A Florida appeals court has ordered an automobile insurer to pay all of a car accident victim’s medical expenses pursuant to the terms of the extended personal injury protection (PIP) provision included in her policy. In Spaid v. Integon Indemnity Corp., a woman asked her auto insurer to pay more than $10,000 in medical bills for the injuries she suffered in a 2011 motor vehicle wreck. Although asked to pay all of her medical expenses, the woman’s insurer refused to pay for any medical costs that exceeded her basic PIP policy’s $10,000 limit of liability. In response, the woman filed a lawsuit seeking a declaratory judgment against her automobile insurer.
In Florida, motorists are required to maintain $10,000 in PIP accident protection. This insurance allows a driver or other individual to collect up to $10,000 in immediate medical coverage, depending on the type and extent of car accident injury treatment, regardless of fault. Under current Florida law, an individual who was harmed in an automobile collision must seek medical treatment within 14 days of the crash in order to recover under a PIP policy. Typically, a PIP policy will pay for 80 percent of an accident victim’s medical bills up to the policy’s limit of liability. An optional extended PIP policy will normally increase that coverage to 100 percent of an insured’s medical expenses. The question in this case was whether or not the woman’s extended PIP policy incorporated her basic PIP policy’s $10,000 cap.
Before a trial court, the insured woman claimed that the entirety of her medical expenses should be paid because the plain language of her extended PIP policy included no limit of liability. Instead, the declarations page stated “100% Medical,” on the extended PIP line. In contrast, the automobile accident policy expressly limited basic PIP to $10,000 for each person. Because of this, the woman argued the limits of her policy’s extended PIP were ambiguous. The insurance company claimed the optional extended coverage did not change the overall PIP limit of liability. In the end, the trial court sided with the insurer and the woman appealed her case to Florida’s First District Court of Appeal.
According to the appellate court, a Florida insurance policy must be construed according to the plain language of the policy documents in such a way that each provision is provided with its full effect. Additionally, any ambiguity should be read in favor of an insured party. After examining the motor vehicle insurance policy documents, Florida’s First District determined the language of the policy was ambiguous with regard to the extended PIP liability limits. Consequently, the Court of Appeals reversed the decision of the trial court and ordered the insurance company to pay 100 percent of the injured woman’s medical bills.
If you were harmed in a South Florida car accident, contact the experienced attorneys at Friedman, Rodman & Frank, P.A. through our website or give us a call at (305) 448-8585.
Spaid v. Integon Indemnity Corp., Fla: Dist. Court of Appeals, 1st Dist. 2014
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