HARTFORD ACCIDENT & INDEMNITY COMPANY, APPELLANT,
v.
ANGEL DIAZ AND ALICIA DIAZ, HIE WIFE, APPELLEES

Fla. 3d DCA | 1974-06-18
No. 73-1542
Before PEARSON, CARROLL and HAVERFIELD, JJ.
296 So. 2d 504 Florida District Court of Appeal, Third District (1974) Positive Treatment
Cited by 6 cases

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Synopsis

An insurer sought reimbursement of personal injury protection benefits paid to an insured who recovered $65,000 in a tort settlement. The trial court awarded only 10% reimbursement ($500 of $5,000 paid), and the appellate court reversed, holding that equitable distribution under Florida law requires substantially greater reimbursement when recovery from suit significantly exceeds benefits paid.


Holding

A reimbursement allowance of only 10% of paid personal injury protection benefits is inadequate and constitutes an abuse of discretion when recovery through suit is substantially greater than benefits paid. Equitable distribution requires reimbursement of a substantial portion of paid benefits, proportionally reduced to account for the expenses and effort of recovery through litigation.


Headnotes

[1] An insurer's right to reimbursement for personal injury protection benefits paid is subject to equitable distribution by the court when recovery is obtained through settl…

[2] A trial court's determination of equitable distribution for insurer reimbursement must consider the substantiality of the recovery relative to the benefits paid.

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Key Quotes

“in this case where a substantial recovery was made, a reimbursement allowance of only 10% of the personal injury protection benefits was inadequate”

Establishes the court's holding that the trial court's reimbursement allocation was insufficient given the magnitude of recovery relative to benefits paid

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Facts & Procedural History

Angel Diaz received $5,000 in personal injury protection benefits from Hartford Accident & Indemnity Company following an automobile accident. Diaz an…

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Opinion of the Court
PER CURIAM.

PER CURIAM.

Appellee Angel Diaz was injured in an automobile accident. After having received $5,000 in personal injury protection benefits from his insurer Hartford Accident & Indemnity Company, Diaz filed an action for damages for personal injuries -.gainst the responsible tortfeasor and the atter’s insurer. His wife joined therein aaiming loss of consortium.

Prior to trial of that action it was set-.ied for $65,000. Diaz moved the court, under § 627.736(3) (b) Fla.Stat, F.S.A., for a determination, based upon equitable distribution of the amount recovered, of the extent to which his insurer should be reimbursed.

Upon hearing the matter, based on the record and without further evidence, the court entered an order holding the insurer was entitled to receive reimbursement for its paid benefits to the extent of 10% thereof ($500). The insurance company appealed, contending the amount allowed as reimbursement was inadequate as an equitable distribution, and amounted to an abuse of discretion.

The appellees contended to the contrary, and in argument revealed that the net amount received by the plaintiffs from the settlement, above attorney fees and other expenses of the litigation, was $24,000, and that on the basis thereof the reimbursement allowance of 10% of the personal injury payments made by the insurer was not inadequate. In absence of the delineation of standards in subparagraph (b) of Section 3 of § 627.736 for determining the portion of such paid benefits to which an insurer should be entitled to reimbursement upon “equitable distribution of the amount recovered”,1 we are impelled to conclude that in this case where a substantial recovery was made, a reimbursement allowance of only 10% of the personal injury protection benefits was inadequate. See State Farm Automobile Insurance Co. v. Hauser, Fla. App. 1973, 281 So. 2d 563; Liberty Mutual Ins. Co. v. Guillet, Fla.App.1974, 294 So. 2d 1.

In this connection it must be noted that under subparagraph (a) of Section 3 of § 627.736, when recovery is had without suit, an insurer having paid personal injury protection benefits is entitled to full reimbursement to the extent the net amount of the recovery will so permit.2

Where the succeeding subparagraph (b) provides for the court to determine the amount of reinbursement based upon such equitable distribution of the amount recovered [by judgment or settlement after filing action against the tortfeasor], the fact that full reimbursement would be permitted from such a recovery when made without suit would appear to indicate that reimbursement out of recovery obtained through suit should not be minimal, but should be a substantial part of the paid benefits, although reduced proportionately due to the added expense and effort of recovery or settlement through the filing of an action.

In this case the recovery was thirteen times greater than the personal injury protection benefits paid, and on the basis of the net recovery, was approximately five times the amount of such paid benefits. In that circumstance it would appear that equitable distribution would require that a portion of the paid benefits greater than 10% thereof should have been allowed to the insurer. Accordingly, the order appealed from is reversed, and the cause is remanded to the trial court for a reconsideration and determination of the amount of reimbursement to be granted to the appellant insurer on equitable distribution, under § 627.-736(3) (b), Fla.Stat, F.S.A. It is so ordered.

. Reyes v. Banks, Fla.App.1974, 292 So. 2d 39, states certain guide lines.

. State Farm Automobile Insurance Co. v. Hauser, Fla.App.1973, 281 So. 2d 563, 565; Reyes v. Banks, Fla.App.1974, 292 So. 2d 39.


Cases With Similar Vibessemantic neighbors from the corpus


Citator

Cited By

  • Cent. Nat'l Ins. Co. v. Fernandez, 307 So. 2d 906 (Fla. 3d DCA 1975)
    …asonable in light of the record and under the principles of law enunciated in White v. Reserve Insurance Company, Fla.App.1974, 299 So. 2d 661; Reyes v. Banks, Fla.App.1974, 292 So. 2d 39; Hartford Accident & Indemnity Company v. Diaz, Fla.App.1974, 296 So. 2d 504; and, Johnson v. State Farm Mutual Auto. Ins. Co., Fla.App.1974, 294 So. 2d 2. Accordingly, the judgment appealed is affirmed. Affirmed.…
  • State Farm Mut. Auto. Ins. Co. v. Benton, 322 So. 2d 618 (Fla. 3d DCA 1975)
    …The burden of the carrier’s argument here is that the trial court departed from the guide lines set forth in State Farm Automobile Insurance Co. v. Hauser, Fla.App.1973, 281 So. 2d 563, and Hartford Accident & Indemnity Co. v. Diaz, Fla. App.1974, 296 So. 2d 504. We are unable to determine that question upon the record before us. The carrier argues that it is the duty of the moving party in the trial court to make a record that will justify the equitable distribution. See Liberty Mutual Insurance Company v.…
  • Liberty Mut. Ins. Co. v. Marcelino Avila, 317 So. 2d 784 (Fla. 3d DCA 1975)
    …4, 292 So. 2d 52; Liberty Mutual Insurance Company v. Guillet, Fla.App. 1974, 294 So. 2d 1; Johnson v. State Farm Mutual Automobile Insurance Company, Fla.App.1974, 294 So. 2d 2; Hartford Accident Insurance & Indemnity Company v. Diaz, Fla.App.1974, 296 So. 2d 504; White v. Reserve Insurance Company, Fla.App. 1974, 299 So. 2d 661;1 Unigard Insurance Company v. Davis, Fla.App.1974, 299 So. 2d 667; Hartford Accident & Indemnity Company v. Orlow, Fla.App.1974, 300 So. 2d 36; Central National Insurance Company v…

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