RELIANCE INSURANCE COMPANIES, APPELLANT,
v.
THOMAS L. KILBY ET AL., APPELLEES

Fla. 4th DCA | 1976-08-06
No. 75-1613
ALDERMAN, J., and DAKAN, STEPHEN L., Associate Judge, concur.
336 So. 2d 629 Florida District Court of Appeal, Fourth District (1976) 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

Reliance Insurance appealed a trial court's award of attorney fees to an insured in a dispute over equitable distribution of personal injury protection (PIP) benefits recovered from a third-party settlement. The Fourth District affirmed, holding that an insurer who unreasonably denies its obligation to the insured by demanding disproportionate reimbursement must pay the insured's attorney fees when the insured pursues judicial resolution.


Holding

The court affirmed the attorney fee award, holding that only a dispute is required as a predicate for attorney fees, not a judgment. An insured is entitled to attorney fees when the insurer refuses or fails to negotiate in good faith, which can be gauged by the gross disparity between the amount the insurer demands and the amount the trial court awards.


Headnotes

[1] A dispute necessitating court proceedings for resolution under Fla.Stat. …

[2] An insurer's demand for reimbursement of personal injury protection benefits that is grossly disproportionate to the amount judicially awarded to the insurer may constitu…

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Key Quotes

“It is our interpretation that only a dispute is required and we feel that the award of an attorney fee here is justified and authorized by Catches v. Government Employees Insurance Company, 318 So. 2d 552 (1st DCA Fla.1975); White v. Reserve Insurance Company, 299 So. 2d 661 (1st DCA Fla.1974).”

Establishes that a dispute alone, without a judgment, suffices for attorney fee awards in PIP equitable distribution cases.

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Facts & Procedural History

Reliance Insurance paid $778.86 in PIP benefits to its insured Thomas Kilby. After Kilby's personal injury suit settled for $5,700, Reliance filed a l…

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Opinion of the Court
WALDEN, Judge.

WALDEN, Judge.

We affirm an award of attorney fees.

The agreed appellate issue is:

Whether the trial court erred in awarding Kilby attorney’s fees in a proceeding for equitable distribution under Fla.Stat. § 627.736.

Appellant, Reliance Insurance Company, paid $778.86 as personal injury protection benefits to its insured, Thomas L. Kilby. The Kilby personal injury suit was settled for $5,700, whereupon Reliance filed a Notice of Lien on account of the PIP benefits paid.

Kilby and Reliance being unable to negotiate a settlement, Kilby filed a Motion For Equitable Distribution and Assessment of Attorney Fees.

This is important — Reliance prior to judicial decision demanded 80% of its total payout, or $623.09, in settlement. The trial court found that the true value of Kilby’s claim was $22,800 and that Reliance was entitled to only 18% of the PIP payments, or a total reimbursement of $138.24.

The trial court further found that a “dispute” between Kilby and Reliance had arisen necessitating court proceeding for its resolution under Fla.Stat. 627.736(3)(b) (1975). The court awarded Kilby’s attorney an attorney’s fee of $350 under authority of Fla.Stat. 627.736(8) (1975) and Fla.Stat. 627.428 (1975).

Reliance appeals. We affirm.

Reliance argues that, under the pertinent Florida Statutes, supra, a dispute is required, plus a judgment as a predicate for an award of an attorney fee. We disagree. It is our interpretation that only a dispute is required and we feel that the award of an attorney fee here is justified and authorized by Catches v. Government Employees Insurance Company, 318 So. 2d 552 (1st DCA Fla.1975); White v. Reserve Insurance Company, 299 So. 2d 661 (1st DCA Fla.1974).

Reliance seeks to distinguish Catches because there the carrier had demanded 100% reimbursement, while here the demand was for only 80%. In Catches the court said by demanding 100% the carrier was, in effect, denying a material obligation of coverage to its insured. We feel that in the instant case Reliance, by demanding 80% reimbursement when it was only entitled to 18%, did, as in Catches, deny a material obligation of coverage to its insured. Because of this denial Kilby is entitled to an award of an attorney fee under Fla.Stat. 627.428(1) (1975).

We would also adopt and repeat the caution found in Catches,

“We do not hold that an insurer, who in good faith negotiates with its insured as to the ‘equitable distribution’ of sums recovered from a tortfeasor, is liable for attorney’s fees when the insured pursues judicial relief.” 318 So. 2d 552 at 553.

In the practical operation of equitable distribution of PIP benefits, we would suppose and hope that the insurer and insured, negotiating in good faith, would in most instances be able to amicably settle on an agreed apportionment without judicial help. However, we recognize that there may be problems in the everyday working relationship between the mentioned statutes and the Catches decision.

To begin with, as illustrated by the facts in the instant case, the amount of PIP benefits is often relatively small. With PIP benefits of $778.86 to be apportioned, it would make no economic sense for the insured to seek judicial apportionment if the insured must pay his own attorney fee. The fees could very well equal or surpass the award of benefits. After all, the legal work of demonstrating the value of the claim falls on the insured. So, if an insured is not to receive an award of attorney fees, he or she is left to the mercy and dictates of the insurer in the amounts of apportionment.

On the other nand, it would be an equally unfair application and interpretation to allow every insured an attorney fee upon the mere filing of a motion for equitable distribution, regardless of the good faith efforts of the insurer. And so it is our view that an insured is entitled to an award of attorney fees when the insurer refuses or fails to negotiate in good faith. We further feel that the trier of the fact can gauge that good faith or lack thereof by the percentage imbalance between that amount demanded and that judicially awarded to the insurer. Where, as here, the difference is gross, it is our judgment that the trial court was correct in finding a dispute and awarding fees.

AFFIRMED.

ALDERMAN, J., and DAKAN, STEPHEN L., Associate Judge, concur.


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Citator

Cited By

  • Luisa Rodriguez v. Travelers Ins. Co., 367 So. 2d 687 (Fla. 3d DCA 1979)
    …sured is entitled to an attorney’s fee under § 627.428(1), Fla.Stat. (1975). Accordingly we reverse that portion of the final order below which denied the plaintiff such an award. Essentially, we agree with the holding in Reliance Ins. Co. v. Kilby, 336 So. 2d 629 (Fla. 4th DCA 1976) that fees should be awarded when the insured is successful in a judicial battle with his own p. i. p. carrier over the amount of equitable distribution to which the company is entitled under § 627.736(8), Fla.Stat. (1975). See al…
  • Travelers Ins. Co. v. Luisa Rodriguez, 387 So. 2d 341 (Fla. 1980)
    …ict Court of Appeal, First District, in Catches v. Government Employees Insurance Co., 318 So. 2d 552 (Fla. 1st DCA 1974), cert. denied, 333 So. 2d 41 (Fla.1976), and the District Court of Appeal, Fourth District, in Reliance Insurance Co. v. Kilby, 336 So. 2d 629 (Fla. 4th DCA 1976), that in an equitable distribution situation pursuant to former section 627.736(3)(b), an insured is entitled to an award of attorney’s fees when the insurer refuses or fails to negotiate in good faith. I concur in result, howe…
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