WADE K. SEMERENA, ETC.,
v.
THE DISTRICT BOARD OF TRUSTEES OF MIAMI DADE COLLEGE, ET AL.,
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The appellate court affirmed the trial court's dismissal of a former professor's class action complaint against his former employer, Miami Dade College (MDC). The court found that MDC had no duty to ensure the professor selected the most financially advantageous health insurance plan offered through the college, as retirees are responsible for understanding and choosing their own coverage.
No, Miami Dade College (MDC) had no statutory or common law duty to ensure that its retirees selected the most financially suitable health insurance plan. Therefore, MDC did not breach any duty to the retiree.
[1] A party to a contract is conclusively presumed to know and understand its contents, terms, and conditions.
[2] A party who cannot read an instrument has a duty to procure someone to read and explain it before signing.
Previewing 2 of 5 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“MDC, however, has no statutory or common law duty to ensure that Semerena was enrolled in “suitable” healthcare insurance.”
Establishes the core legal principle that the college had no duty to select the best plan for the retiree.
Previewing 1 of 3 key quotes on this case — the court’s exact language, pinpointed for members.
Join FLexlaw to unlock all legal intelligenceAfter retiring from Miami Dade College (MDC), Wade Semerena continued his health insurance through MDC's group plan, which was secondary to Medicare a…
The full statement of facts, procedural history, and disposition for this case are member content.
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HENDON, J.
Wade K. Semerena (“Semerena”) seeks to reverse the trial court’s order dismissing his first amended complaint with prejudice as to Miami Dade College and the District Board of Trustees of Miami Dade College (collectively, “MDC”). We affirm.
In 2003, when Semerena retired from MDC after thirty-four years of employment as a philosophy professor, he enrolled in Medicare Part B and elected to continue his health insurance coverage under MDC’s group plan, as a “supplemental”1 insurance policy to Medicare. The monthly premiums for any insurance Semerena chose would be deducted from his Florida Retirement System (“FRS”) pension. The record indicates that Semerena made several choices from the menu of retirement benefits, and he opted to continue group health insurance with United HealthCare, as a supplemental policy to Medicare.2 In 2008, Aetna took over as the insurance provider for the health care insurance Semerena chose.3 Semerena’s coverage would continue unless he chose to opt out and lose the FRS subsidy. Semerena alleges that in 2014 he discovered that the Aetna policy was a more expensive secondary health insurance plan for which he had been paying higher premiums since 2008.
Semerena filed a putative class action complaint against MDC and Aetna. The order on appeal here dismissed the complaint with prejudice as to MDC.4 In this appeal, Semerena alleges:1) MDC, as Semerena’s agent, negligently failed to enroll him and others similarly situated in a group health insurance plan appropriate for retirees enrolled in Medicare;2) MDC breached its fiduciary duty to Semerena
by failing to ensure that the money taken out of his pension to pay the insurance premium was not grossly expensive;3) MDC was unjustly enriched by its actions by having Semerena pay full price for a secondary health insurance policy, thereby lowering MDC’s risk pool;4) MDC behaved unconscionably by binding Semerena to a non-negotiable insurance policy and by charging him and other retired Medicare recipients excessive premiums;5) MDC negligently misrepresented the insurance options available to Semerena and induced him to choose the more expensive group health insurance to his detriment.5
We review a final order dismissing a complaint with prejudice under the de novo standard of review. In doing so, we assume all of the allegations in the complaint are true. We construe all reasonable inferences from the allegations in favor of Semerena. See United Auto. Ins. Co. v. Law Offices of Michael I. Libman, 46 So. 3d 1101, 1103–04 (Fla. 3d DCA 2010); Extraordinary Title Servs., LLC v. Fla. Power & Light Co.,1 So. 3d 400, 402 (Fla. 3d DCA 2009) (quoting Susan Fixel, Inc. v. Rosenthal & Rosenthal Inc., 842 So. 2d 204, 206 (Fla. 3d DCA 2003)). After a thorough review of the record, we find no merit in any of Semerena’s claims against MDC.
Semerena argues that MDC was negligent and breached its duty to provide him and others similarly situated with an appropriate retirement health insurance package. MDC, however, has no statutory or common law duty to ensure that Semerena was enrolled in “suitable” healthcare insurance. MDC negotiates with Aetna and other insurers to allow MDC to offer various group-rate insurance options to its retirees, should those retirees so choose. MDC does not manage the policies or take into account its retirees’ individual financial needs – it is up to the individual retiree to assess his or her own financial and health care needs, read the policy information provided by the insurer, and make an informed choice from among the insurances offered.6 “Florida law has long held that a party to a contract is ‘conclusively presumed to know and understand the contents, terms, and conditions of the contract.’” Rocky Creek Ret. Props., Inc. v. Estate of Fox, 19 So. 3d 1105, 1108–09 (Fla. 2d DCA 2009) (quoting Stonebraker v. Reliance Life Ins. Co. of Pittsburgh, 166 So. 583, 584 (Fla. 1936)). MDC had no duty to Semerena to ensure that he was enrolled in the most financially appropriate insurance contract for him. As there was no duty, it follows there is no cause of action against MDC for negligence.
