State Farm Mutual Automobile Insurance Company v. Robin Curran
135 So. 3d 1071
| Fla. | 2014Background
- Curran, insured under State Farm UM policy, failed to attend a CME under contract terms.
- Policy states no right of action until terms met; CME is requested after a UM claim.
- Curran sought UM benefits; State Farm denied coverage based on CME breach.
- Fifth District en banc held CME prejudice requirement; insurer bears burden to plead/prove prejudice.
- Court certified whether CME breach forfeits benefits without prejudice; and who bears burden of proving prejudice.
- Supreme Court granted review to resolve the proper characterization and burden regarding CME in UM context.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Does CME breach automatically forfeit UM benefits without regard to prejudice? | Curran breached CME but not automatically forfeited without prejudice. | State Farm argues CME is a condition precedent to coverage/suit causing automatic forfeiture. | No automatic forfeiture; prejudice must be pleaded and proved by insurer. |
| Who bears the burden to plead and prove prejudice if CME breach is at issue? | Burden should shift based on contract language and precedent. | Insurer should prove prejudice as part of its affirmative defense. | Insurer bears burden to plead and prove prejudice. |
Key Cases Cited
- Bankers Ins. Co. v. Macias, 475 So.2d 1216 (Fla. 1985) (prejudice relevant for certain breaches; cooperation/default rules differ)
- Custer Medical Center v. United Automobile Insurance Co., 62 So.3d 1086 (Fla. 2010) (CME not a condition precedent in PIP; burden on insurer to prove prejudice in some contexts)
- De Ferrari v. Gov’t Emps. Ins. Co., 613 So.2d 101 (Fla. 3d DCA 1993) (presuit CME as condition precedent; prejudice not required to deny claim)
- Goldman v. State Farm Fire Gen. Ins. Co., 660 So.2d 300 (Fla. 4th DCA 1995) (EUO/CMEs can be condition precedent; prejudice not always required)
- Diaz-Hernandez v. State Farm Fire & Cas. Co., 19 So.3d 996 (Fla. 3d DCA 2009) (UM statute purposive protection; UM provisions scrutinized against public policy)