Justia Insurance Law Opinion SummariesArticles Posted in Florida Supreme Court
MRI Associates of Tampa, Inc. v. State Farm Mutual Automobile Insurance Co.
In this considering the provisions of a personal injury protection (PIP) insurance policy permit permitting the insurer to limit reimbursement payments in accordance with a statutory schedule of maximum charges the Supreme Court held that the PIP policy in this case was effective to authorize the use of the schedule of maximum charges under the pertinent provisions of Fla. Stat. 627.736(5).The certified question in this case related to the Second District Court of Appeal's holding that State Farm's policy provisions permitted State Farm to use the schedule of maximum charges even though the policy also referred to the use of other statutory factors for determining reasonable charges. The Supreme Court affirmed, holding that the PIP policy issued by State Farm was effective to authorize the use of the schedule of maximum charges under the relevant provisions of Fla. Stat. 627.736(5). View "MRI Associates of Tampa, Inc. v. State Farm Mutual Automobile Insurance Co." on Justia Law
Arch Insurance Co. v. Kubicki Draper, LLP
In this legal malpractice action by an insurer against a law firm retained to represent its insured in a separate prior litigation, the Supreme Court held that, where the insurer had a duty to defend, the insurer had standing through its contractual subrogation provision to maintain the malpractice action against counsel hired to represent the insured.The trial court granted summary judgment in favor of the law firm, concluding that the insurer lacked standing to directly pursue a legal malpractice action because there was no privity between the law firm and the insurer. The Fourth District Court of Appeal affirmed, concluding that the insurer lacked standing to pursue the professional negligence action. The Supreme Court quashed the decision below, holding that the insurer had standing to maintain this legal malpractice action because the insurer was contractually surrogated to the insured's rights under the insurance policy. View "Arch Insurance Co. v. Kubicki Draper, LLP" on Justia Law
Citizens Property Insurance Corp. v. Manor House, LLC
The Supreme Court answered in the negative a question certified by the Fifth District Court of Appeal, holding that in a first-party breach of insurance contract action brought by an insured against its insurer not involving suit under Fla. Stat. 624.155, Florida law does not allow the insured to recover extra-contractual, consequential damages.The insureds in this case sought to recover from the insurer extra-contractual, consequential damages for lost rental income. The trial court granted the insurer's motion for partial summary judgment regarding the breach of contract claim for lost rental income. The Fifth District reversed the partial summary judgment regarding the consequential damages claim, concluding that the insurer was not statutorily immune from this aspect of the insureds' claim. The Supreme Court quashed the Fifth District's decision and remanded the case, concluding that extra-contractual, consequential damages are not available in a first-party breach of insurance contract action. View "Citizens Property Insurance Corp. v. Manor House, LLC" on Justia Law
American Southern Home Insurance Co. v. Lentini
The Supreme Court approved the decision of the Fifth District Court of Appeal in this insurance dispute, holding that an insurer that issues a reduced premium collector vehicle policy may not limit uninsured motorist coverage under the specialty policy to accidents involving the occupancy or use of the collector vehicle.The Estate of Michael Lentini, who was operating his motorcycle when he was involved in a fatal accident, sought uninsured motorist benefits under a policy issued on a collector vehicle. The policy limited uninsured motorist coverage to accidents involving the covered collector vehicle. The Insurer denied coverage, and the Estate sued. The trial court entered summary judgment for the Insurer. The Fifth District reversed, concluding that the collector vehicle policy must and did not comply with the statutory requirements of Fla. Stat. 627.727. The Supreme Court affirmed, holding that the requirements of section 627.727 prohibited the limitations placed on uninsured motorist coverage in the collector vehicle policy at issue in this case. View "American Southern Home Insurance Co. v. Lentini" on Justia Law
Progressive Select Insurance Co. v. Florida Hospital Medical Center
In this case involving the proper method of applying a personal injury protection (PIP) insurance policy deductible to a medical provider’s bill for hospital emergency services and care, the Supreme Court approved the Fifth District Court of Appeal’s decision, holding that the deductible should be subtracted from the total charges prior to application of the reimbursement limitation in Fla. Stat. 627.736(5)(a)1.b.While this case was pending in the Court, the Fourth District Court of Appeal issued an opinion in State Farm Mutual Automobile Insurance Co. v. Care Wellness Center, LLC (Care Wellness), 240 So. 3d 22 (Fla. 4th DCA 2018), holding that the deductible should be applied after charges are reduced under any fee schedule found in section 627.736. The Supreme Court approved the Fifth District’s decision in the instant case and disapproved the Fourth District’s decision in Care Wellness, holding that, under Fla. Stat. 627.739(2), the deductible should be applied to the total medical charges prior to reduction under the reimbursement limitation. View "Progressive Select Insurance Co. v. Florida Hospital Medical Center" on Justia Law
Harvey v. Geico General Insurance Co.
