Justia Florida Supreme Court Opinion Summaries

Articles Posted in Insurance Law
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Petitioner was injured in an automobile accident with an underinsured motorist. Petitioner filed a claim with his insurer (Insurer) for the limits of his uninsured/underinsured motorist (UM) policy of $50,000. After Insurer refused to pay, Petitioner filed a complaint against Insurer to determine liability under the UM policy and the full extent of his damages. Prior to trial, Insurer tendered a check to Petitioner for $50,000 and filed a confession of judgment for that amount. Petitioner opposed the entry of a confessed judgment, arguing that a jury verdict would determine the upper limits of Insurer’s potential liability under a future bad faith claim. The trial court denied Insurer’s motion to confess judgment. After a trial, the jury set Petitioner’s damages at $1 million. The court of appeal vacated the jury’s verdict, concluding that after Insurer confessed judgment in the amount of $50,000, Petitioner’s UM action became moot. The Supreme Court quashed the court of appeal’s decision, holding (1) an insured is entitled to a determination of liability and the full extent of his damages in a UM action before filing a first-party bad faith action; and (2) that determination of damages is generally binding, as an element of damages, in a subsequent first-party bad faith action. Remanded. View "Fridman v. Safeco Ins. Co. of Ill." on Justia Law

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Luke Joerg (“Luke”) was a developmentally disabled adult who had lived with his parents his entire life and had never worked. Luke was struck by a car in 2007. John Joerg (“Joerg”), Luke’s father, filed an action against State Farm Mutual Automobile Insurance Company, Joerg’s uninsured motorist carrier. Joerg filed a motion in limine to exclude evidence of any collateral source benefits to which Luke was entitled, including discounted benefits under Medicare and Medicaid. The trial court precluded State Farm from introducing evidence of Luke’s future Medicare or Medicaid benefits. The jury awarded a total of $1,491,875 in damages, including $469,076 for future medical expenses. The Second District Court of Appeal reversed the award for future damages, concluding that Luke’s Medicare benefits should not have been excluded by the collateral source rule. The Supreme Court quashed the decision below, holding that the trial court properly excluded evidence of Luke’s eligibility for future benefits from Medicare, Medicaid, and other social legislation as collateral sources. View "Joerg v. State Farm Mut. Auto. Ins. Co." on Justia Law

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After a condominium association (Association) prevailed in a breach of contract action against its insurance company (Insurer), it sued Insurer a second time, alleging a statutory first-party bad faith claim under Fla. Stat. 624.155. Insurer moved to dismiss the complaint, citing its immunity from suit under Fla. Stat. 627.351(6)(s). The trial court dismissed the complaint, concluding that a statutory bad faith action under section 624.155 was not among the specifically listed exceptions to the immunity provided in section 627.351(6)(s). The First District Court of Appeal reversed, determining that Insurer’s immunity did not extend to the “willful tort” of failing to attempt in good faith to settle claims as provided by section 624.155. The Supreme Court quashed the decision below, holding that a statutory first-party bad faith cause of action under section 624.155(1)(b) is not an exception to the immunity granted to Insurer by the Legislature. View "Citizens Prop. Ins. Corp. v. Perdido Sun Condo. Ass’n, Inc." on Justia Law

Posted in: Insurance Law
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Horace Mann issued an insurance policy to Richard Chase. Richard signed a form in which he selected reduced uninsured motorist limits. Horace Mann later removed Richard as the sole named insurance from the policy and instead listed Allison Chase, Richard’s daughter, as the named insured on that policy. At no time did Allison reject uninsured/underinsured motorist coverage in writing or select lower limits. After a crash that injured Allison and killed Richard, Allison asserted that she, individually and as personal representative of her father’s estate, was entitled to uninsured motorist (UM) coverage in the amount equal to the policy’s bodily injury limits because she never selected lower UM coverage in writing as required by Fla. Stat. 627.727. The trial court agreed with Allison and determined that Allison and the Estate were entitled to $100,000 of insurance coverage under Allison’s policy. The district court reversed, concluding that Richard’s waiver of high UM coverage bound Allison individually and as personal representative of the Estate. The Supreme Court quashed the decision of the district court, holding that Allison was not subject to Richard’s waiver of benefits, and therefore, Horace Mann did not obtain a valid waiver of benefits from Allison as the named insured of her auto insurance policy. View "Chase v. Horace Mann Ins. Co." on Justia Law

Posted in: Insurance Law
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Santana Morales died while working for Lawns Nursery and Irrigation Designs, Inc. (Lawns). Thereafter, Lawns’ surviving spouse entered into a workers’ compensation settlement agreement with Lawns and Zenith Insurance Company (Zenith), Lawns’ workers’ compensation and employer liability insurance carrier. In a separate wrongful death lawsuit, Morales’ Estate obtained a default judgment against Lawns. Zenith refused to pay the tort judgment, and the Estate sued Zenith under Lawns’ employer liability policy. A federal district court entered summary judgment for Zenith, holding that the policy’s workers’ compensation exclusion barred the Estate’s suit. On appeal, the Eleventh Circuit certified three questions of law to the Supreme Court. The Court answered (1) the Estate had standing to bring direct action against Zenith to recover the judgment against Lawns; (2) the workers’ compensation exclusion barred coverage of the Estate’s tort judgment under the employer liability policy; and (3) a release in the workers’ compensation settlement agreement, through which Mrs. Morales elected the consideration described in the agreement as the sole remedy with respect to the insurance coverage that Zenith provided to Lawns, precluded the Estate from collecting the tort judgment from Zenith. View "Morales v. Zenith Ins. Co." on Justia Law

