repairs to the property” in accordance with section 631.54(3), Florida Statutes (2011). FIGA alleged that under section 631.54(3)(c), it was only obligated to pay for “the actual repair of the loss” and that it could not pay attorney’s fees or public adjuster fees or pay the policy holder directly....

...FIGA argued (1) that appraisal was not an appropriate remedy to resolve the dispute over the correct method of repair; (2) that even if appraisal were appropriate for that purpose, it was inappropriate in the context of a sinkhole claim because under the 2011 amendment to section 631.54(3)(e), FIGA may only pay the contractor the cost for “actual repairs” and the “amount of loss” was to be determined as the repairs were performed; and (3)' that the Hunne-wells had waived any right to seek appraisal by their active litigation of the case to that point....

...ls waived any right to appraisal by engaging in litigation activities for an extended period before requesting appraisal. The issue of whether the Hunnewells were entitled to appraisal under the terms of their policy under the *991 2011 amendment to section 631.54(3) is controlled by this court’s decision in de la Fuente....

...5th DCA 2014) (“Here, while the trial court made no findings of fact on the issue of waiver, the facts are not in dispute. Therefore, we review the waiver issue de novo.”). Our review of the question of the applicability of the 2011 amendment to section 631.54(3) to the Hunne-wells’ rights under the policy is a question of statutory construction that we review de novo....

...n this court’s recent decision in de la Fuente. The provisions in the Hunnewells’ policy are the same as the provisions under review in de la Fuente. Under the analysis in that case, the definition of “covered claim” in the 2011 amendment to section 631.54(3) is applicable, and appraisal is unavailable under the amended statute to determine the amount of loss....

...CONCLUSION For the foregoing reasons, we reverse the order compelling appraisal and remand for further proceedings consistent with this opinion. As we did in de la Fuente, we certify the following questions to the Florida Supreme Court as questions of great public importance: I. DOES THE DEFINITION OF “COVERED CLAIM” IN SECTION 631.54(3), FLORIDA STATUTES, EFFECTIVE MAY 17, 2011, APPLY TO A SINKHOLE LOSS UNDER A HOMEOWNERS’ POLICY THAT WAS ISSUED BY AN INSURER BEFORE THE EFFECTIVE DATE OF THE NEW DEFINITION WHEN THE INSURER WAS ADJUDICATED TO BE INSOLVENT AFTER THE EFFECTIVE DATE OF THE NEW DEFINITION? II....

...Ins. Guar. Ass’n v. Devon Neighborhood Ass’n, 67 So.3d 187, 189 (Fla.2011); see §§ 631.51, 631.55, Fla. Stat. (2011). . FIGA also raises concerns regarding the limits on its liability and having to directly pay the insureds in contravention of section 631.54(3), Florida Statutes (2011). Our scope of review is limited to determining whether the court erred in compelling appraisal. We have no authority to decide whether the trial court applied the correct version of section 631.54(3), Florida Statutes....

...facilitator to liquidator. On that date, pursuant to section 631.57 of the Florida Statutes and the Consent Order, FIGA was deemed Mendoza’s insurer to the extent that Mendoza’s claims against First Home were “covered claims,” as that term is defined in section 631.54(3) of the Florida Statutes. On December 6, 2011, First Home filed a copy of the Consent Order in the instant case, along with a Notice of Mandatory Stay of Proceedings, whereby the trial court and the parties were informed tha...

...part applies, issued by an insurer, if such insurer becomes an insolvent insurer and the claimant or insured is a resident of this state at the time of the insured event or the property from which the claim arises is permanently located in this state. § 631.54(3), Fla....

...rt applies, issued by an insurer, if such insurer becomes an insolvent insurer and the claimant or insured is a resident of this state at the time of the insured event or the property from which the claim arises is permanently located in this state. § 631.54(3) (emphasis added)....

...Thus, “the statutory language defines the extent of FIGA’s obligations. FIGA is not responsible for claims against an insurer that do not fall within FIGA’s statutory obligations.” Id. at 1130 . In addressing the definition of “covered claim” in section 631.54(3), this court stated, “Under the plain language of the statute, to be a covered claim, the claim must both ‘arise out of the insurance policy and be ‘within the coverage of the insurance policy.” Id....

