The insurance company denied UM (underinsured motorist) coverage for a golf cart accident based on a policy exclusion in Amica Mutual Insurance Company v. Willis, Case Number 2D16-2319 (Fla. 2d DCA 2018).
The Second DCA held that the insurance policy in question could not exclude UM coverage for an accident involving an uninsured non-owned golf cart if the policy provides liability coverage in the event that the insured were to cause a similar accident.
UM Coverage in a Florida Auto Policy Must Be Reciprocal
The plaintiff in this case, Sylvia Willis, was injured after being hit by an underinsured golf cart when she was walking on a paved pathway in Sun City Center, Florida. Ms. Willis’s insurance company, Amica, denied her claim because of an exclusion in the policy that excludes coverage for vehicles “designed mainly for use off public roads.”
Amica filed a declaratory action (an action to determine rights under a contract) seeking a court ruling that there was in fact no coverage for Ms. Willis’s claim. Instead, the court found that the insurance company’s exclusion was invalid because covered events under the UM section of her policy did not mirror those in the liability section of her policy.
UM Coverage Was Intended To Protect
UM coverage was created by statute in section 627.727, Fla. Stat. The law states that “[n]o motor vehicle insurance policy which provides bodily injury liability coverage shall be delivered or issued” unless UM coverage is also provided (offered) in the same limits. You have this coverage on your Florida automobile policy unless you affirmatively reject it.
Thereafter, section 627.727(9), Fla. Stat. has been interpreted to mean that “[a]n insurance policy may contain other general conditions affecting coverage or exclusion on coverage as long as the limitations are unambiguous and ‘consistent with the purposes of the UM statute.'” (See Varro v. Federated Mut. Ins. Co., 854 So. 2d 726 (Fla. 2002).
Therefore, UM coverage in Florida is “reciprocal” to that of liability coverage. In other words, UM coverage protects from the same thing that your policy protects other people in the event of an accident.
Amica’s Failed Comeback
Despite the purpose and intent of UM coverage to “protect” the insured from the same losses that other people are protected from, Amica defended this case by arguing that its UM exclusion for non-owned golf carts does not violate the intent of the UM statute because Florida law does not require liability for non-owned golf carts by statute in the first place.
At this juncture, we cannot forget that insurance companies are in the business to make money. Insurance companies charge people premiums for coverage and try to minimize the losses that they pay. They can increase their profits by selling more policies or by successfully defending claims. Therefore, an insurance policy that provides golf cart coverage (even if not statutorily mandated) has more value to someone who plays golf than an insurance policy that does not provide such coverage and is more likely to sell on the open market. That is exactly what Amica did-they sold policies for liability while driving non-owned golf carts.
But yet at the very same time, they also want to exclude coverage when one of their insureds gets hit by a golf cart with no insurance. Therein lies the unfairness within.
Goose Versus Gander, An Important Principle In Law
While not an officially recognized principle of the law of any jurisdiction, the idea of fairness is supposed to be a two way street. We have called this “goose versus gander” for many years in the sense that what is acceptable for the wealthy and powerful must also be acceptable for those who are not so privileged. In this case, a multi-billion dollar insurance company was not allowed to deny coverage in the very market that they sold policies in.
Additionally, since this case involved a denial of coverage, the claimant should be entitled to reasonable attorney fees pursuant to section 627.428, Fla. Stat.
To read more about uninsured motorist’s coverage in general, click here.
Get Help If Your Claim Has Been Denied
If your claim has been denied by the insurance company, you should talk to an attorney to see whether your claim was properly denied. A consultation with a Lakeland personal injury attorney is free.
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