Merly Nunez v. Geico General Insurance Company
685 F.3d 1205
11th Cir.2012Background
- Nuñez is the class representative in a Florida No-Fault/PIP dispute against Geico for denial of medical benefits.
- EUOs are argued by Nuñez to be impermissible prerequisites for PIP under Florida law; Geico contends EUOs can be required as a condition precedent.
- The district court dismissed Nuñez’s complaint, including count two on the EUO issue, and denied reconsideration.
- Geico supplemented the record with Florida appellate authority interpreting Custer Med. Ctr. v. United Auto. Ins. Co. on EUOs, arguing dicta or controlling relevance.
- The court finds Florida law unclear on EUOs in statutorily mandated PIP coverage and certifies a Florida Supreme Court question, delaying final judgment.
- The court explains Custer’s dicta and the need for authoritative Florida Supreme Court guidance, given conflicting state decisions.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether EUOs can be a condition precedent to PIP recovery under Fla. Stat. § 627.736 | Nuñez argues EUOs are not permissible prerequisites under statutorily mandated PIP. | Geico argues EUOs may be required as a condition precedent under the statute. | Court certifies Florida Supreme Court question; no final ruling on the issue. |
| Whether Florida law would permit or disallow EUOs as conditions precedent given Custer dicta | Custer’s dicta suggest EUOs are not required in statutorily mandated coverage. | Custer’s dicta show EUOs can be considered; Florida law unclear otherwise. | Question certified to the Florida Supreme Court for interpretation. |
Key Cases Cited
- Flores v. Allstate Ins. Co., 819 So. 2d 740 (Fla. 2002) (analysis of veiled analogies to non-statutory coverages)
- Shaw v. State Farm Fire & Cas. Co., 37 So. 3d 329 (Fla. Dist. Ct. App. 2010) (EUO clause as condition precedent to recovery; ascribed to policy context)
- McMahan v. Toto, 311 F.3d 1077 (11th Cir. 2002) (state-law decisions govern Florida questions absent Florida Supreme Court guidance)
- Auto-Owners Ins. Co. v. Se. Floating Docks, Inc., 632 F.3d 1195 (11th Cir. 2011) (certified-state-law interpretation to avoid Erie guesses)
- Pardo v. State, 596 So. 2d 665 (Fla. 1992) (Florida Supreme Court acknowledged law of appellate decisions unless overruled)
- Goldman v. State Farm Gen. Ins. Co., 660 So. 2d 300 (Fla. Dist. Ct. App. 1995) (insurer’s EUO-related breach in homeowner context; not statutorily mandated coverage)