...the settlement agreement. Id. In reaching its conclusion to affirm the award of fees, the Third District stated that a covered claim was “an unpaid claim arising out of and covered by a policy issued by the insolvent insurer.” Id. at 966 (citing section 631.54(3), Florida Statutes (2001))....

...icies of the kind involved here.” Id. (citing State Farm Fire & Cas. Co. v. Palma, 629 So.2d 830, 832 (Fla. 1993)). The Third District then concluded that Soto’s stipulated but unpaid attorney’s fee judgment was a “covered claim” under section 631.54(3)....

...slature limited FIGA’s obligation to the express terms of the policy.” Notably, the parties have not pointed to any language in the applicable insurance policy that provides coverage for fees awarded under section 627.428. Thus, we conclude that section 631.54(3) does not impose coverage for fees claimed under section 627.428 when such fees are not within the insurance policy’s coverage provisions....

...3d 115 (Fla. 2015), in which the Second District Court of Appeal ruled upon the following questions certified under article I, section 3(b)(4) of the Florida Constitution to be of great public importance: I. DOES THE DEFINITION OF “COVERED CLAIM” IN SECTION 631.54(3), FLORIDA STATUTES, EFFECTIVE MAY 17, 2011, APPLY TO A SINKHOLE LOSS UNDER A HOMEOWNERS’ POLICY THAT WAS ISSUED BY AN INSURER BEFORE THE EFFECTIVE DATE OF THE NEW DEFINITION WHEN THE INSURER WAS ADJUDICATED...

...However, “the full gamut of a defunct insurance company’s liabilities was not intended to be shifted onto FIGA.” FIGA v. Devon Neighborhood Ass’n, Inc., 67 So. 3d 187, 189-90 (Fla. 2011) (citations and footnote omitted). -8-  The statute at issue here is section 631.54(3), Florida Statutes (2011), in which the Legislature amended the definition of “covered claim” to limit FIGA’s financial responsibility for sinkhole loss....

...into the shoes of their insurer from the date the policy issued. They thus claim their “right” to recover against FIGA vested in 2009. de la Fuente, 158 So. 3d at 678. And as a result, they conclude that the 2009 statutory definition of “covered claim” in section 631.54, applies to their claim of sinkhole loss, and that the district court’s application of the 2011 statute, constituted an invalid retroactive application of the law. We disagree. -9-  The provision chiefly at issue in this case is the statutory definition of “covered claim” in section 631.54(3)....

...pay for attorney’s fees or public adjuster’s fees in connection with a sinkhole loss or pay the policyholder. The association may pay for actual repairs to the property but is not liable for amounts in excess of policy limits. § 631.54(3), Fla. Stat. (2011) (emphasis added). The 2011 amended statute does not prohibit FIGA from paying for a “covered claim” of sinkhole loss. But the plain language of section 631.54(3)(c), Florida Statutes (2011), does expressly limit how FIGA “covers” the claim....

...�covered claim.” See §§ 631.55- .57, Fla. Stat. The insurer’s insolvency triggers FIGA’s statutory duties. FIGA assumes no contractual duties absent statutory direction. As a result, in this case, the definition of “covered claim,” in section 631.54(3), Florida Statutes (2011), applies to Petitioners’ sinkhole loss claim, and the amended Florida statute is applicable prospectively—not retroactively as Petitioners claim....

...From the record, it seems that Continental should have prorated its uninsured benefits with those available under McLeod's Iowa National policy. See Sellers v. U.S. Fidelity & Guar. Co., 185 So.2d 689 (Fla. 1966). However, the parties treated the policy as excess, and did not make that an issue on appeal. [3] Section 631.54(3), Florida Statutes (1985), provides in part: "Member insurers shall have no right of subrogation against the insured of any insolvent member." [4] 15A Couch on Insurance 2d § 58:1 (1983): [T]he insurer should not be held liable for...

