Insurer Read Your Policy

When The Full Policy is Read it Must Provide Coverage

Owners Insurance Company (Owners) appealed the entry of a final summary judgment in favor of Allstate Fire and Casualty Insurance Company (Allstate) in an action filed by Allstate against Owners and Allstate’s insured, James M. Horne, Jr. (Horne) in Owners Insurance Company v. Allstate Fire And Casualty Insurance Company and James M. Horne, Jr., Case No. 2D18-2309, District Court Of Appeal Of Florida Second District (June 19, 2020) to decide if Owners is required to provide UM benefits to Horne.

FACTS

Horne resided with his mother and stepfather, who had an automobile insurance policy with Owners. The Owners policy provided uninsured motorist (UM) coverage but only afforded it to relatives who did not own an automobile. Horne got into an accident while driving his own automobile. Allstate sought a declaration that Horne was covered under the Owners policy for injuries he suffered in the accident.

Because the Owners policy provided basic liability coverage to resident relatives, the trial court concluded that Owners was required to provide UM coverage to Horne.

ANALYSIS

Owners argued that “the basic liability coverage under the Owners policy extends only ‘to relatives who do not own an automobile.'” However, upon a closer examination of the policy these relatives are only excluded from the extended liability coverage of unlisted automobiles. Section II of the policy, entitled “Liability Coverage,” provides the following:

We will pay damages for bodily injury and property damage for which you become legally responsible because of or arising out of the ownership, maintenance or use of your automobile (that is not a trailer) as an automobile. We will pay such damages . . . on behalf of any relative using your automobile (that is not a trailer).

This provision affords Horne, who is a relative as that term is defined in the policy, basic liability coverage when driving one of the listed automobiles. Neither Owners nor Allstate cited to the Section II Liability Coverage provision in their briefs but the appellate court found the provision to be telling.

Allstate argued that Horne was entitled to UM coverage because “he is insured for basic liability coverage” under the overlooked Section II Liability Coverage provision.  However, if a trial court reaches the right result, as it did here, that decision will be upheld if there is any basis which would support the judgment in the record.

Under Florida law, if a motor vehicle liability insurance policy provides bodily injury liability coverage, then it must also provide UM coverage to those insured under the policy. Uninsured motorist protection does not inure to a particular motor vehicle, but protects the named insured or insured members of his family against bodily injury inflicted by the negligence of any uninsured motorist under whatever conditions, locations, or circumstances any of such insureds happen to be in at the time.

A policy may include specified provisions that exclude certain insureds from UM coverage if the named insured knowingly accepts such a limitation and the insurer offers a reduced premium.

To limit coverage validly, the insurer must satisfy the statutorily-mandated requirement of notice to the insured and obtain a knowing acceptance of the limited coverage and must file revised, decreased premium rates for such policies. Owners neither obtained the informed acceptance nor provided the reduced rates required of insurers that include the statutory exceptions to the UM-coverage mandate in their policies.

Since the Owners policy provides basic liability coverage to Horne, Florida law mandates the provision of UM coverage to him as well. As such, the trial court correctly granted summary judgment in favor of Allstate.

ZALMA OPINION

Had Owners Read The Full Policy (RTFP) it would have seen that it owed UM coverage to Horne and would have avoided the lawsuit and appeal. Under Florida law, since the Owners policy provided liability coverage to Horne as a member of its named insureds’ household, it was required to also provide UM benefits to Horne.


© 2020 – Barry Zalma

Barry Zalma, Esq., CFE, now limits his practice to service as an insurance consultant  specializing in insurance coverage, insurance claims handling, insurance bad faith and insurance fraud almost equally for insurers and policyholders. He also serves as an arbitrator or mediator for insurance related disputes. He practiced law in California for more than 44 years as a

n insurance coverage and claims handling lawyer and more than 52 years in the insurance business. He is available at http://www.zalma.com and zalma@zalma.com.

Mr. Zalma is the first recipient of the first annual Claims Magazine/ACE Legend Award.

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