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Crystal Harrington was injured in a single-car accident while riding as a passenger in a car owned by her father but driven by Joey Williams, a non-family member. The vehicle was insured by Travelers Commercial Insurance Company (Travelers), but the vehicle was excluded from uninsured motorist (UM) coverage pursuant to a “family vehicle exclusion” provision in the policy. Williams was underinsured, and the liability payments from Williams’ insurer, when combined with payments under Harrington’s policy, did not fully cover Harrington’s medical costs. Therefore, Harrington sought UM benefits from Travelers, which denied the claim. Harrington sued Travelers, seeking payment of stacked UM benefits, despite the fact that her mother, the named insured and purchaser of the policy, had expressly selected non-stacking UM coverage. The trial court granted summary judgment for Harrington, concluding (1) the policy provision excluding family vehicles from UM coverage was invalid because it conflicted with Fla. Stat. 627.727(3); and (2) Harrington’s mother’s election of non-stacking UM coverage did not apply to Harrington. The Supreme Court reversed, holding (1) a family vehicle exclusion in an automobile insurance policy does not conflict with section 627.727(3); and (2) UM benefits are not stackable under section 627.727(9) if the named insured or purchaser of the policy made a non-stacking election. View "Travelers Commercial Ins. Co. v. Harrington" on Justia Law

Posted in: Insurance Law
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ICI Homes, Inc. (ICI) had a general liability insurance policy with General Fidelity Insurance Company. In 2007, Katherine Ferrin, the owner of a residence constructed by ICI, was injured while using stairs installed by Custom Cutting, Inc. Ferrin filed suit against ICI. ICI, in turn, sought indemnification from Custom Cutting. The parties agreed to a $1.6 million settlement of Ferrin’s claim. ICI accepted $1 million from Custom Cutting’s insurer to settle its indemnification claim, which it paid to Ferrin. ICI and General Fidelity then claimed the other was responsible for paying Ferrin the remaining $600,000. Both parties paid $300,000 to Ferrin to settle Ferrin’s claim. ICI then filed suit against General Fidelity seeking return of the $300,000 ICI paid above the $1 million indemnification payment. General Fidelity counterclaimed seeking return of the $300,000 it had paid to Ferrin. The district court entered judgment for General Fidelity. The court of appeals certified two questions to the Supreme Court for resolution. The Supreme Court answered (1) the General Fidelity policy allowed ICI to apply indemnification payments received from Custom Cutting’s insurer towards satisfaction of its $1 million self-insured retention; and (2) the transfer of rights provision in the policy did not abrogate the made whole doctrine.View "Intervest Constr. of Jax, Inc. v Gen. Fidelity Ins. Co." on Justia Law

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After Plaintiff was rear-ended by an underinsured motorist (UM), Plaintiff requested her $100,000 UM policy limits from State Farm. Plaintiff indicated that her damages were estimated to be $3.5 million because she suffered from reflex sympathetic dystrophy syndrome. State Farm responded that Plaintiff must schedule a compulsory medical examination (CME) pursuant to the terms of the policy. Plaintiff refused to attend a CME and instead filed suit against State Farm. The trial court entered judgment against State Farm for the UM policy limits. The court of appeal affirmed, holding (1) Plaintiff breached the contract when she failed to attend the CME; but (2) State Farm must plead and prove prejudice to avoid liability based on noncompliance with the CME clause, and State Farm failed to meet its burden in this case. The Supreme Court approved of the court of appeal’s decision, holding (1) the forfeiture of benefits under a UM policy will not automatically result upon an insured’s breach of a CME provision unless the insurer pleads and proves actual prejudice as an element of its affirmative defense; and (2) the undisputed facts demonstrate that State Farm was not prejudiced in this case. View "State Farm Mut. Auto. Ins. Co. v. Curran" on Justia Law

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Several insureds filed a class action against the predecessor of Washington National Insurance Corporation concerning insurance policies that provide for reimbursement of certain home health care expenses. The district court granted summary judgment for the insureds, concluding that various provisions in the policy, including a certificate schedule, demonstrated an ambiguity concerning whether an automatic increase applied only to the daily benefit or also applied to the lifetime maximum benefit amount and the per occurrence maximum benefit amount. Because there was ambiguity in the policy, the court of appeal certified questions of law to the Florida Supreme Court, which held (1) because the policy was ambiguous, it must be construed against the insurer and in favor of coverage without consideration of extrinsic evidence; and (2) when so construed, the policy's automatic benefit increase applies to the daily benefit, the lifetime maximum benefit, and the per occurrence maximum benefit. View "Washington Nat'l Ins. Corp. v. Ruderman" on Justia Law

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Plaintiff filed a claim with Defendant, his homeowner's insurance company, for fire damage on his home. Plaintiff's insurance policy with Defendant was a replacement cost policy. Defendant made a payment to Plaintiff that included costs of repair even though Defendant had not completed any repairs to the home. Defendant, however, refused to pay for a general contractor's overhead and profit because Plaintiff had not yet incurred those expenses. Plaintiff filed a breach of contract claim against Defendant, contending that, like the other costs of repair Defendant paid, Defendant was required to pay costs for overhead and profit. The trial court granted summary judgment for Defendant, and the court of appeal affirmed. The Supreme Court quashed the court of appeal's decision, holding (1) replacement cost insurance includes overhead and profit where the insured is reasonably likely to need a general contractor for repairs; and (2) the court of appeal erred in determining the Florida law and the insurance policy permitted Defendant to withhold payment of overhead and profit because Plaintiff had not actually incurred those costs. Remanded. View "Trinidad v. Fla. Peninsula Ins. Co." on Justia Law