...Saldukas, 896 So.2d 707, 711 (Fla.2005); Fla. Ins. Guar. v. Reynolds, 148 So.3d 840 (Fla. 5th DCA 2014); Branco, 148 So.3d at 493 . In FIGA’s Answer, FIGA admitted that it “has agreed to pay Plaintiffs ‘covered claim’ for sinkhole loss as defined by Fla. Stat. § 631.54 (3)(c) (2011).” We believe that this was an admission of coverage....

...sured of an insolvent insurer or the association within 1 year after the deadline for filing claims, or any extension thereof, with the receiver of the insolvent insurer shall thenceforth be barred as a claim against the association and the insured. Section 631.54(3), Florida Statutes (1983) defines a "covered claim" to be [A]n unpaid claim, including one of unearned premiums, which arises out of, and is within the coverage, and not in excess of, the applicable limits of an insurance policy to w...

...Florida public policy prohibits liability insurance coverage for punitive damages assessed against a person because of his wrongful conduct. U.S. Concrete Pipe Co. v. Bould, 437 So.2d 1061 (Fla. 1983). Therefore, punitive damages could not fall within the "covered claim" provisions of section 631.54....

...See § 631.51, Fla. Stat. (2001). In short, "[t]he act is designed to protect Florida citizens, not the insurance industry." Jones, 908 So.2d at 442. "Covered claim" means an unpaid claim arising out of and covered by a policy issued by the insolvent insurer. § 631.54(3), Fla....

...The Florida Supreme Court has held that section 627.428 is an implicit part of all insurance policies of the kind involved here. See State Farm Fire & Cas. Co. v. Palma, 629 So.2d 830, 832 (Fla.1993). It follows that Soto's stipulated but unpaid attorney's fee judgment is a "covered claim" within the meaning of subsection 631.54(3)....

...The particular policy language in that case specified that Reliance would only pay reasonable expenses incurred by Vernay at Reliance's request. Because neither Reliance nor FIGA had made such a request, the court held that the attorney's fees were not a "covered claim" under subsection 631.54(3)....

"a 'covered claim' as defined by § 631.54(3), [Florida Statutes (2011),]1" and that

...The applicable statute defines “covered claim” as: [A]n unpaid claim, including one of unearned premiums, which arises out of, and is within the coverage, and not in excess of, the applicable limits of an insurance policy to which this part applies .... § 631.54(3), Fla....

...promised. Based on the errors and omissions of the insurance agent as alleged in this case, 4 we do not think there is a sufficient basis to find a “covered claim” under Chapter 631. 5 AFFIRMED. DAUKSCH and COBB, JJ„ concur. . §§ 631.51(1), 631.54(3), Fla....

...(1) The association shall: (a) Be obligated to the extent of the covered claims existing: [[Image here]] 2. The obligation under subparagraph 1. includes only the amount of each covered claim which is in excess of $100 and is less than $300,000, ... Section 631.54(3) defines a “covered claim” as: “Covered claim” means an unpaid claim, including one of unearned premiums, which arises out of, and is within the coverage, and not in excess of, the applicable limits of an insurance policy to...

...After this court issued its Miller decision, Heid filed an amended motion for fees, asserting that "when FIGA denies coverage for sinkhole loss, then later accepts coverage, the [i]nsured is entitled to fees pursuant to Florida statute 631.70." FIGA responded that fees were precluded under section 631.54(3)(c) because the fees were "in connection with a sinkhole loss," that a large portion of Heid's fees were for testing and thus prohibited by section 631.54(3)(c), that Heid's claim was not a "covered claim" at the time it was affirmatively denied by FIGA, and that Heid was not entitled to costs because no judgment had been entered. After a hearing, the trial court denied Heid's motion for fees, concluding that the fees Heid spent on testing for a sinkhole loss were excluded under the definition of "covered claim" in section 631.54(3)(c) as interpreted by Miller and that any fees related to sinkhole repairs after FIGA agreed to coverage were also barred by section 631.54(3)(c)....

...an insolvent insurer and the claimant or insured is a resident of this state at the time of the insured event or the property from which the claim arises is permanently located in this state. § 631.54(3).1 The statute goes on to describe certain things that the term does not include, but the definition of "covered claim" does not contain any language regarding FIGA's determination or assessment of the claim....

