Justia Florida Supreme Court Opinion Summaries

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

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

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

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

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

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

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

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

After Insured sustained injuries in a car accident he sought MRIs from Virtual Imaging Services. Virtual Imaging obtained an assignment of personal injury protection (PIP) benefits under Insured's policy with GEICO and billed GEICO $3600 for the MRIs. GEICO paid the bill but limited its reimbursement to eighty percent of 200 percent of the applicable Medicare fee schedule in accordance with the formula described in Fla. Stat. 627.736(5)(a). This statutory provision became effective on January 1, 2008 as part of Florida's PIP statute. Virtual Imaging subsequently sued GEICO, alleging that GEICO's reimbursement was insufficient. The county court granted Virtual Imaging's motion for summary judgment. The court of appeal affirmed then certified a question of law to the Supreme Court, which answered by holding that GEICO was required to give notice to Insured by electing the permissive Medicare fee schedules in its policy before taking advantage of the Medicare fee schedule to limit reimbursements. View "Geico Gen. Ins. Co. v. Virtual Imaging Servs., Inc." on Justia Law

Plaintiff's automobile insurance policy with Geico included a condition that Plaintiff submit to examination under oath (EUO) before recovering personal injury protection (PIP) benefits. Geico denied Plaintiff's PIP claim due to her failure to satisfy this condition after she was injured in a car accident. Plaintiff filed a class action complaint alleging that Geico had violated Florida's PIP statute. The federal district court dismissed the case, concluding that the PIP statute did not prohibit an insured from requiring an EUO. On appeal, the Eleventh Circuit certified a question of law to the Florida Supreme Court, which answered by holding that, under Fla. Stat. 627.736, an insurer cannot require an insured to attend an EUO as a condition precedent to recovery of PIP benefits. View "Nunez v. GEICO Gen. Ins. Co." on Justia Law