HOWARD LAYTON MACDONALD, APPELLANT,
v.
THE PENN MUTUAL LIFE INSURANCE COMPANY, AN INSURANCE CORPORATION, ET AL., APPELLEES
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The court held that the conversion privilege in the group insurance policy did not extend to major medical coverage, and that damages for emotional distress and punitive damages are not recoverable for a simple breach of contract in Florida.
[1] A group insurance policy's conversion privilege, which allows an employee to convert hospital, surgical, or major medical expense insurance to an individual policy withou…
[2] Ambiguities in insurance policy language are generally construed in favor of the insured.
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Join FLexlaw to unlock all legal intelligenceAppellant sought to convert group insurance to an individual policy after employment termination. The insurer issued a hospital/surgical policy but re…
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Appellant appeals an adverse final judgment and assigns as error the trial court’s *233ruling in dismissing, with prejudice, the first count of the original complaint and the sixth count of the amended complaint,
Appellee issued a group insurance policy to a bank where appellant was employed. Appellant thereafter terminated his employment and sought to convert his coverage under the group policy to an individual policy and to thereby obtain major medical insurance coverage on an individual basis. The appellee issued an individual policy for hospital and surgical benefits but refused to issue an individual major medical insurance policy to appellant without further proof of insurability. In Count I the appellant sought specific performance to compel appellee to issue an individual major medical insurance policy and on ap-pellee’s motion to dismiss the lower court held that the conversion privilege set forth in the policy did not require the appellee to issue individual major medical insurance or coverage to appellant under the terms of the conversion privilege of the group contract.
The pertinent part of the contract read in part:
“Conversion Privilege If an employee’s Hospital, Surgical or Major Medical Expense Insurance has been in force for three months and thereafter terminates because his employment terminates for any reason, he shall have the privilege of converting that insurance without submission of evidence of insurability to an individual policy of hospital and surgical insurance.”
Appellant contends that the language of the quoted portion of the policy was ambiguous, and that such ambiguity should be resolved in favor of the insured. We think that the conversion privilege paragraph clearly states, without ambiguity, that upon termination of his employment the insured shall have the privilege of converting his insurance coverage while an employee into an individual policy of hospital and surgical insurance without submission of evidence of insurability, but that the privilege of conversion was not extended to major medical insurance.
We hold that the lower court correctly dismissed Count I of the original complaint.
The lower court also correctly dismissed Count 6 of the amended complaint for failure to state a cause of action. In said count appellant sought compensatory and punitive damages for emotional stress and physical damages as a result of a vexatious and deliberate refusal of appellee to pay claims over a long period of time. Appellant’s claim for compensatory damages was also alleged in other counts of the amended complaint with respect to specific medical claims due and owing.
Generally, damages for breach of contract are limited to the pecuniary loss sustained, or those which are the natural and proximate result of the breach. An award of punitive damages for a breach of contract is generally not permitted in Florida unless the breach amounts to an independent tort; Griffith v. Shamrock Village, Fla.1957, 94 So.2d 854; Fontainbleau Hotel Corp. v. Kaplan, Fla.App.1959, 108 So.2d 503; Maco Supply Corp. v. Masciarelli, Fla.App.1968, 213 So.2d 265.
The allegations of appellant’s Count 6 fail to show a case of sufficient severity to impose liability for an independent tort. There was only an alleged mishandling and refusal to pay claims or delay in paying claims due under the contract.
Appellant admits that there is no Florida case specifically permitting this cause of action, but urges this court to adopt the rationale of a California case, Fletcher v. Western National Life Ins. Co., 1970, 10 Cal.App.3d 376, 89 Cal.Rptr. 78, where the court allowed both compensatory and punitive damages for maliciously withholding payments of amounts due.
*234Even if the Florida courts recognized such a cause of action, the case sub.judice cannot be viewed as controlled by the principles in Fletcher, supra. In that case the conduct of the insurer was of such a heinous character that it met the requirements of the independent tort of intentional infliction of emotional distress. See Gruenberg v. Aetna Insurance Company, 1972, 27 Cal.App.3d 616, 103 Cal.Rptr. 887.
Considering the allegations made in all the counts of the complaint, Count 6 failed to support a cause of action for any additional damages or any punitive damages arising out of the alleged breach of contract.
The judgment appealed is thereupon
Affirmed.
LILES, A. C. J., and PIERCE, J., (Ret.), concur.
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Indus. Fire & Cas. Ins. Co. v. Romer, 432 So. 2d 66 (Fla. 4th DCA 1983)…of emotional distress. See Butchikas v. Travelers Indemnity Co., 343 So. 2d 816 (Fla.1976); Allstate Insurance Co. v. Gibbs, 340 So. 2d 1202 (Fla. 4th DCA 1976), cert. dismissed 354 So. 2d 980 (Fla.1977); MacDonald v. Penn Mutual Life Insurance Co., 276 So. 2d 232 (Fla. 2d DCA 1973), and Hanft v. Southern Bell Telephone and Telegraph Company, 402 So. 2d 453 (Fla. 3d DCA 1981). As we said in Henry Morrison Flagler Museum v. Lee, 268 So. 2d 434, 436 (Fla. 4th DCA 1972), “where the gravamen of the proceeding is…
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Allstate Ins. Co. v. Gibbs, 340 So. 2d 1202 (Fla. 4th DCA 1976)…Company v. Wright, 308 So. 2d 612 (Fla. 1st DCA 1975). An insuror’s bad faith refusal to settle a claim of its insured is not per se a willful and independent tort giving rise to a claim for damages. MacDonald v. Penn Mutual Life Insurance Company, 276 So. 2d 232 (Fla. 2d DCA 1973). See also Butchikas v. Travelers Indemnity Company, Supreme Court of Florida Case No. 47,733 opinion filed June 30, 1976; Baxter v. Royal Indemnity Company, 285 So. 2d 652 (Fla. 1st DCA 1973) cert. discharged 317 So. 2d 725 (Fla.1…
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Edwards v. Lawyers Title Guar. Fund, 370 So. 2d 58 (Fla. 3d DCA 1979)…s Indemnity Co., 343 So. 2d 816 (Fla.1977); Allstate Insurance Co. v. Gibbs, 340 So. 2d 1202, 1204 (Fla.4th DCA 1976); Sena v. State Farm Mutual Automobile Insurance Co., 305 So. 2d 243 (Fla.3d DCA 1974); MacDonald v. Penn Mutual Life Insurance Co., 276 So. 2d 232 (Fla.2d DCA 1973); State Farm Mutual Automobile Insurance Co. v. Herrin, 230 So. 2d 709 (Fla.2d DCA 1970).…
Previewing 3 of 14 citing cases — full citator treatment, depth of discussion, and citing context are member features.
Join FLexlaw to unlock all legal intelligenceAuthorities Cited
- Griffith v. Shamrock Vill., Inc., 94 So. 2d 854 (Fla. 1957)
- Fontainebleau Hotel Corp. v. Kaplan, 108 So. 2d 503 (Fla. 3d DCA 1959)
- Maco Supply Corp. v. Masciarelli, 213 So. 2d 265 (Fla. 3d DCA 1968)