In 2006, Harvey, the insured, was involved in an automobile accident with Potts. Potts, age 51, died as a result, leaving a wife and three children. Harvey’s vehicle was registered in both his name and his business’s name and was covered under a $100,000 GEICO liability policy. Two days after the accident, GEICO resolved the liability issue adversely to Harvey. GEICO did not communicate a request by the estate’s attorney for a statement. GEICO tendered $100,000 to the estate’s attorney. The estate returned GEICO’s check and filed a wrongful death suit. A jury awarded the estate $8.47 million. Harvey filed a bad faith claim against GEICO. The estate's lawyer testified that he did not receive any communication from GEICO following his initial letter and that had he known that Harvey’s only other asset was a business account worth approximately $85,000, he would not have filed suit. The Fourth District Court of Appeal reversed the judgment entered in favor of Harvey, stating that “the evidence was insufficient as a matter of law to show ... bad faith,” and, “even if the insurer’s conduct were deficient, the insurer’s actions did not cause the excess judgment.” The Supreme Court of Florida reversed. The Fourth District failed to properly apply the directed verdict standard and misapplied precedent setting forth the fiduciary duties of insurance companies. An insurer can be liable for bad faith even “where the insured’s own actions or inactions . . . at least in part” caused the excess judgment. View "Harvey v. Geico General Insurance Co." on Justia Law
Altman Contractors, Inc. v. Crum & Forster Specialty Insurance Co.
The notice and repair process set forth in Fla. Stat. 558 is a “suit” within the meaning of the commercial general liability policy issued in this case by Crum & Forster Speciality Insurance Company (C&F) to Altman Contractors, Inc.According to the policy, C&F had a duty to defend Altman in any “suit” arising from the construction of a condominium. Altman claimed that this duty to defend was invoked when the property owner served it with several notices under chapter 558 cumulatively claiming over 800 construction defects in the project. Altman filed a declaratory judgment action seeking a declaration that C&F owed a duty to defend and to indemnify it under the policy. The federal district court granted summary judgment for C&F, concluding that nothing about the chapter 558 process satisfied the definition of “civil proceeding.” Altman appealed, and the United States Circuit Court of Appeals for the Eleventh Circuit certified the legal issue to the Supreme Court. The Supreme Court answered the certified question in the affirmative because the chapter 558 presuit process is an “alternative dispute resolution proceeding” as included in the policy’s definition of “suit.” View "Altman Contractors, Inc. v. Crum & Forster Specialty Insurance Co." on Justia Law
Joyce v. Federated National Insurance Co.
The Supreme Court quashed the decision of the Fifth District Court of Appeals, which held on appeal in this case that trial courts may apply a contingency fee multiplier to an award of attorney’s fees to a prevailing party only in “rare” and “exceptional” circumstances. Petitioners, the insureds in a successful dispute with their homeowners’ insurance carrier, argued before the Supreme Court that the Fifth District’s decision misapplied Supreme Court precedent from Florida Patient’s Compensation Fund v. Rowe, 472 So. 2d 1145 (Fla. 1985), and its progeny. The Supreme Court agreed with Petitioners, holding that there is no “rare” and “exceptional” circumstances requirement before a trial court may apply a contingency fee multiplier. View "Joyce v. Federated National Insurance Co." on Justia Law
Government Employees Insurance Co. v. Macedo
The ambiguous section of the insurance policy at issue in this case must be construed in favor of coverage for the costs and attorneys’ fees awarded against the insured pursuant to the offer of judgment statute, Fla. Stat. 768.79.Alysia Macedo sued Zackery Lombardo for damages resulting from injuries she sustained in an automobile collision.The jury returned a verdict in favor of Macedo in the amount of $243,954.55. Macedo joined to the judgment GEICO, which provided bodily injury liability coverage to Lombardo. The trial court awarded taxable fees and costs against GEICO jointly and severally with its insured pursuant to section 768.79. The First District Court of Appeal affirmed. The Supreme Court approved the First District’s decision, holding that the key provision in the insurance policy was ambiguous and must be construed in favor of coverage. View "Government Employees Insurance Co. v. Macedo" on Justia Law
State Farm Mutual Automobile Insurance Co. v. Shands Jacksonville Medical Center, Inc.
A hospital provided medical services to twenty-nine insureds who were injured in motor vehicle accidents. After paying the hospital, the insurer requested certain documentation relating to the reasonableness of the charges pursuant to Fla. Stat. 627.736(6)(b). The hospital provided the insurer with various documents but refused to furnish copies of third-party contracts containing negotiated discount rates between the hospital and other insurers and payers, arguing that the information was not covered by subsection (6)(b). The insurer filed a petition pursuant to Fla. Stat. 627.736(6)(c) asking the trial court to compel discovery of the withheld information. The trial court ordered the hospital to produce the requested discovery. The court of appeal reversed, concluding that the trial court’s order exceeded the scope of discovery permissible under sections 627.736(6)(b) and (c). Specifically, the court ruled that discovery of facts under section 627.736(6)(c) is limited to the production of the documents described in section 627.736(6)(b). The Supreme Court approved the court of appeal’s interpretation of the scope of discovery under section 627.736(6)(c), holding that the scope of permissible discovery under subsection (6)(c) is limited to the production of documents described in subsection (6)(b). View "State Farm Mutual Automobile Insurance Co. v. Shands Jacksonville Medical Center, Inc." on Justia Law