NELSON DEAN, D/B/A COLONIAL KITCHEN, APPELLANT,
v.
CENTRAL MUTUAL INSURANCE COMPANY, APPELLEE

Fla. 1st DCA | 1980-04-01
No. QQ-181
ERVIN and SHAW, JJ., concur.
381 So. 2d 737 Florida District Court of Appeal, First District (1980) Positive Treatment
Cited by 4 cases

AI-generated. These summaries, headnotes, and key points are machine-generated and may contain errors or omissions. Always verify against the full opinion text below. Not legal advice.

Synopsis

An employer appealed a workers' compensation coverage denial after purchasing a restaurant, claiming coverage under the former owner's still-active insurance policy. The court reversed because the judge's coverage decision was based on an unrelated policy and he failed to address the employer's estoppel defense.


Holding

The court reversed the coverage denial and remanded because the judge based his decision on an interpretation of the new policy rather than the policy under which coverage was claimed, and failed to address the estoppel defense that could apply if the insurer induced reliance through its agent's conduct.


Headnotes

[1] An order finding no workmen's compensation insurance coverage is not supported by competent and substantial evidence when the finding is based solely on an interpretation…

[2] An insurer may be estopped from denying coverage if it has conducted itself in a manner that induces action in reliance by the insured, even if the policy contains condit…

Previewing 2 of 3 headnotes on this case. FLexlaw’s editorially structured points of law — every proposition, pinpointed — are reserved for members.

Join FLexlaw to unlock all legal intelligence

Key Quotes

“Since the finding of no coverage was based solely upon an interpretation of the new policy and not the policy under which appellant claims coverage, there is no competent and substantial evidence to support the order.”

Establishes the fundamental error—the judge decided the case on the wrong insurance policy, depriving the decision of evidentiary support.

Previewing 1 of 3 key quotes on this case — the court’s exact language, pinpointed for members.

Join FLexlaw to unlock all legal intelligence

Facts & Procedural History

Nelson Dean purchased Colonial Kitchen Restaurant on November 1, 1977. An employee was injured on January 21, 1978, while a prepaid workers' compensat…

The full statement of facts, procedural history, and disposition for this case are member content.

Join FLexlaw to unlock all legal intelligence

© FLexlaw, Inc. — AI-generated enrichments are proprietary. All rights reserved.


Opinion of the Court
SHIVERS, Judge.

SHIVERS, Judge.

Appellant/employer appeals an order of the Judge of Industrial Claims finding that the appellee/carrier did not provide workmen’s compensation insurance coverage for appellant’s employees. Because the insurance policy in question was not before the Judge of Industrial Claims at the time of the entry of the order, we reverse.

Appellant purchased the Colonial Kitchen Restaurant on November 1, 1977. The claimant, a restaurant employee of appellant, was injured on January 21, 1978. On the date of the accident, the former owner of the restaurant had a prepaid workmen’s compensation insurance policy from appel-lee which covered the restaurant and was still in effect. There was no proration of the prepaid coverage at the sale of the restaurant and the former owner never requested a refund from appellee. Appellee did not cancel the former owner’s policy until it expired on March 8, 1978, the same date appellee commenced coverage under a new policy issued to appellant.

At the hearing below, appellant claimed compensation coverage under the former owner’s policy. Appellee denied coverage of the claimant’s accident on the grounds that the policy in effect on the date of the accident was for the benefit of the former owner and not for the benefit of appellant. Appellant contended appellee was estopped from denying coverage because it had received timely notice of the change in the restaurant’s ownership. Appellant and appellant’s attorney testified that they notified an agent of appellee of the change in the ownership of the restaurant both before and immediately after appellant purchased the business. However, appellee’s agent denied receiving notice of the sale of the restaurant until after the date of the accident.

The Judge of Industrial Claims did not resolve the issue of estoppel by notice but, instead, held that appellee did not provide appellant with workmen’s compensation insurance coverage. Although the Judge of Industrial Claims did not have before him the former policy under which appellant claimed coverage, he found that such policy did not extend to appellant or his employees. This finding was based upon an interpretation of the new policy issued to appellant subsequent to the accident which provided that all changes must appear as an endorsement on the policy and that the agent writing the policy has no power to bind appellee. Since the finding of no coverage was based solely upon an interpretation of the new policy and not the policy under which appellant claims coverage, there is no competent and substantial evidence to support the order. Additionally, the Judge of Industrial Claims erred in failing to rule on the issue of estoppel by notice. Estoppel is applicable when the insurer has conducted itself in such a manner as to induce action in reliance upon by it by the insured. Reliance Mutual Life Insurance Company v. Booher, 166 So. 2d 222 (Fla. 2d DCA 1964); City Homes, Inc. v. Balido, 9 FCR 40 (1974), cert. denied 308 So. 2d 112 (Fla.1975). Consequently, even assuming the policy in question contains a condition that all changes must appear as an endorsement on the policy and that the agent writing the policy has no power to bind appellee, it is possible appellee may have conducted itself in such a manner as to be estopped from raising any condition of the policy in support of its denial of coverage.

Therefore, the order is reversed and the case remanded for additional proceedings consistent with this opinion.

ERVIN and SHAW, JJ., concur.


Cases With Similar Vibessemantic neighbors from the corpus


Citator

Cited By

  • Dan's Plumbing & CNA Ins. v. Smith, 410 So. 2d 941 (Fla. 1st DCA 1982)
    …to its responsibilities and be estopped from asserting the untimeliness of claimant’s application for wage-loss benefits and his failure to conduct an adequate job search through the date of the deputy’s order. Dean v. Central Mutual Insurance Co., 381 So. 2d 737 (Fla. 1st DCA 1980). Consequently, the order is reversed and the case remanded for additional proceedings consistent with this opinion. LARRY G. SMITH, and THOMPSON, JJ., concur.…
  • Allstate Ins. Co. v. Pierce, 597 So. 2d 388 (Fla. 5th DCA 1992)
    …concluded that Pierce’s contention was correct. This conclusion constitutes error. An estoppel can only be invoked against an insurer when its conduct has been such as to induce actions in reliance upon it. Dean v. Central Mutual Insurance Company, 381 So. 2d 737, 738 (Fla. 1st DCA 1980); Burns v. Consolidated American Insurance Company, 359 So. 2d 1203, 1207 (Fla. 3d DCA 1978); Travelers Indemnity Company of Rhode Island v. Mirlenbrink, 345 So. 2d 417, 419 (Fla. 2d DCA 1977); Mutual of Omaha Insurance Compa…

Authorities Cited

Full citator, related cases, and AI research tools

Open in FLexlaw