Nunez v. Geico General Insurance
117 So. 3d 388
Fla.2013Background
- Nunez's Geico PIP policy included an EUO as a condition for coverage; Geico denied benefits for failure to attend.
- Nunez filed a class action seeking declaratory relief that EUOs cannot bar PIP benefits under the 2008 statute.
- The district court and Eleventh Circuit analyzed Custer and Flores to assess EUOs as a statutory condition precedent.
- Governor Scott amended the PIP statute effective January 1, 2013 to explicitly include EUOs in policy terms, but the amendment did not apply to Nunez's 2008 claim.
- The Florida Supreme Court-aligned analysis held EUO conditions were invalid under the 2008 statute; the 2012 amendment was a substantive change not controlling here.
- The Florida Supreme Court ultimately answered the certified question in the negative, holding EUOs cannot be required as a condition precedent to PIP benefits under the 2008 statute.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether EUOs can be required as a condition precedent to PIP benefits under 627.736 (2008). | Nunez argues EUOs are invalid under the No-Fault statute. | Geico argues statutes permit EUOs as part of investigation. | EUO conditions are invalid under 627.736 (2008). |
| How Custer and Flores affect the interpretation of EUOs in statutorily mandated PIP coverage. | Nunez relies on Custer to invalidate EUOs. | Geico relies on Flores and related cases to justify EUOs. | Court aligns with Custer, disapproving Shaw regarding EUOs in statutorily required PIP. |
| Whether the 2012 amendment informs or controls the case. | Amendment clarifies policy terms including EUO. | Amendment could be interpreted as legislative interpretation. | Amendment substantively changes the statute and does not control the 2008-case outcome. |
Key Cases Cited
- Flores v. Allstate Ins. Co., 819 So.2d 740 (Fla. 2002) (statutory-based coverage must align with purpose of no-fault statute)
- Custer Med. Ctr. v. United Auto. Ins. Co., 62 So.3d 1086 (Fla. 2010) (No-Fault statute mandatory; EUOs not recognized as condition precedent)
- Shaw v. State Farm Fire & Cas. Co., 37 So.3d 329 (Fla. Dist. Ct. App. 2010) (EUO clause in policy; assignee not required to submit; dicta on statutorily imposed coverage)
- Vasques v. Mercury Cas. Co., 947 So.2d 1269 (Fla. 5th DCA 2007) (exclusions inconsistent with PIP statute invalid; liberal construction in insured's favor)