by Mario Ariza

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Last October, Peter and Linda Kilfoil returned from an overnight trip and found water pooling in the kitchen of their Fort Lauderdale, Florida, home. The pair couldn’t pinpoint the source of the leak and had a hard time getting a plumber. So Linda Kilfoil called their insurer, Citizens Property Insurance Corp.

The call was the beginning of the Kilfoils’ journey through an alternate legal universe set up by Citizens, a quasi-governmental insurer in Florida, to reduce its staggering legal costs. In this state-sanctioned world, the judges’ salaries are funded by Citizens, the rules followed in Florida’s circuit courts don’t all apply and the insurance company almost always triumphs.

It’s a legal landscape so fraught that a Tampa judge recently paused all its proceedings — twice. But that didn’t come soon enough to help the Kilfoils.

Citizens sent an adjuster to their home the day after they called. He couldn’t pinpoint the source of the leak either but suspected it was coming from a pipe that drained wastewater from the kitchen, he said later in a deposition. He snapped photos of the warped, soggy cabinets. A short while later, Citizens denied their claim, saying that the damage to their cabinets was consistent with a long-term leak, and that their insurance contract excluded coverage of such leaks — unless they were hidden.

Eleven days after the denial, the Kilfoils’ plumber found the leaking pipe in the home’s exterior wall. It had been spilling water into a recess between their kitchen cabinets and slab foundation, records show. The total cost of repair has come close to $40,000, according to Linda Kilfoil and construction estimates provided by her attorney.

The Kilfoils had permanently relocated to Florida from Long Island to enjoy retirement. But with Peter Kilfoil ill with prostate and skin cancer, his wife faced the prospect of handling repairs while tending to his health.

“I am a former physician,” Peter Kilfoil said in an interview from the hospital. “I’m not like some carjacker. They accuse me of letting that leak persist until it destroyed my kitchen.”

Just before Thanksgiving, the Kilfoils sued Citizens. Instead of going to circuit court, as most lawsuits against insurers would, Citizens routed their case to arbitration before the Florida Division of Administrative Hearings.

On the surface, the change of venue — made possible by a provision lawmakers empowered Citizens to insert at the end of most of its policies — didn’t seem like a big deal. Legislators and Citizens executives touted DOAH as advantageous for both consumers and the insurer. Cases in the forum tend to move faster, cost less and are decided by expert administrative law judges rather than juries.

But in practice, homeowners forced by Citizens into DOAH have trouble exercising key rights.

Judge Britney Horton kept the Kilfoils’ lawyer from deposing a Citizens adjuster, siding with the company after it argued it had already made another employee available and produced “all non-privileged facts.” The ruling deprived them of a fair opportunity to investigate the denial, according to their attorney. On at least 20 other occasions, DOAH judges have issued similar rulings during a dispute’s fact-finding phase.

In addition, some DOAH judges have denied motions requesting that they disclose any potential conflicts they might have as arbitrators. Some plaintiff’s attorneys say that has made it difficult to trust in the impartiality of their decisions.

And the forum’s rules make it impossible for homeowners to drop their lawsuit without Citizens’ approval, unless they withdraw their claim, a move that can lead to court costs and attorney’s fees if not filed early in the process. Some have felt forced to go to final hearings where they lost and ended up owing thousands to Citizens.

“You don’t have to be a rocket scientist to figure out something’s wrong,” said Chip Merlin, president of Merlin Law Group, a firm that represents insurance policyholders.

In a written response to questions about the homeowners’ experiences, Citizens spokesperson Michael Peltier defended the current process.

“We believe the statute authoring the resolution of claims by DOAH provides a well-established, impartial, and efficient process for policyholders, who no longer must wait nearly two years, on average, for a resolution of their claim,” he wrote.

When it comes to depositions, the forum is not “materially different” from Florida’s circuit courts, he added. And he explained that while homeowners are barred from dismissing their cases at DOAH — a move that might allow them to pursue the claim in circuit court — they aren’t blocked from withdrawing their claim, a more terminal maneuver. (Withdrawing, though, grants Citizens........

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