337 So.3d 411
Fla. Dist. Ct. App.2021Background
- Pro-Medics, as assignee of Isel Suarez, sued United Automobile Insurance Company for personal injury protection (PIP) benefits for treatment of injuries from a June 2012 car accident.
- The policy declarations (Mar. 3, 2012–Mar. 3, 2013) listed Alberto Guerra as the “principal” and Isel Suarez as a “co-insured”; an endorsement also listed Suarez as Guerra’s spouse.
- Guerra and Suarez lived together but were not married to each other (each married to other persons and separated); they obtained the policy together and told the agent they were not married.
- United Auto moved for summary judgment, arguing Suarez was not a “resident relative” (not related by blood/marriage) and the accident vehicle was not listed or owned by Guerra.
- The trial court granted summary judgment for United Auto; Pro-Medics appealed, arguing the declarations listing Suarez as “co-insured” entitled her to coverage.
- The appellate court agreed Suarez was not a resident relative but held the undeclared term “co-insured” on the declarations page conferred coverage, reversing and remanding.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Suarez is a “resident relative” covered by the policy | Suarez resided with named insured; thus covered as a resident relative | Suarez not related by blood, marriage, or adoption; therefore not a resident relative under policy | Court: Suarez is not a resident relative under the policy definition |
| Whether listing Suarez as “co-insured” on the declarations page provides coverage despite no policy definition | The declarations page names Suarez as “co-insured,” a term giving her coverage | insurer: absence of defined term and nonresidence/missing vehicle negates coverage | Court: “Co-insured” given its plain meaning entitles Suarez to coverage; declarations control; ruled for plaintiff (reversed trial judgment) |
Key Cases Cited
- Gonzalez v. Citizens Prop. Ins. Corp., 273 So. 3d 1031 (Fla. 3d DCA 2019) (summary judgment reviewed de novo)
- Barcelona Hotel, LLC v. Nova Cas. Co., 57 So. 3d 228 (Fla. 3d DCA 2011) (policy terms given plain and ordinary meaning when undefined)
- Penzer v. Transp. Ins. Co., 29 So. 3d 1000 (Fla. 2010) (approach to construing insurance policy language)
- Auto-Owners Ins. Co. v. Anderson, 756 So. 2d 29 (Fla. 2000) (read policy as a whole and give every provision effect)
- Transamerica Leasing, Inc. v. Inst. of London Underwriters, 267 F.3d 1303 (11th Cir. 2001) (coinsured has rights of named assured and can recover independently)
- Bethel v. Sec. Nat'l Ins. Co., 949 So. 2d 219 (Fla. 3d DCA 2006) (ambiguities construed against insurer; undefined terms cannot be narrowly construed)
- State Farm Fire & Cas. Co. v. CTC Dev. Corp., 720 So. 2d 1072 (Fla. 1998) (ambiguities in insurance contracts construed in favor of coverage)
- Taurus Holdings, Inc. v. U.S. Fid. & Guar. Co., 913 So. 2d 528 (Fla. 2005) (insurance contracts construed according to plain meaning; ambiguities favor insured)