EARLIE BROWN, APPELLANT,
v.
GULF LIFE INSURANCE COMPANY, APPELLEE
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Earlie Brown appealed a summary judgment denying his claim for health insurance benefits under a group policy issued by Gulf Life Insurance Company. Brown argued that Gulf Life's no-fault auto insurance exclusion clause constituted uncompleted excess insurance requiring specific labeling under Florida law. The court affirmed, holding that the exclusion was merely a deductible provision, not excess insurance subject to statutory labeling requirements.
The court held that Gulf Life's provision is not excess insurance but merely a $5,000 deductible for no-fault type injuries. Therefore, the statutory labeling requirement does not apply, and Gulf Life properly denied Brown's claim for $4,222.40 in benefits.
[1] An insurance policy provision that excludes coverage for expenses for which medical benefits are payable under the Florida Automobile Reparations Reform Act, unless the t…
[2] Where the language of an insurance contract is clear and unambiguous, it must be given effect as written without requiring construction.
Previewing 2 of 3 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“Where the language of the insurance contract is clear and unambiguous it does not require construction and must be given effect as written.”
Establishes the interpretive principle that plain policy language controls and requires no construction
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Join FLexlaw to unlock all legal intelligenceBrown was insured under a group health insurance policy through his employer, Florida Power & Light Company. In December 1973, Brown sustained injurie…
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PER CURIAM.
Plaintiff, Earlie Brown, is appealing a final summary judgment for the defendant, Gulf Life Insurance Company, in this action to recover benefits under his group health insurance policy.
Earlie Brown through his employer, Florida Power & Light Company, was insured under a group health insurance policy issued by Gulf Life Insurance Company. This policy provided in pertinent part;
“SPECIAL EFFECT OF NO-FAULT AUTO INSURANCE
“No benefits are payable under any section of the Group Policy for any expenses incurred with respect to injury or illness for which medical benefits are payable in accordance with the Florida Automobile Reparations Reform Act (sometimes referred to as the ‘No-Fault’ Auto Insurance Law). In the event the total of benefits as defined as medical under the ‘No-Fault’ Auto Insurance Law exceeds $5,000, the amount of benefits which otherwise would have been payable under the Group Policy shall be payable up to the amount of such excess.”
On December 8, 1973 Brown was involved in an automobile accident and sustained personal injuries. He made a claim for $4,222.40 for these injuries against his automobile insurance carrier, Gateway Insurance Company, and received a partial payment of $1,582.40 under the “no-fault” benefits provision of Gateway’s policy. Gateway subsequent!'' became insolvent and Brown claimed the balance against the Florida Insurance Guaranty Association, which refused payment. Thereupon, Brown filed a claim against Gulf Life for benefits in the amount of $4,222.40. Gulf Life under the special effect of no-fault auto insurance provision of its group policy denied the claim and Brown filed the instant action against Gulf Life. He contended that the above provision renders the policy “excess insurance” within the purview of Section 627.635, Florida Statutes (1975)1 and that Gulf Life failed to comply with section (2) thereof by failing to stamp conspicuously upon the face of the policy the designation “excess insurance” thereby rendering this provision void. Gulf Life answered and denied its policy came within the purview of this statute. Pretrial discovery ensued and both parties moved for summary judgment. After a hearing, the trial judge entered summary judgment for Gulf Life. We affirm.
Where the language of the insurance contract is clear and unambiguous it does not require construction and must be given effect as written. See Midwest Mutual Insurance Company v. Santiesteban; 287 So. 2d 665 (Fla.1973); Ranger Insurance Company v. Harrell, 286 So. 2d 261 (Fla.2d DCA 1973). The special effect of the no-fault auto insurance provision of Gulf Life’s policy plainly excludes payment of benefits arising out of the no-fault type injury, unless that injury exceeds $5,000. In other words, this exclusion is merely a $5,000 deductible for this type of injury and is not excess insurance within the purview of Section 627.635(1), Florida Statutes (1975). Earlie Brown’s claim for $4,222.40 against Gulf Life having arisen out of injuries which are payable under no-fault benefits, the trial judge was eminently correct in entering summary judgment for Gulf Life.
We have considered appellant’s remaining point on appeal and find it without merit.
Affirmed.
. “627.635 Excess Insurance
“(1) No provision of this chapter shall be deemed to prohibit an insurer from issuing a policy as, or including in a policy a provision providing for, excess insurance; that is, to the effect that the insurer’s liability for benefits payable on account of expense incurred for any hospitalization, medical, surgical and other service resulting from covered sickness or injury of the insured, shall be limited to that part of such expenses, if any, which is in excess of all benefits payable on account thereof by the same insurer under any other policy or policies covering the same insured and by all other insurers and service organizations by whom benefits are payable as to the same such expense.
“(2) Any such policy, or any policy containing any such provision, shall have imprinted or stamped conspicuously upon the face thereof the designation ‘excess insurance’ or appropriate words of similar import approved by the department.”
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Patience R. Morgan v. Cont'l Cas. Co., 382 So. 2d 351 (Fla. 3d DCA 1980)…le construction and interpretation that a “passenger” includes a “pilot” within the policy coverage. Defendant urges, and we agree, that the coverage provisions are unambiguous and must be construed as written. Brown v. Gulf Life Insurance Company, 343 So. 2d 91 (Fla. 3d DCA 1977); Stewart v. State Farm Mutual Insurance Company, 316 So. 2d 598 (Fla. 1st DCA 1975). Moreover, in construing the provision of insurance contracts, courts are bound to give the language its plain, normally accepted meaning. Hertz C…
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Duncan Auto Realty, Ltd. v. Allstate Ins. Co., 754 So. 2d 863 (Fla. 3d DCA 2000)…reate insurance coverage where none otherwise exists; see Universal Underwriters Ins. Co. v. Fallaro, 597 So. 2d 818, [*865] 819 (Fla. 3d DCA 1992)(citing Midwest Mut. Ins. Co. v. Santiesteban, 287 So. 2d 665 (Fla.1973); Brown v. Gulf Life Ins. Co., 343 So. 2d 91 (Fla. 3d DCA 1977)), we must give this unambiguous contract of insurance its effect as written. Fallaro, 597 So. 2d at 819. We believe that a “temporary substitute auto” in this policy clearly refers to a vehicle that is used in the place of a disa…
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Universal Underwriters Ins. Co. v. Fallaro, 597 So. 2d 818 (Fla. 3d DCA 1992)…y definition of an “insured.” An unambiguous contract of insurance does not require construction, and must be given effect as written. Midwest Mutual Insurance Company v. Santiesteban, 287 So. 2d 665 (Fla.1973); Brown v. Gulf Life Insurance Company, 343 So. 2d 91 (Fla. 3d DCA 1977). Courts have no power to create insurance coverage where none exists on the face of the insurance contract. Pastori v. Commercial Union Insurance Company, 473 So. 2d 40 (Fla. 3d DCA 1985); See also American Casualty Company of Rea…
Previewing 3 of 8 citing cases — full citator treatment, depth of discussion, and citing context are member features.
Join FLexlaw to unlock all legal intelligenceAuthorities Cited
- Midwest Mut. Ins. Co. v. Santiesteban, 287 So. 2d 665 (Fla. 1973)
- Ranger Ins. Co. v. Harrell, 286 So. 2d 261 (Fla. 2d DCA 1973)