...ch is "to avoid excessive delay in payment," § 631.51(1). Because FIGA affirmatively denied Heid's claim, which was a covered claim, section 631.70 is satisfied. We now turn to the trial court's ruling that fees are precluded under section 631.54(3). Section 631.54(3) provides that a covered claim does not include: (c) Any amount payable for a sinkhole loss other than testing deemed appropriate by the association or payable for the actual repair of the l...

...its. (Emphasis added.) In Miller, this court considered whether an insured could obtain attorney's fees under section 631.70, even though the definition of a covered claim contains language specifically excluding attorney's fees in section 631.54(3)(c)....

...allows the insured to seek attorneys' fees related to the enforcement of the policy itself." Miller, 200 So. 3d at 203. In other words, section 631.70 allows "fees in connection with the policy itself and FIGA's refusal to honor it." Miller, 200 So. 3d at 204. On the other hand, section 631.54(3)(c) disallows "attorney's fees related to: (1) testing for a sinkhole loss, and (2) repair of a sinkhole loss." Id....

...uld potentially seek to recover attorney's fees under his or her insurance policy and related to the testing for or repair of a sinkhole loss." Id. In those circumstances, FIGA would be insulated from paying such fees according to the language in section 631.54(3)(c)....

...4th DCA 1981); Harris v. Winn-Dixie Stores, Inc., 378 So.2d 90 (Fla. 1st DCA 1979); Industrial Trucks of Fla., Inc. v. Gonzalez, 351 So.2d 744 (Fla. 3d DCA 1977); St. Anne Airways Corp. v. Larotonda, 308 So.2d 129 (Fla. 3d DCA) cert. denied, 316 So.2d 295 (Fla.1975); § 631.54(4), Fla.Stat....

...he statutory deductible set forth in section 631.57(1)(a)(2), Florida Statutes (2009). Pupo initiated this appeal arguing that contrary to this and other appellate courts' prior holdings, the amended definition of "covered claim" in section 631.54(3)(c), Florida Statutes (2011), does not apply to claims arising out of insurance policies that were issued before the effective dates of the statutory amendment....

...We reverse the order compelling appraisal and remand for further proceedings. For the reasons expressed in Florida Insurance Guaranty Ass’n v. de la Fuente, 158 So.3d 675 (Fla. 2d DCA 2015), we conclude that appraisal is not available under the 2011 amendment to section 631.54(3), Florida Statutes, applicable to this case....

...As a result, they waived any right to appraisal they may have had. See id. at D356. As we did in de la Fuente, we certify the following questions to the Florida Supreme Court as questions of great public importance: I. DOES THE DEFINITION OF “COVERED CLAIM” IN SECTION 631.54(3), FLORIDA STATUTES, EFFECTIVE MAY 17, 2011, APPLY TO A SINKHOLE LOSS UNDER A HOMEOWNERS’ POLICY THAT WAS ISSUED BY AN INSURER BEFORE *1031 THE EFFECTIVE DATE OF THE NEW DEFINITION WHEN THE INSURER WAS ADJUDICATED TO BE INSOLVENT AFTER THE EFFECTIVE DATE OF THE NEW DEFINITION? II....

...2d DCA 2015), we reverse the order compelling appraisal and remand for further proceedings. As in de la Fuente, we certify the following questions to the Florida Supreme Court as questions of great public importance: I. DOES THE DEFINITION OF “COVERED CLAIM” IN SECTION 631.54(3), FLORIDA STATUTES, EFFECTIVE MAY 17, 2011, APPLY TO A SINKHOLE LOSS UNDER A HOMEOWNERS’ POLICY THAT WAS ISSUED BY AN INSURER BEFORE THE EFFECTIVE DATE OF THE NEW DEFINITION WHEN THE INSURER WAS ADJUDICATED TO BE INSOLVENT AFTER THE EFFECTIVE DATE OF THE NEW DEFINITION? II....

