The circuit court sitting in its appellate capacity did not depart from the essential requirements of law by affirming a county court judgment for a medical provider in a personal injury protection (PIP) case because the Florida Supreme Court has accepted for review a conflict of decisions on the same issue of contractual interpretation. Allstate Fire and Casualty Ins. Co. v. Hallandale Open MRI, LLC, 41 Fla. L. Weekly D2208 (Fla. 3d DCA Sept. 28, 2016).
The Florida Supreme Court found that the Fifth District Court of Appeal’s decision in Omega Ins. Co. v. Johnson, 39 Fla. L. Weekly D1911 (Fla. 5th DCA Sept. 5, 2014) conflicted with its decision in Universal Ins. Co. of North America v, Warfield, 82 So.3d 47 (Fla. 2012), and held “that the presumption of correctness granted to the insurer’s investigative report in section 627.7073(1)(c) of the sinkhole statutes is only applicable to the sinkhole initial claims process, and does not continue to apply during the trial stage.” Johnson v. Omega Ins. Co., 41 Fla. L. Weekly S415 (Fla. Sept. 29, 2016) (emphasis in original).
In a response to a question certified by the Eleventh Judicial Circuit, The Florida Supreme Court held that a party cannot “challenge the validity of a life insurance policy after the two-year contestability period established by section 627.455 because of its creation through a [stranger-originated life insurance] STOLI scheme.” Wells Fargo Bank, N.A. v. Pruco Life Ins. Co., 41 Fla. L. Weekly S403 (Fla. Sept. 22, 2016).
The circuit court sitting in its appellate capacity departed from the essential requirements of law in holding that an insurance company waive its right to litigate the reasonableness of medical bills by not specifically electing to use Medicare’s fee schedules in its policy. Progressive Select Ins. Co. v. Emergency Physicians of Central Florida, LLP, 41 Fla. L. Weekly D2145 (Fla. 5th DCA Sept. 16, 2016).
Appellate court found that the phrase “subject to” in section 627.736, Florida Statutes was not ambiguous, and certified its opinion was in conflict with Orthopedic Specialists v Allstate Ins. Co., 177 So.3d 19 (Fla. 4th DCA 2015). Florida Wellness & Rehabilitation v. Allstate Fire & Casualty Ins. Co., 201 So.3d 169 (Fla. 3d DCA July 13, 2016).
In sinkhole case, trial court properly ruled that a repair contract was not a condition precedent to filing a lawsuit for breach of contract, but erred by including in final judgment the amount required to pay for subsurface repairs before the insureds contracted to pay for those repairs. Citizens Property Ins. Corp. v. Nunez, 194 So.3d 1064 (Fla. 2d DCA June 24, 2016).