COMPREHENSIVE BENEFIT ADMINISTRATORS, INC., APPELLANT,
v.
NU-CAPE CONSTRUCTION, INC., LAWRENCE KIRBY AND JOAN KIRBY, APPELLEES
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LEHAN, Judge.
We affirm the summary judgment entered against defendant insurer. The summary judgment determined coverage existed under a group health insurance policy issued to appellee company for medical expenses incident to cancer suffered by the wife of a company employee.
We agree with the trial court’s determination that coverage was not precluded due to a misrepresentation through a negative answer to a question in the policy application about knowledge of cancer suffered by the wife. The question was ambiguous as to whether it asked about a then existing condition (in which case the negative answer would have been correct) or about a prior condition (in which case the negative answer would have been incorrect). The trial court properly construed the ambiguity against the insurer and found that coverage was not precluded. See Hulse v. Blue Cross/Blue Shield of Florida, Inc., 424 So. 2d 191, 192 (Fla. 5th DCA 1983); Ellenwood v. Southern United Life Insurance Co., 373 So. 2d 392, 394 (Fla. 1st DCA 1979); United Services Automobile Ass’n v. Porras, 214 So. 2d 749, 750 (Fla. 3d DCA 1968).
Affirmed.
RYDER, A.C.J., and PARKER, J., concur.
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Boca Raton Cmty. Hosp., Inc. v. Brucker, 695 So. 2d 911 (Fla. 4th DCA 1997)…t information, and any ambiguity in the insurance policy application should be construed against the insurer. William Penn Life Ins. Co. v. Sands, 912 F. 2d 1359, 1362 (11th Cir.1990); see Comprehensive Benefit Adm’rs, Inc. v. Nu-Cape Constr., Inc., 549 So. 2d 700 (Fla. 2d DCA 1989). Here, the insurer requested additional information concerning medical histories only if the initial question elicited either a “YES” answer or if the number of people in the group insurance plan was fewer than twenty people. The…
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Mora v. Tower Hill Prime Ins. Co., 155 So. 3d 1224 (Fla. 2d DCA 2015)…der this statute, however, if the alleged misrepresentation was in response to an ambiguous question. See Boca Raton Comty. Hosp., Inc. v. Brucker, 695 So. 2d 911, 913 (Fla. 4th DCA 1997); Comprehensive Benefit Adm’rs, Inc. v. Nu-Cape Constr., Inc., 549 So. 2d 700 (Fla. 2d DCA 1989). A question is ambiguous when it is susceptible to two reasonable interpretations, one in which a negative response would be correct and one in which an affirmative response would be correct. If Tower Hill intended “cracking dama…
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Mercury Ins. Co. OF Fla. v. Markham, 36 So. 3d 730 (Fla. 1st DCA 2010)…der this statute, however, if the alleged misrepresentation was in response to an ambiguous question. See Boca Raton Comty. Hosp., Inc. v. Brucker, 695 So. 2d 911, 913 (Fla. 4th DCA 1997); Comprehensive Benefit Adm’rs, Inc. v. Nu-Cape Constr., Inc., 549 So. 2d 700 (Fla. 2d DCA 1989). A question is ambiguous when it is susceptible to two reasonable interpretations, one in which a negative response would be correct and one in which an affirmative response would be correct. Comprehensive Benefit, 549 So. 2d at 7…
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Join FLexlaw to unlock all legal intelligenceAuthorities Cited
- Ellenwood v. S. United Life Ins. Co., 373 So. 2d 392 (Fla. 1st DCA 1979)
- United Servs. Auto. Ass'n v. Porras, 214 So. 2d 749 (Fla. 3d DCA 1968)
- Hulse v. Blue Cross/Blue Shield OF Fla., Inc., 424 So. 2d 191 (Fla. 5th DCA 1983)