Florida Second District Court of Appeal Reverses Block to UM Coverage

When responsible drivers purchase car insurance, especially additional coverage for uninsured/underinsured motorist (UM) coverage, they believe they are ensuring payment when accidents occur. A recently issued opinion from Florida’s Second District Court of of Appeal presents all of the various considerations a claimant should have when seeking payment from the insurer. The plaintiff-appellant in this Florida auto accident lawsuit was injured as a passenger in her father’s car. The woman filed claims against the driver of the other vehicle, alleging the costs of her injury exceeded the policy limits of the defendant. The injured daughter was covered by two UM policies through her father and mother, each from different auto insurers. The father’s policy provided $20,000 worth of UM coverage, and her mother’s provided $25,000 of UM coverage.

The daughter sued her mother’s insurer for UM benefits but did not sue her father’s insurer.  Pushing throughThe circuit court found she did not satisfy the condition precedent in her mother’s policy, denying her benefits of any amount. The court additionally ruled that even if the condition precedent were satisfied, she would only be able to access the difference between the policies in the amount of $5,000.00. Her mother’s insurer moved for summary judgment after this assessment, knowing the statute of limitations prevented the injured person from obtaining the father’s policy limits, so she would never be able to satisfy the preceding condition. The injured person appealed.

The insurer’s policy stated that an injured party may not sue for benefits if they have not met the terms of the policy. The relevant parts of the mother’s policy stated that when the injured person is entitled to recover damages in excess of the other policy limit, the insurer will pay up to the UM policy limit after the other collectible insurance has been exhausted. Florida Rule of Civil Procedure 1.120(c) allows condition precedents to be generally made, but the party denying the occurrence or performance of a condition precedent must plead it with particularity and specificity.

The insurer argued on appeal it raised the condition precedent in its seventh affirmative defense. The company alleged any recovery should be reduced or barred if there is any insurance coverage available to the individual or entity that is partially or wholly liable for damages. The injured person argued section 627.727(9)(c) only limited UM recovery to the highest limit applicable to the vehicle covered under the Allstate policy. She stated there was no reason to credit the excess carrier for proceeds owed by a primary carrier. The injured person asserted the insurer waived its affirmative defense by failing to seek a diminished or non-existent recovery in reliance on the “other insurance” clause.

The appellate court parted ways with the trial court’s assessment and agreed with the injured person that the insurer waived the defense by failing to plead with specificity. The Court of Appeal noted the insurer’s position is contrary to the legislative intent behind the UM statutes and case law interpreting UM contract language. The court noted the goal of the Florida UM statute was to place the injured party in the same position in which they would have been if the at-fault party were insured. Case law specifically holds this was not created for the benefit of insurance companies or motorists causing harm to others. Conditions or exclusions within policies are first assessed by whether or not the language excludes or limits coverage without ambiguity, and if it successfully does so, if it is contrary to the purpose of the UM statutes.

The appellate court reversed and remanded, directing the circuit court to allow recovery of the full $25,000 policy limits. The court held the original ruling was made in error, pointing to the statute’s allowance of stacking UM benefits. Section 627.727(9)(c) does not require insurers to credit their excess UM benefits with a primary insurer’s payouts.

The Florida uninsured motorist accident attorneys at Donaldson & Weston are experienced car accident attorneys here to help you with your case. Call our office today at 772-266-5555 or 561-299-3999 for a free, confidential consultation.

More Blog Posts:

Florida District Appellate Court Reviews Future Medical Expenses in Multi-Car Accident Case, Florida Injury Lawyer Blog, November 28, 2016

Federal Circuit Court of Appeal Declines to Find Equitable Tolling in Slip and Fall Case, Florida Injury Lawyer Blog, October 21, 2016

Florida Court of Appeal Allows Injured Motorist to Pursue Additional PIP Payments to Medical Providers, Florida Injury Lawyer Blog, May 18, 2017