ALFONSO RIVEROLL, JR., AND ALFONSO RIVEROLL, SR., APPELLANTS,
v.
WINTERTHUR INTERNATIONAL LTD., AND AMEDEX INSURANCE COMPANY, APPELLEES

Fla. 3d DCA | 2001-04-25
No. 3D00-2400
Before GERSTEN, GODERICH and SHEVIN, JJ.
787 So. 2d 891 Florida District Court of Appeal, Third District (2001) Positive Treatment
Cited by 10 cases

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Synopsis

The Riverolls appealed a summary judgment finding their insurance policy did not cover medical treatment expenses incurred after the policy expired, even though the underlying accident occurred during the policy period. The court affirmed, holding that the plain language of the exclusion clause clearly prohibited coverage for treatment costs incurred after policy expiration unless the policy was renewed.


Holding

The court held that the policy does not provide coverage for treatment expenses incurred after the policy expiration date. The plain language exclusion clause clearly disallows such coverage unless the policy has been renewed, and no ambiguity exists in the policy language that would require a different interpretation.


Headnotes

[1] An insurance policy's plain language, if clear and unambiguous, must be given effect according to its plain meaning.

[2] An insurance policy exclusion clause that disallows coverage for medical treatment incurred after the policy's expiration date, unless renewed, will be enforced as writte…

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Key Quotes

“The exclusion clause in the policy excludes "[c]laims and costs for medical treatment incurred after the expiration date of the Policy, resulting from accidents or illnesses during the policy period, unless the Policy has been renewed."”

The court identifies the controlling policy language that clearly excludes coverage for post-expiration treatment expenses.

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Facts & Procedural History

The Riverolls held an insurance policy with Winterthur International Limited (later succeeded by Amedex Insurance Company) that covered an accident. T…

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Opinion of the Court
PER CURIAM.

PER CURIAM.

Alfonso Riveroll, Jr., and Alfonso Rive-roll, Sr., appeal a partial final summary judgment in favor of insurers, Winterthur International Limited and Amedex Insurance Company, on count III of the Rive-rolls’ complaint, finding that the subject policy does not afford coverage for treatment rendered after the policy expired. We affirm.

The Riverolls brought this lawsuit against Winterthur and its successor, Am-edex Insurance Company, asserting that they were entitled to coverage under the policy for all treatment resulting from an accident covered under the policy for as long as treatment was medically necessary, regardless of when the policy expired. Winterthur and Amedex asserted that the policy did not cover claims for treatment after the expiration thereof. The trial court granted the Insurance Companies’ motion for summary judgment.

We agree with the trial court’s conclusion. The exclusion clause in the policy excludes “[cjlaims and costs for medical treatment incurred after the expiration date of the Policy, resulting from accidents or illnesses during the policy period, unless the Policy has been renewed.” (Emphasis added.) Under basic insurance contract interpretation principles, as this policy language is clear and unambiguous, we must give effect to the plain language of the policy. Auto-Owners Ins. Co. v. Anderson, 756 So. 2d 29, 33 (Fla.2000). The clause plainly disallows coverage for the expenses the Riverolls’ claim-expenses incurred after the policy expiration date.

The Riverolls suggest that the claims definition clause conflicts with the exclusion clause and creates an ambiguity in the policy. However, no ambiguity exists. The claims definition clause states that an insured can claim from the start of the course of treatment until the time it is medically confirmed that treatment is no longer necessary.”1 This clause defines when a new claim is being submitted, triggering the application of the policy’s deductible provision.2 This clause does not operate to create coverage in perpetuity for injuries suffered while the policy was in force. Hence, there is no conflict with the exclusion clause.

We are not unmindful of our obligation to “read each policy as a whole, endeavoring to give every provision its full meaning and operative effect.” Anderson, 756 So. 2d at 34. However, where no ambiguity exists in the policy, we will not impose a construction contrary to its plain language. We therefore affirm the partial summary judgment.

Affirmed.

. The clause provides:

When an Insured Person undergoes medical treatment for accident or illness, they can claim from the start of the course of treatment until the time that it is medically confirmed that treatment is no longer necessary. Where compensation is claimed for medical treatment received, and the Insured Person subsequently claims for a new course of treatment which is not in any way connected with the former treatment, the subsequent Claim will be regarded as a new Claim.

. The policy conditions provide: "A deductible of $250 will be applied to each and every claim resulting from accident or sickness. ...”


Cases With Similar Vibessemantic neighbors from the corpus


Citator

Cited By

  • State Farm Mut. Auto. Ins. Co. v. Mashburn, 15 So. 3d 701 (Fla. 1st DCA 2009)
    …struing insurance policies, courts should read each policy as a whole, endeavoring to give every provision its full meaning and operative effect.” Auto-Owners Ins. Co. v. Anderson, 756 So. 2d 29, 34 (Fla.2000); see Riveroll v. Winterthur Int’l Ltd., 787 So. 2d 891, 892 (Fla. 3d DCA 2001). In other words, a single policy provision should not be read in isolation and out of context, for the contract is to be construed according to its entire terms, as set forth in the policy and amplified by the policy applicat…
  • First Prof'ls Ins. Co., Inc. v. Barbara McKINNEY, M.D., 973 So. 2d 510 (Fla. 1st DCA 2007)
    …struing insurance policies, courts should read each policy as a whole, endeavoring to give every provision its full meaning and operative effect.” Auto-Oumers Ins. Co. v. Anderson, 756 So. 2d 29, 34 (Fla.2000); see Riveroll v. Winterthur Int’l Ltd., 787 So. 2d 891, 892 (Fla. 3d DCA 2001). In other words, a single policy provision should not be read in isolation and out of context, for the contract is to be construed according to its entire terms, as set forth in the policy and amplified by the policy applicat…
  • Infinity Auto Ins. Co v. Sunshine Rehab Med. Inc (11th Cir. Ct. App. Div. 2015)

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