WJA REALTY LIMITED PARTNERSHIP, APPELLANT,
v.
EMPLOYEE BENEFIT CLAIMS, INC., A MINNESOTA CORPORATION; EQUITABLE BENEFIT PLANS, INC., A FLORIDA CORPORATION; AND THE HARTFORD ACCIDENT AND INDEMNITY COMPANY, APPELLEES

Fla. 3d DCA | 1986-05-06
No. 85-1619
Baskin, J.
488 So. 2d 121 Florida District Court of Appeal, Third District (1986) Positive Treatment
Cited by 3 cases

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Synopsis

WJA Realty's claim for reimbursement under a Stop Loss Agreement was properly dismissed because the claim was paid after the excess coverage policy's effective period expired, and Hartford's return of the June premium and WJA's failure to tender a July premium defeated any estoppel or waiver argument.


Holding

An insurer is not estopped from denying excess coverage where it returns the premium payment and the insured fails to tender a premium for the month in which the claim is paid.


Headnotes

[1] An insurer that returns a premium payment and receives no premium tender for the month in which a claim is paid cannot be estopped from denying coverage based on the prio…

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Facts & Procedural History

WJA Realty sought reimbursement under a Stop Loss Agreement for a claim paid in July 1984. Hartford had received a June 1984 premium payment but retur…

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Opinion of the Court
BASKIN, Judge.

BASKIN, Judge.

Finding that, contrary to the specific terms of the parties’ Stop Loss Agreement, the payment of the claim for which WJA Realty Limited Partnership [WJA] seeks reimbursement was not made until after the expiration of the effective period of the excess coverage insurance policy, we affirm the trial court’s dismissal with prejudice of WJA’s second amended complaint. See Travelers Indemnity Co. v. Mirlenbrink, 345 So. 2d 417 (Fla. 2d DCA 1977).

We reject WJA’s argument that its payment of the June 1984, premium estopped Hartford from denying excess coverage for a claim paid in July 1984. Estoppel and waiver are inapplicable for two reasons: first, Hartford returned the June premium payment to WJA, cf. Travelers Indemnity Co. v. Dana, 434 So. 2d 48 (Fla. 3d DCA 1983) (insurance company estopped from denying coverage where injury occurred after past-due premium paid and insurer retained past-due premium); Mixon v. Allstate Insurance Co., 388 So. 2d 608 (Fla. 3d DCA 1980) (unconditional acceptance of premium payment constituted waiver of insurer’s right to contend policy lapsed), review denied, 397 So. 2d 777 (Fla.1981); second, WJA did not tender a premium payment for July, the month in which the claim was paid. Thus, Hartford was not required to reimburse WJA for its payment of the claim at issue.

Affirmed.


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Citator

Cited By

  • Bristol W. Ins. Co. v. Albertson, 41 So. 3d 378 (Fla. 4th DCA 2010)
    …m Mut. Auto. Ins. Co., 460 F. 2d 776, 778 n. 3 (5th Cir.1972) (unconditional acceptance and retention of delinquent premium is waiver of right to cancel policy or to refuse reinstatement) with WJA Realty Ltd. P’ship v. Employee Benefit Claims, Inc., 488 So. 2d 121, 122 (Fla. 3d DCA 1986) (acceptance of past-due premium was not unconditional when insurer returned premium to insured) and Travelers Indem. Co. of R.I. v. Mirlenbrink, 345 So. 2d 417, 419 (Fla. 2d DCA 1977) (insurer was not es-topped from denying c…
  • Pajcic Ex Rel. Stephen J. Pajcic v. Am. Gen. Life Ins., 419 F. Supp. 2d 1380 (M.D. Fla. 2006)
    …o. Ins. Co., 460 F.2d 776, 778 (5th Cir.1972) (unconditional acceptance and retention of delinquent premium payment is waiver of right to cancel policy or to refuse reinstatement); WJA Realty Ltd. Partnership v. Employee Ben., Claims, Inc., 488 So.2d 121, 122 (Fla. 3d DCA 1986) (acceptance of past-due premium payment was not unconditional when insurer returned the payment to insured after failure to complete necessary paperwork); Travelers Indem. Co. of Rhode Island v. Mirlenbrink, 345 So.2d 4…

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