State Farm Mutual Automobile Insurance Co. v. Curran
2011 Fla. App. LEXIS 19186
| Fla. Dist. Ct. App. | 2011Background
- Curran sought $100,000 UM policy limits after an accident with an underinsured motorist and settled with the tortfeasor; she then faced a CME requirement under the policy.
- State Farm attempted to schedule CME dates; Curran imposed conditions, including waivers of future examinations and in-person attendance constraints.
- Curran eventually filed suit after failing to attend a scheduled CME; State Farm reserved rights and asserted no coverage due to CME breach.
- Trial court granted Curran summary judgment, concluding CME requests were not unreasonable; the jury later awarded Curran substantial damages, and the final UM judgment was $100,000.
- State Farm appealed, arguing Curran’s CME breach defeated coverage or that prejudice obviated the breach; Curran cross-appealed on the prejudice issue and related doctrines.
- The en banc court substituted its own reasoning and affirmed, while certifying a question to the Florida Supreme Court about prejudice and burden of proof in CME breaches.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Curran’s CME breach defeated UM coverage | Curran did not refuse; she conditioned attendance on reasonable terms | State Farm properly invoked a CME as a contractual right | No automatic forfeiture; prejudice must be shown; breach alone did not defeat coverage |
| Whether prejudice must be shown to defeat coverage | No-prejudice rule applies when insurer can investigate; no prejudice shown | Prejudice analysis should apply; insurer burden to prove prejudice | Prejudice Burden of proof on insurer; no prejudice shown on record |
| Whether CME is a condition precedent or a condition subsequent | CME is not clearly a condition precedent to coverage; failure should not automatically bar UM | CME functions as a condition precedent; noncompliance bars recovery unless cured | CME is a condition precedent to recovery; breach can bar UM without automatic prejudice analysis |
| Who bears the burden of pleading/proving prejudice if prejudice is at issue | Insurer bears burden to plead/prove prejudice | Insurer may argue prejudice as an affirmative defense | Burden on insurer to plead and prove prejudice; Curran did not prove lack of prejudice |
| Post-suit CME under Rule 1.360 cures or negates the breach | Rule 1.360 could cure after suit is filed | Post-suit CME cannot retroactively cure willful breaches | Post-suit CME does not cure a willful, material CME breach; prejudice analysis remains unresolved in this context |
Key Cases Cited
- Bankers Ins. Co. v. Macias, 475 So.2d 1216 (Fla. 1985) (burden to show lack of prejudice when insurer prevented investigation)
- De Ferrari v. Gov't Emps. Ins. Co., 613 So.2d 101 (Fla. 3d DCA 1993) (IME/EME breach as condition precedent; prejudice not required)
- Goldman v. State Farm Fire Gen. Ins. Co., 660 So.2d 300 (Fla. 4th DCA 1995) (prejudice analysis debated; generally burden on insured if prejudice claimed)
- Pervis v. State Farm Fire & Cas. Co., 901 F.2d 944 (11th Cir. 1990) (EUO/cooperation issues; exclusionary consequences without prejudice)
- Custer Med. Ctr. v. United Auto. Ins. Co., 62 So.3d 1086 (Fla. 2010) (CME not a PIP-like condition precedent; prejudice burden discussed)
- Shaw v. State Farm Fire & Casualty Co., 37 So.3d 329 (Fla. 5th DCA 2010) (EUO/condition precedent framework in policy terms)
- Kazouris v. Gov't Emps. Ins. Co., 706 So.2d 960 (Fla. 5th DCA 1998) (adoption of De Ferrari approach for UM claims)
- Griffin v. Stonewall Ins. Co., 346 So.2d 97 (Fla. 3d DCA 1977) (PIP context used in CME discussions; caution on statutory changes)