Case Background
Jose Ortiz Viera and Yadira Rodriguez owned a home at 16433 SW 95th Street in Miami, Florida. Universal Property & Casualty Insurance Company insured this property under a homeowner's policy. According to the complaint, the property sustained damage from strong winds and rain on May 24, 2020, while the policy remained in force. The couple reported the loss to Universal on November 13, 2020. Universal assigned claim number PL20-0155046-N520 to the loss and stated it was not permitted to inspect the property until December 2, 2020.
The couple filed their complaint on March 9, 2021, in the Circuit Court of the Eleventh Judicial Circuit in Miami-Dade County, Florida. They alleged that Universal failed to attend the claim, failed to acknowledge or deny coverage, and failed to make any payment despite more than three months passing since the company became aware of the loss. Universal filed its answer and defenses on May 13, 2021, denying the majority of the allegations and raising several defenses.
Cause
The complaint contained a single count for breach of contract. The Plaintiffs alleged that Universal breached the terms of the homeowner's insurance policy by failing to attend the claim, acknowledge or deny coverage, and pay insurance proceeds for the damage to their property.
Injury
The dispute concerned property damage to the couple's home, which the Plaintiffs attributed to wind and rain. Universal's answer stated that its inspection found no wind damage to the roof and instead identified wear and tear and pre-existing damage.
Damages Sought
The complaint sought damages exceeding $30,000, exclusive of interest, costs, and fees, along with interest, Court costs, and reasonable attorneys' fees under Florida Statute Section 627.428.
Key Arguments and Proceedings
Legal Representation
Plaintiff(s): Jose Ortiz Viera | Yadira Rodriguez
· Counsel for Plaintiff(s): Alian M. Perez, Esq. | Amado Alan Alvarez | Benjamin R Alvarez | Robert Jonathan Lee
Defendant(s): Universal Property & Casualty Insurance Company
· Counsel for Defendant(s): Sasha Haro, Esq. | Steven Liss Chackman | Adriana Pavon | Yadhira Ramirez-Toro
Key Arguments or Remarks by Counsel
Claims
According to the complaint, the Plaintiffs stated that their property sustained a covered loss on May 24, 2020, as a result of strong winds and rain. They stated they had paid all premiums due under the policy and had satisfied all post-loss obligations, including protecting the property from further loss, making reasonable and necessary repairs, and keeping an accurate record of repair expenses. The complaint stated that Universal failed to attend the claim, failed to acknowledge or deny coverage, and failed to make any payment of insurance proceeds, which the Plaintiffs characterized as a breach of the policy.
Defense
Universal's answer denied the majority of the complaint's allegations and raised three defenses. The first defense addressed estoppel, in which Universal stated it had not waived any of its rights or defenses under the policy. The second defense addressed conditions precedent. Universal stated that the claim was reported on November 13, 2020, almost six months after the alleged May 24, 2020 date of loss, which the company characterized as a failure to provide prompt notice under the policy. Universal also stated that it sent letters on November 24, 2020, and December 18, 2020, requesting documents, including proof that emergency mitigation, remediation, or tarp services had been completed, along with a valid sworn proof of loss. Universal stated that the Plaintiffs had not produced these documents.
The third defense addressed policy exclusions. Universal stated that its inspection on December 2, 2020, found no wind damage to the roof as reported by the Plaintiffs. Instead, Universal stated it found long-term wear and tear and pre-existing damage resulting from neglect and failure to maintain the property. Universal also stated that the Plaintiffs had submitted an invalid sworn proof of loss that was not supported by any damage estimate, and that the claimed repairs were excessive, inaccurate, unwarranted, and represented an unnecessary upgrade to the property. Universal cited specific policy provisions covering existing damage, wear and tear, neglect, faulty or inadequate maintenance, constant or repeated seepage, and fungi, wet or dry rot, or bacteria as grounds supporting its position.
Jury Verdict
The case proceeded to a jury trial. The jury received a verdict form containing a sequence of questions. The first question asked whether the Plaintiffs proved, by the greater weight of the evidence, that their property sustained a "direct physical loss" during the policy period. The form instructed that if the answer was "no," the verdict would be for Universal, and the jury would not need to address the remaining questions.
The jury marked "NO" on this first question, and the verdict form indicates no marks on any of the subsequent questions. The foreperson, identified as Alex Rivero, signed the verdict form, which was dated June 6, 2025.
The Court entered a final judgment on July 14, 2025, signed by Judge Migna Sanchez-Llorens. The judgment ordered that Jose Ortiz Viera and Yadira Rodriguez take nothing in the action and that Universal Property & Casualty Insurance Company go hence without day. The judgment noted that the Court reserved jurisdiction to rule on Universal's motions for attorney's fees and costs. The final judgment identified the matter as disposed by jury trial and closed the case as to all parties.