...nsurer would be.’ ” Fla. Ins. Guar. Ass’n v. Petty, 44 So.3d 1191 , 1194 (Fla. 2d DCA 2010) (quoting Fla. Ins. Guar. Ass’n v. All the Way until Bill Vernay, Inc., 864 So.2d 1126, 1129 (Fla. 2d DCA 2003)). However, under the plain language of section 631.54(3), Florida Statutes (2008), a claim is a “covered claim” if it arises out of the insurance policy and “is within the coverage, and not in excess of’ the policy limits....

BARFIELD, Judge. We reject appellant’s argument that common paternity denotes a single covered claim under section 631.54(4), Florida Statutes (Supp.1982)....

...denial of Miller's claim "by affirmative action other than delay." But although Miller met the threshold requirement for attorney's fees under section 631.70, the trial court ruled that Miller's claim for attorney's fees was specifically precluded by language in section 631.54(3)(c), Florida Statutes (2012), which excludes attorney's fees for sinkhole claims from "covered claims": (3) "Covered claim" means an unpaid claim, including one of unearned premiums, which arises out of...

...(Emphasis added.) On this statutory basis, the trial court denied Miller's attorney's fees motion. It is from this denial that Miller appeals. Miller raises two arguments on appeal. First, he argues that the trial court erred when it found that section 631.54(3)(c) invalidates the attorney's fees provision of section 631.70 because the rules of statutory interpretation allow both statutes to exist. Second, he argues that the trial court erred in applying the 2012 version of section 631.54(3)(c) to find that attorney's fees were not allowed because the pre-2011 version of section 631.54(3)(c), which does not contain the "sinkhole loss" exclusion under "covered claims," applies when the loss occurred in 2009....

...1st DCA 2012), the issue before us is one of statutory interpretation, to which the de novo standard of review applies. See Borden v. E.-European Ins. Co., 921 So. 2d 587, 591 (Fla. 2006). Regarding Miller's argument that the trial court erred when it found that the definition of "covered claims" in section 631.54(3)(c) precludes the grant of attorney's fees under section 631.70, we initially note that "[t]here exists a presumption that laws are passed with knowledge of all prior laws already on the books, as well as a presumption that the le...

...Bentley, 496 So. 2d 862, 863 (Fla. 2d DCA 1986). Accordingly, we must first endeavor to adopt -4- a scheme of statutory construction that reconciles any inconsistencies between sections 631.70 and 631.54(3)(c) and preserves the force and effect of both. See id. at 864. We find the language of section 631.54(3)(c) that excludes attorney's fees from "covered claims" in relation to a sinkhole loss to be reconcilable with the provisions of section 631.70. This is so because the structure of section 631.54(3)(c) indicates that the legislature intended to exclude from "covered claims" any attorney's fees related to: (1) testing for a sinkhole loss, and (2) repair of a sinkhole loss....

...reasonable attorney's fees and other expenses incurred in defending the action brought by [a] third party as damages for the breach of contract."). These would be fees specifically "in connection with a sinkhole loss" from which FIGA would be insulated from under 631.54(3)(c)'s exclusion from covered claims, as opposed to fees in -5- connection with the policy itself and FIGA's refusal to honor it. Thus, we find that the language in section 631.54(3)(c) that excludes attorney's fees in sinkhole cases from "covered claims" does not override section 631.70's language that allows payment of attorney's fees when FIGA denies a claim by affirmative act, and further that the trial c...

...as subrogation, contribution, indemnification, or otherwise; or (b) Any claim that would otherwise be a covered claim under this part that has been rejected by any other state guaranty fund . . . . § 631.54(3), Fla. Stat. (2008). The legislature amended the definition of "covered claim" effective May 17, 2011, by adding a new paragraph (c) to section 631.54(3)....

...It seems reasonable to assume that these issues will continue to arise in numerous cases. For this reason, we certify the following questions to the Florida Supreme Court as questions of great public importance: I. DOES THE DEFINITION OF "COVERED CLAIM" IN SECTION 631.54(3), FLORIDA STATUTES, EFFECTIVE MAY 17, 2011, APPLY TO A SINKHOLE LOSS UNDER A HOMEOWNERS' POLICY THAT WAS ISSUED BY AN INSURER BEFORE THE EFFECTIVE DATE OF THE NEW DEFINITION...