The causes of action for unjust enrichment and unconscionability similarly fail. MDC is not an agent for any of the health insurers that provide insurance for MDC’s retirees. The contract between MDC and Aetna specifically states that neither entity is an agent of the other. MDC does not collect any premiums or reap any financial benefit from the insurers its retirees choose to do business with, and MDC does not manage any of the insurance policies its retirees choose. The premiums are set by the insurance companies, the insurance premiums are deducted from the policyholders’ pension benefits by the FRS, and the policyholders are notified annually of the costs and benefits under the policies they have chosen. MDC did not deceive Semerena, did not lure him into a bad bargain, and this record reveals no substantive or procedural unconscionability on MDC’s part.
Semerena admits he was on annual notice of any changes in benefits or premiums, but argues that the policy was too lengthy and the language too complicated for him to understand. As the Fifth District Court of Appeal stated in Merrill, Lynch, Pierce, Fenner & Smith, Inc. v. Benton, 467 So. 2d 311, 313 (Fla. 5th DCA 1985): The rule that one who signs a contract is presumed to know its contents has been applied even to contracts of illiterate persons on the ground that if such persons are unable to read, they are negligent if they fail to have the contract read to them. If a person cannot read the instrument, it is as much his duty to procure some reliable person to read and explain it to him, before he signs it, as it would be to read it before he signed it if he were able to do so . . . .
(quoting Sutton v. Crane, 101 So. 2d 823, 825 (Fla. 2d DCA 1958) (quoting 12 Am. Jur. Contracts §137)); Rivero v. Rivero, 963 So. 2d 934, 938 (Fla. 3d DCA 2007) (holding that parties to a contract have a duty to understand the contents); Breckenridge v. Farber, 640 So. 2d 208, 211 (Fla. 4th DCA 1994) (holding that a party is “assumed to have known, and [is] charged with the knowledge, of the provisions incorporated into the contract [he] executed.”) (quoting Marthame Sanders & Co. v. 400 W. Madison Corp., 401 So. 2d 1145, 1146 (Fla. 4th DCA 1981)).
MDC negotiates with a variety of insurance companies, which in turn provide a menu of insurance options to MDC employees and retirees. Although MDC makes these options available, MDC does not endorse or recommend any specific policies. Consequently, MDC did not negligently misrepresent the insurance package that Semerena chose; the information was there for Semerena to read and compare. The record indicates that Semerena chose a group health insurance plan that clearly stated it was secondary to Medicare. The bottom line is that Semerena always had the ability to shop for insurance outside of the choices provided by MDC, or to choose an option within the MDC menu. If Semerena had questions about the various provisions of the group health policy, he had the responsibility and opportunity to educate himself and choose accordingly.
None of Semerena’s claims against MDC have legal merit. We accordingly affirm the trial court’s order dismissing Semerena’s complaint against MDC with prejudice.
Affirmed.
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Authorities Cited (11 total)
- Susan Fixel, Inc. v. Rosenthal & Rosenthal, Inc., 842 So. 2d 204 (Fla. 3d DCA 2003)
- Merrill v. Lelia C. Benton, 467 So. 2d 311 (Fla. 5th DCA 1985)
- Extraordinary Title Servs., LLC v. Fla. Power & Light Co. & FPL Grp., Inc., 1 So. 3d 400 (Fla. 3d DCA 2009)
- United Auto. Ins. Co. v. LAW Offs. OF Michael I. Libman, 46 So. 3d 1101 (Fla. 3d DCA 2010)
- Stonebraker v. Reliance Life Ins. Co. of Pittsburgh, 123 Fla. 244 (Fla. 1936)
- Breckenridge v. Farber, 640 So. 2d 208 (Fla. 4th DCA 1994)
- Sutton v. Crane, 101 So. 2d 823 (Fla. 2d DCA 1958)
- Marthame Sanders & Co. v. 400 W. Madison Corp., 401 So. 2d 1145 (Fla. 4th DCA 1981)
- Rocky Creek Ret. Props., Inc. v. The Est. OF Va. B. FOX, 19 So. 3d 1105 (Fla. 2d DCA 2009)
- Stovall v. State, 963 So. 2d 934 (Fla. 5th DCA 2007)