SUN COAST HOME CARE, INC., APPELLANT,
v.
STATE OF FLORIDA, DEPARTMENT OF INSURANCE, APPELLEE
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Sun Coast Home Care challenged a Department of Insurance declaratory statement that classified two of its service contracts as insurance. The Florida District Court of Appeal reversed, holding that the Department lacked sufficient factual evidence in the record to support its determination.
The court reversed because the abbreviated record did not contain the factual information necessary to support the Department's determination that the contracts were insurance. The Department lacks authority to issue a declaratory statement adverse to a petitioner when the record contains no competent, substantial evidence supporting the declaration.
[1] A Department of Insurance may not issue a declaratory statement adverse to a petitioner when the administrative record contains no competent, substantial evidence to supp…
[2] A court or agency considering whether a contract constitutes insurance must examine its purpose, effect, contents, and import, not merely its terminology.
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“whether a contract is insurance depends on its purpose, effect, contents, and import, rather than its terminology”
Establishes the legal standard for determining whether a contract constitutes insurance
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Join FLexlaw to unlock all legal intelligenceIn November 1996, Sun Coast filed a petition seeking a declaratory statement that its two service contracts (an annual membership plan and a lifetime …
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ALTENBERND, Judge.
Sun Coast Home Care, Inc. (Sun Coast), appeals a declaratory statement issued by the Department of Insurance pursuant to section 120.565, Florida Statutes (Supp.1996). The declaratory statement ruled that two contracts for services offered by Sun Coast were insurance. We reverse because the record before the Department was insufficient to support this declaration.
In November 1996, Sun Coast filed a petition for a declaratory statement. Sun Coast asked the Department to issue a statement that their “service contracts [were] not insurance or health insurance as defined by sections 624.02 and 624.603.” The allegations in Sun Coast’s petition are very limited. It contains five short paragraphs describing the factual circumstances involved and attaches two proposed contracts: an annual membership plan and a lifetime membership plan. These contracts are not lengthy documents and do not contain detailed terms and conditions.
Without requesting supplemental pleading or conducting an evidentiary hearing, the Department issued a declaratory statement adverse to Sun Coast, affirmatively ruling that the two contracts were insurance. The Department’s statement correctly observes that whether a contract is insurance depends on its purpose, effect, contents, and import, rather than its terminology. See Boyle v. Orkin Exterminating Co., 578 So. 2d 786 (Fla. 4th DCA 1991). In determining whether a contract is insurance, courts generally examine five factual elements. See Professional Lens Plan, Inc. v. Department of Ins., 387 So. 2d 548 (Fla. 1st DCA 1980). The fundamental problem in this ease is that the abbreviated record does not contain the factual information necessary to make the legal decision requested by Sun Coast, much less the decision that the Department actually made.
The Department has the discretion to conduct a hearing on a petition for declaratory statement. See Fla. Admin. Code R. 4-121.043(2). When it is called upon to issue a declaratory statement that is not supported by specific facts, it may decline to issue the statement. See Florida Optometric Assoc. v. Department of Prof. Reg., Bd. of Opticianry, 567 So. 2d 928 (Fla. 1st DCA 1990). It does not, however, have the authority to issue a declaratory statement adverse to the petitioner when the record contains no competent, substantial evidence to support the declaration.
Reversed and remanded.
CAMPBELL, A.C.J., and GREEN, J., concur.
Cases With Similar Vibessemantic neighbors from the corpus
Citator
Cited By
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Liberty Care Plan v. Dep't OF Ins., 710 So. 2d 202 (Fla. 1st DCA 1998)…t. Nor did the Department of Insurance order such a hearing, as it had authority to do under Florida Administrative Code Rule 4-121.043(2). Although the question is not free from doubt, see Sun Coast Home Care, Inc. v. State Department of Insurance, 710 So. 2d 120 (Fla. 2d DCA 1998), I agree with the majority that the Department had enough information to decide the merits of the Liberty Care Plan petition. As to the “Level I” contract, I concur in the judgment reversing the declaratory statement. Inasmuch a…
Authorities Cited
- Fla. Optometric Ass'n & Alan P. Fisher v. Dep't OF Prof'l Reg., 567 So. 2d 928 (Fla. 1st DCA 1990)
- Prof'l Lens Plan, Inc. v. Dep't OF Ins., 387 So. 2d 548 (Fla. 1st DCA 1980)
- Boyle v. Orkin Exterminating Co., Inc., 578 So. 2d 786 (Fla. 4th DCA 1991)