...about the method necessary to repair the damage. Ultimately, the circuit court granted Frank's motion to compel an appraisal, a process provided for in the Homewise insurance policy. FIGA argues that appraisal is not appropriate under section 631.54(3)(c), Florida Statutes (2011)....

...Part of the FIGA Act, §§ 631.50-.70, Fla. Stat. (2011), this statute excludes from the definition of covered claim "[a]ny amount payable for a sinkhole loss other than testing deemed appropriate by the association or payable for the actual repair of the loss." § 631.54(3)(c)....

...at D125. Accordingly, we reverse the nonfinal order compelling appraisal and remand for further proceedings. As this court did in de la Fuente, we certify the following questions of great public importance: I. DOES THE DEFINITION OF "COVERED CLAIM" IN SECTION 631.54(3), FLORIDA STATUTES, EFFECTIVE MAY 17, 2011, APPLY TO A SINKHOLE LOSS UNDER A HOMEOWNERS' POLICY THAT WAS ISSUED BY AN INSURER BEFORE THE EFFECTIVE DATE OF THE NEW DEFINITION WHE...

...We instruct the trial court to enter an order in favor of Appellant in accordance with the cited authorities. We certify the following question to the Florida Supreme Court as one of great public importance: Does the 2011 amendment to the definition of “covered claim” in section 631.54(3), Florida Statutes (2011), apply to a sinkhole claim, where the claim was filed with the insurer prior to the date of the amendment, but after the insurer became insolvent, triggering FIGA’s obligation to pay the claim....

...The claimant and insured contended that the decisive date was that of the accident which occurred while FIGA covered Aries II. FIGA now appeals the holding that the later date was determinative. We affirm. The result below and its affirmance are required by the unambiguous language of section 631.54(6) which provides that an “insolvent insurer,” subject to the terms of the act: means a member insurer [1] authorized to transact insurance in this state, either at the time the policy was issued or when the insured event occurred,...

...Here, the opposite facts mandate an opposite result. As the trial judge concluded: [Tjhere are no genuine issues of material fact [the] Plaintiffs insurer was a ‘member insurer’ at the time of the insured event (July 30, 2001) as defined by Florida Statute 631.54(6) and [the] Plaintiffs’ insurer was an ‘insolvent insurer’ as defined by Florida Statute 631.54(7)....

...For these reasons, the appellees’ motion for rehearing of Florida Insurance Guaranty Ass’n v. Karelas, 37 Fla. L. Weekly D1678 (Fla. 3d DCA July 18, 2012), is granted; that opinion is set aside and the judgment under review is *3 Affirmed. 3 1. Section 631.54(7), Florida Statutes (2011) provides: "Member insurer” means any person who writes any kind of insurance to which this part applies under s....

conduct is not a “covered claim” as defined in Section 631.54(4), Florida Statutes (1977). See also Section

...ch claim. § 631.57(1), Fla.Stat. (1989). See also Martino v. Florida Ins. Guar. Ass’n., 383 So.2d 942 (Fla. 3d DCA 1980). The defendant FIGA argues, however, that the subject claim was not a “covered claim” which FIGA is required to pay under Section 631.54(3), Florida Statutes (1989)....

...respond to covered claims that arise prior to adjudication of the insurer’s insolvency and within a specified period after insolvency.” Devon, 67 So. 3d at 189 (emphasis added) (citing Jones v. Fla. Ins. Guar. Ass’n, 908 So. 2d 435, 442 (Fla. 2005)). Section 631.54(4), Florida Statutes (2020), defines a “covered claim” as: an unpaid claim ....

...The fact that Golf Villas asserts its action was for breach of FIGA’s statutory duties, rather than a straightforward suit for breach of contract does not change the result, because FIGA was statutorily obligated to respond to “covered claims,” which section 631.54(4) defines as “an unpaid claim ....

insurance carrier in order to urge as a defense section 631.54(3), Fla.Stat. (1985). The trial court denied

...First, the Lustres had waived appraisal by their actions in litigating the case. Second, the parties' dispute related to the method of repair rather than the amount of the loss; for that reason, appraisal was either unavailable or was premature. Third, appraisal was unavailable under the 2011 amendment to section 631.54(3), Florida Statutes....

