SANDRA THIBODEAU, APPELLANT,
v.
ALLSTATE INSURANCE COMPANY, APPELLEE
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Sandra Thibodeau appealed a judgment denying her personal injury protection (PIP) recovery from Allstate Insurance following a car accident that killed the policy owner, her cousin Brian Thibodeau. The court affirmed, holding that under Florida's insurance statute, the $4,000 deductible for resident relatives applies to the $5,000 PIP benefit, resulting in Allstate's liability of only $1,000.
The court held that the $4,000 deductible for resident relatives is properly applied to reduce the $5,000 PIP benefit under Florida Statute section 627.739(1), resulting in Allstate's total liability of $1,000. The court also rejected the argument that the policy language was ambiguous, finding the deductible clause clearly tracked the insurance statute.
[1] A personal injury protection policy's stated coverage limit is reduced by the amount of the deductible applicable to the insured.
[2] A deductible for a resident relative under a personal injury protection policy applies to the total amount of benefits otherwise payable to that person.
Previewing 2 of 4 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“The amount of any deductible stated in the declarations or in a schedule of the policy shall be deducted from the total amount of all sums otherwise payable by the Company with respect to all loss and expense incurred by or on behalf of each person to whom the deductible applies . . . and if the total amount of such loss and expenses exceeds the deductible, the total limit of benefits the Company is obligated to pay shall then be the difference between such deductible amount and the applicable limit of the Company's liability.”
Policy language establishing how the deductible operates under the insurance contract
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Join FLexlaw to unlock all legal intelligenceSandra Thibodeau suffered over $8,000 in medical injuries in a November 10, 1978 car accident involving a vehicle owned and driven by her cousin Brian…
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SHARP, Judge.
Sandra Thibodeau appeals from a final judgment denying her any recovery against Allstate Insurance Company. She suffered in excess of $8,000 in medical injuries on November 10, 1978, when a car owned and driven by Brian Rex Thibodeau was involved in an accident. Brian was killed. Sandra claimed she was entitled to $4,000 in personal injury protection payments from Allstate under Brian’s policy with Allstate because the policy stated there was $5,000 coverage for “personal injury protection” with a $4,000 “deductible” for “relatives” residing in the household.1 The policy provided:
The amount of any deductible stated in the declarations or in a schedule of the policy shall be deducted from the total amount of all sums otherwise payable by the Company with respect to all loss and expense incurred by or on behalf of each person to whom the deductible applies . . . and if the total amount of such loss and expenses exceeds the deductible, the total limit of benefits the Company is obligated to pay shall then be the difference between such deductible amount and the applicable limit of the Company’s liability. (Emphasis supplied).
Allstate paid $1,000 on Sandra’s behalf and denied further liability. We affirm.
This case is controlled by the provisions of section 627.739(1), Florida Statutes (1977). The statute required an insurer to offer the policy owner “deductibles, in amounts of $250, $500, $1,000, $2,000, $3,000, and $4,000, said amount to be deducted from the benefits otherwise due each person subject to the deduction. . . .” (Emphasis supplied). As a “resident relative,” Sandra was subject to the “deductible” amount of $4,000 under Brian’s policy, and the amount “otherwise due” was $5,000. Under this statute Allstate’s total liability was $1,000. Industrial Fire & Casualty Insurance Company v. Cowan, 364 So. 2d 810 (Fla. 3d DCA 1978).
The appellant argues the policy statement of “$5,000 coverage” is ambiguous and misleading because under no circumstances is $5,000 ever payable if it is subject to a deduction,2 and the general public assumes, upon reading such a statement, that there is $5,000 coverage after the insured pays the first $4,000. This is an appealing argument because clearly the “deductible clause” is given a double effect. However based on the record before us we are unable to conclude an ambiguity exists because the policy explanation of the “deductible” tracks the insurance statute clearly and precisely. If this result is contrary to public policy or understanding and expectation, the legislature should revise section 627.739(1).
AFFIRMED.
COBB and FRANK D. UPCHURCH, Jr., JJ., concur. . Sandra and Brian were first cousins living together in the same household. Appellant agreed in her appeal she was subject to the “resident relative” deductible clause.
. A more accurate statement would have been: $1,000 coverage after the insured pays the first-$4,000 loss.
Cases With Similar Vibessemantic neighbors from the corpus
Citator
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Int'l Bankers Ins. Co. v. Arnone, 552 So. 2d 908 (Fla. 1989)…orily mandated personal injury protection (PIP) coverage limits of $10,000. We have jurisdiction to review International Bankers Insurance Co. v. Arnone, 528 So. 2d 917 (Fla. 4th DCA 1988), based on conflict with Thibodeau v. Allstate Insurance Co., 391 So. 2d 805 (Fla. 5th DCA 1980), disapproved, Govan v. International Bankers Insurance Co., 521 So. 2d 1086 (Fla.1988), and Industrial Fire and Casualty Insurance Co. v. Cowan, 364 So. 2d 810 (Fla. 3d DCA 1978), disapproved, Govan v. International Bankers Insur…1 / 2
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Int'l Bankers Ins. Co. v. Govan, 502 So. 2d 913 (Fla. 4th DCA 1986)…trial Fire & Casualty Co., 409 So. 2d 28, 30 n. 3 (Fla. 3d DCA 1981), approved, 447 So. 2d 1337 (Fla. 1983). We acknowledge that our holding appears to conflict with the opinions of two of our sister courts. See Thibodeau v. Allstate Insurance Co., 391 So. 2d 805 (Fla. 5th DCA 1980); Industrial Fire & Casualty Insurance Co. v. Cowan, 364 So. 2d 810 (Fla. 3d DCA 1978). Those cases appear to hold that “benefits otherwise due” refers to the no-fault benefit limits, such as the $10,000.00 limit involved herein.…
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Govan v. Int'l Bankers Ins. Co., 521 So. 2d 1086 (Fla. 1988)…t of appeal determined the proper method to compute the deductibility provisions for medical and wage-loss benefits under section 627.739(2), Florida Statutes (1983). The district court acknowledged conflict with Thibodeau v. Allstate Insurance Co., 391 So. 2d 805 (Fla. 5th DCA 1980), and Industrial Fire and Casualty Insurance Co. v. Cowan, 364 So. 2d 810 (Fla. 3d DCA 1978). We find conflict and have jurisdiction. Art. V, § 3(b)(3), Fla. Const. For the reasons expressed below, we approve the decision of the d…
Previewing 3 of 6 citing cases — full citator treatment, depth of discussion, and citing context are member features.
Join FLexlaw to unlock all legal intelligenceAuthorities Cited
- Indus. Fire & Cas. Ins. Co. v. Cowan, 364 So. 2d 810 (Fla. 3d DCA 1978)