GATEWAY INSURANCE COMPANY, C/O CENTRAL STATES ADJUSTMENT BUREAU, APPELLANT,
v.
GEORGE LYMUS, APPELLEE

Fla. 3d DCA | 1974-05-28
No. 73-1198
Before CARROLL and HENDRY, JJ., and BOARDMAN, EDWARD F., Associate Judge.
295 So. 2d 326 Florida District Court of Appeal, Third District (1974) Positive Treatment
Cited by 6 cases

AI-generated. These summaries, headnotes, and key points are machine-generated and may contain errors or omissions. Always verify against the full opinion text below. Not legal advice.

Synopsis

Gateway Insurance Company appealed a trial court judgment that awarded it only $150 in equitable distribution for $1,727 in personal injury protection (PIP) benefits paid to its insured. The appellate court reversed, holding that Gateway was entitled to full reimbursement of $1,727 under Florida's PIP statute, while affirming the trial court's decision that the insured could still pursue additional PIP claims.


Holding

The insurer is entitled to full reimbursement of $1,727 in PIP benefits paid under subsection (3)(a), since the insured's net recovery of $6,750 from the tortfeasor is sufficient to reimburse the insurer. The insured is not barred from pursuing further PIP claims against the insurer for benefits exceeding the net recovery from the tortfeasor.


Headnotes

[1] An insurer who has paid personal protection benefits to a claimant is entitled to full reimbursement from the claimant's recovery from a tortfeasor, provided the net reco…

[2] The determination of whether an insurer is entitled to reimbursement under Fla.Stat. …

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

Key Quotes

“a claimant's insurer who has paid personal protection benefits to the claimant is stated to be entitled to be reimbursed in full therefor, provided the net amount of the 'recovery' by the claimant from the tortfeasor is sufficient.”

Establishes the standard for full reimbursement of PIP benefits under subsection (3)(a)

Previewing 1 of 3 key quotes on this case — the court’s exact language, pinpointed for members.

Join FLexlaw to unlock all legal intelligence

Facts & Procedural History

Gateway Insurance paid $1,727 in PIP benefits to its insured, the appellee Lymus. Lymus then settled with the tortfeasor's insurance company for $6,75…

The full statement of facts, procedural history, and disposition for this case are member content.

Join FLexlaw to unlock all legal intelligence

© FLexlaw, Inc. — AI-generated enrichments are proprietary. All rights reserved.


Opinion of the Court
PER CURIAM.

PER CURIAM.

This is an appeal by Gateway Insurance Company from an amended final judgment of the trial court awarding it $150 as equitable distribution for payment of personal injury protection (PIP) benefits to its insured, the appellee herein.

The trial court awarded this sum as equitable distribution to the appellant for its previous payment of $1,727 to the appellee in PIP. benefits under the provisions of Fla.Stat. § 627.736(1), F.S.A. In so doing, the court determined that subsection (3) (b) of Section 627.736 was applicable to the instant case, and not subsection (3) (a).

Further, the court ruled that the judgment would not serve to bar the appellee from seeking further PIP benefits against Gateway which were occasioned by the accident in this case, and that the appellant would retain the right to subrogation for any further benefits paid.

It is conceded that the appellee settled this case with the tortfeasor’s insurance company for the sum of $6,750 without instituting a lawsuit. Thereafter, appellee filed a complaint seeking equitable distribution of the $1,727 paid by Gateway.

Then, the record reflects that appellee filed a new complaint, styled “First Amended Complaint,” alleging certain losses sustained by the appellee, including permanent disability and loss of earning and working ability, which are permanent and continuing in nature.

