FLORIDA RULES OF CIVIL PROCEDURE

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PIP Insurers Prevail on Coverage Dispute on PIP Language in Rare DCA Review of a PIP Matter

Facts:   Several providers sought reimbursement for the full amount of their charges.  The multiple matters were consolidated on appeal. The providers sought full PIP reimbursement based on an alleged ambiguity in the policies at issue as follows:

….. the total limit of benefits we are obligated to pay shall then be based on the difference between such deductible amount and the total amount of all loss and expense incurred, subject to the $10,000 limit of benefits.

Holding:   The Fourth District found that the insurer’s policy was not ambiguous. The Court affirmed the underlying summary judgments holding that the language did not create a sperate or independent obligation to pay. The insurers prevailed.

Rationale:   The Court found the providers attempt to create an ambiguity was a  “fanciful . . . interpretations.” BKD Twenty-One Mgmt. Co. v. Delsordo, 127 So. 3d 527, 530 (Fla. 4th DCA 2012).   Without a genuine inconsistency, a court is not allowed “to rewrite contracts, add meaning that is not present, or otherwise reach results contrary to the intentions of the parties.” Deni Assocs. of Fla., Inc. v. StateFarm Fire & Cas. Ins. Co., 711 So. 2d 1135, 1138 (Fla. 1998).

Subordinating language, such as “subject to,” only indicates that the main clause it introduces or follows does not
derogate from the provision to which it refers. Thus, despite the alleged ambiguity the benefits available could not exceed the $10,000.00 stated limit.

The opinion may be found here: https://www.4dca.org/content/download/671362/opinion/191398_DC05_09232020_101230_i.pdf

BKD Twenty-One Mgmt. Co. v. Delsordo : https://www.4dca.org/content/download/178877/opinion/4D12-914.op.pdf

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