...Lustres waived any right to appraisal by engaging in litigation activities for an extended period before requesting appraisal. The issue of whether the Lustres were entitled to appraisal under the terms of their policy under the 2011 amendment to section 631.54(3) is controlled by this court's decision in de la Fuente. Thus the dispute for which the Lustres requested appraisal with FIGA was the same dispute evidenced by the letters exchanged by c...

...5th DCA 2014) ("Here, while the trial court made no findings of fact on the issue of waiver, the facts are not in dispute. Therefore, we review the waiver issue de novo."). Our review of the question of the applicability of the 2011 amendment to section 631.54(3) to the Lustres' rights under the policy is a question of statutory construction that we review de novo....

...appraisal based on this court's recent decision in de la Fuente. The provisions in the Lustres' policy are the same as the provisions under review in de la Fuente. Under the analysis in that case, the definition of "covered claim" in the 2011 amendment to section 631.54(3) is applicable, and appraisal is unavailable under the amended statute to determine the amount of loss....

...remand for further proceedings consistent with this opinion. As we did in de la Fuente, we certify the following questions to the Florida Supreme Court as questions of great public importance: I. DOES THE DEFINITION OF "COVERED CLAIM" IN SECTION 631.54(3), FLORIDA STATUTES, EFFECTIVE MAY 17, 2011, APPLY TO A SINKHOLE LOSS UNDER A HOMEOWNERS' POLICY THAT WAS ISSUED BY AN INSURER BEFORE THE EFFECTIVE DATE OF THE NEW DEFINITION WHEN TH...

...But FIGA is not a governmental insurance company that fully replaces the insolvent insurance company as the insurer on a policy. Instead, it provides a limited statutory guarantee payment, which may be based on an underlying insurance claim. A "covered claim" is defined in section 631.54(3)....

...not pay for attorney's fees or public adjuster's fees in connection with a sinkhole loss or pay the policyholder. The association may pay for actual repairs to the property but is not liable for amounts in excess of policy limits. § 631.54(3)(c). FIGA's powers and duties do not require that it pay everything that falls within the definition of a covered claim....

...Thus, to establish the "covered claim" that is used to determine the guaranteed payment by FIGA under section 631.57, one starts with an "unpaid claim" that arises out of and is within the coverage of the relevant insurance policy. § 631.54(3)....

...On May 13, 2013, the Mayas responded by demanding appraisal under the terms of the insurance policy. The Mayas filed their motion to compel appraisal three months later on August 5, 2013. Relying on the 2011 amendment to the definition of "covered claim" contained in section 631.54 (3), Florida Statutes, FIGA argued that appraisal was inappropriate because, among other things, the effect of the amendment was to prohibit any direct payment to the Mayas for their sinkhole loss....

...5th DCA 2014) ("Here, while the trial court made no findings of fact on the issue of waiver, the facts are not in dispute. Therefore, we review the waiver issue de novo."). Our review of the question of the applicability of the 2011 amendment to section 631.54(3) to the Mayas' rights under their policy is a question of statutory construction that we review de novo....

...de la Fuente at the time of the hearing on the Mayas' motion to compel appraisal. -6- review in de la Fuente. Under the analysis in that case, the definition of "covered claim" in the 2011 amendment to section 631.54(3) is applicable, and appraisal is unavailable to determine the amount of the loss....

...praisal and remand for further proceedings. As we did in de la Fuente, we certify the following questions to the Florida Supreme Court as questions of great public importance: I. DOES THE DEFINITION OF "COVERED CLAIM" IN SECTION 631.54(3), FLORIDA STATUTES, EFFECTIVE May 17, 2011, APPLY TO A SINKHOLE LOSS UNDER A HOMEOWNERS' POLICY THAT WAS ISSUED BY AN INSURER BEFORE THE EFFECTIVE DATE OF THE NEW DEFINITION WHEN TH...