In State Farm Automobile Ins. Co. v. Hauser, Fla.App.1973, 281 So. 2d 563, this court stated that subsections (3) (a) and (3) (b) of Section 627.736 “resist reconciliation.” Therein, we indicated that (3) (a) applies when no lawsuit has been filed, and (3) (b) when suit has been commenced. With respect to subsection (3)(a), we stated: A

“ . . .a claimant’s insurer who has paid personal protection benefits to the claimant is stated to be entitled to be reimbursed in full therefor, provided the net amount of the ‘recovery’ by the claimant from the tortfeasor is sufficient.”

Subsequent to the trial court’s determination, this court decided State Farm Mutual Automobile Ins. Co. v. Mance, Fla.App.1974, 292 So. 2d 52, in which we held specifically that the insurer is entitled to full reimbursement of the PIP benefits it has paid to its insured [under subsection (3)(a)] provided that the recovery by the latter from the tortfeasor, exclusive of reasonable attorney’s fees and other reasonable expenses in affecting the recovery, is a sum sufficient to reimburse the insurer. Therefore, we must conclude that the trial court was in error in granting equita ble distribution under subsection (3)(b), rather than full reimbursement under (3) (a). In our view, Gateway was entitled to full reimbursement of the $1,727 in PIP benefits paid, since the net recovery of the $6,750 recovered from the tortfeasor is sufficient to reimburse the insurer. We see no reason, however, to disturb the trial court’s ruling in this case that the appellee is not barred from proceeding to make further PIP claims against the appellant. The insurer will still be liable to its insured for any PIP benefits to which he is entitled which exceed the insured’s net recovery from the tortfeasor. Therefore, for the reasons stated, that part of the judgment awarding the appellant $150 as equitable distribution in this cause is reversed with directions to award the appellant $1,727 as full reimbursement.

That part of the judgment permitting the appellee to make further PIP claims against the insurance company is affirmed.

Affirmed in part; reversed in part.


Cases With Similar Vibessemantic neighbors from the corpus


Citator

Cited By

  • Williams v. Gateway Ins. Co., 331 So. 2d 301 (Fla. 1976)
    …Gateway Ins. Co., 294 So. 2d 422 (Fla.App.3d 1974) conflicts with the decision of the Fourth District in Reyes v. Banks, 292 So. 2d 39 (Fla.App.4th 1974). In turn Reyes conflicts with the Third District’s decisions in Gateway Insurance Co. v. Lymus, 295 So. 2d 326 (Fla.App.3d 1974), State Farm Mutual Auto Insurance Co. v. Manee, 292 So. 2d 52 (Fla.App.3d 1974) and State Farm Automobile Ins. Co. v. Hauser, 281 So. 2d 563 (Fla.App.3d 1973). Additionally, both Williams and Reyes are in conflict with the First Di…
    1 / 2
  • Longman v. Travelers Ins. Co., 371 So. 2d 533 (Fla. 3d DCA 1979)
    …r chargeable with liability or responsibility does not have the effect of releasing an injured insured’s carrier from paying medical expenses under the P.I.P. coverage provision. See, in addition to Hughes, supra, Gateway Insurance Company v. Lymus, 295 So. 2d 326 (Fla. 3d DCA 1974). In Weatherford, the release discharging the defendant-driver and its insurer “and all other persons, firms or corporations liable or who might be claimed to be liable . ” effectively released the owner [*535] and the lessee of a…
  • Creel v. Gov't Emps. Ins. Co., 313 So. 2d 772 (Fla. 3d DCA 1975)
    …issions, it is clear from a line of holdings by this court that the appellee owed him no payment as equitable distribution. State Farm Mutual Auto. Ins. Co. v. Mance, Fla.App.1974, 292 [*774] So. 2d 52; Gateway Insurance Co. v. Lymus, Fla.App. 1974, 295 So. 2d 326. For the reasons stated and upon the authorities cited, the judgment appealed is affirmed. Affirmed. . We have read the affidavit filed by Creel’s attorney, and we find that the matters contained therein refute admissions (1) and (2) ; however, t…

Authorities Cited

Full citator, related cases, and AI research tools

Open in FLexlaw