South Florida Personal Injury Lawyers Blog

Florida Bad Faith Insurance Dispute Over Delayed Appraisal Awards

Published on: March 25, 2022 | by Friedman Rodman Frank & Estrada, P.A.

The District Court of Appeal issued an opinion in favor of a homeowner’s in a Florida bad faith insurance dispute. According to the record, lightning struck the homeowner’s residence in July 2009, causing serious property damage. The owner filed a claim with his insurance provider, who determined the amount of loss and made payments over eight years. However, in 2017 the homeowner disputed the paid amount, and the insurance company invoked the appraisal provision. While the appraisal process was ongoing, the owner filed a notice of his intent to file a bad faith claim against the insurance company. Amongst several claims, the insurance company argued that the sixty-day cure period was tolled pending the appraisal award and payment cured the bad faith allegations.

Under Florida law, insurance companies maintain two distinct duties: contractual and statutory. As such, first, they must timely evaluate and pay benefits. In most cases, the insurance policy conditions dictate how the parties must proceed before an insurer fulfills a claim. For example, as is the case in this situation, the provider might maintain the right to invoke an appraisal.

Second, they must act in reasonably good faith in evaluating claims. If a party experiences damages by an insurance company’s failure to comply, they may pursue civil action against the company.

Workers’ Compensation Benefits Under Florida’s Heart-Lung Bill

Published on: March 25, 2022 | by Friedman Rodman Frank & Estrada, P.A.

Florida Statute 112.18, otherwise known as the Heart-Lung Bill (HLB), provides protections to first responders who develop certain cardiovascular conditions at work. The HLB protects first responders such as law enforcement officers, correctional officers, and firefighters who experience injuries or illnesses related to tuberculosis, high blood pressure, or heart disease during their employment. The HLB presumes that if the Claimant develops one of these conditions during their employment, as long as it was not a pre-existing condition, it was a direct consequence of their employment.

However, the potential recipient must meet the four requirements of the HLB. The presumption requires claimants to:

Fall into the protected class,

Florida Insurance Disputes Stemming from Storm Damage

Published on: March 17, 2022 | by Friedman Rodman Frank & Estrada, P.A.

The District Court of Appeal in Florida issued an opinion in an appeal stemming from an insurance dispute between an insurance company and the insured. The insurance company appealed a final judgment against them after a lower court found that the insured’s material breach of the contract was immaterial.

According to the record, storm damage prompted the homeowner to file a claim with the insurance company. The insurance company argued that the policy bars the homeowner from filing suit because he failed to comply with the three post-loss conditions in the insurance contract. Specifically, the violations include the homeowners’:

Failure to provide the insurance company with prompt notice of the loss.

The Recent Surge in Florida Truck Accidents

Published on: March 17, 2022 | by Friedman Rodman Frank & Estrada, P.A.

While the trucking industry throughout the country is consistently growing, the increasing presence of the online marketplace in combination with the pandemic has resulted in significant truck transport. Although trucking transport is a preferable way of shipping goods, the demand has brought on a surge in Florida trucking accidents. There has been an over 50% rise in truck accidents over the last decade, and various agencies that study truck accident statistics report that truck accidents will likely become the fifth largest cause of death in the country. Currently, nearly 75% of fatal vehicle accidents involve a large truck.

For instance, an Associated Press article described a harrowing, deadly Florida truck accident. According to reports, a tractor-trailer slammed into a vehicle on U.S. 27. The vehicle was carrying two adults and seven children. A teenage boy in the vehicle died, and six children suffered injuries. The truck driver sustained minor injuries in the accident.

Statistics by the Federal Motor Carrier Safety Administration (FMCSA) reports that Florida is one of ten states that comprise half of all deadly truck accidents in the country every year. While truck accidents occur all over the state, certain areas such as Ft. Myers, Sarasota, Bradenton, Lakeland, Auburndale, and Naples have a higher rate of truck accidents. Moreover, the research suggests that driver error was responsible for over 90% of truck accidents. At the same time, road conditions and defective vehicles account for around 6% of truck accidents.

Understanding the Difference Between Criminal and Civil Claims Following a Florida Accident

Published on: March 9, 2022 | by Friedman Rodman Frank & Estrada, P.A.

Sometimes, when an accident takes place, the at-fault party faces criminal charges. However, you may not know that even if the at-fault party is guilty of those criminal charges, you may not receive compensation as the victim of the accident unless you file a separate civil lawsuit successively. Understanding this distinction is crucial, as it directly affects your ability to recover monetarily following a major accident.

According to a recent local news report, a driver who caused an accident that left one individual dead and eight injured likely will not be facing criminal charges. Local police reported that the 75-year-old woman was attempting to parallel park when she suddenly accelerated in reverse, ran over a curb, and hit a parked car before crashing her Bentley into a table with five diners and nearby pedestrians. A 67-year-old man died and eight individuals were injured, but local police reported that there were no signs that the woman was impaired and she will likely only be facing traffic violations. The accident remains under investigation.

Although the woman who caused this Florida accident may not be facing any criminal charges, it does not mean that those who were injured and the survivors of the deceased individual cannot file a civil suit involving personal injury claims separately. Sometimes, when a state’s criminal laws do not hold an at-fault party responsible, suing them for monetary damages is the best way to recover following an accident.

Liability for Suicide Attempt at Florida Apartment Complex

Published on: March 9, 2022 | by Friedman Rodman Frank & Estrada, P.A.

In Florida, the Third District Court of Appeals recently issued a decision in a plaintiff’s appeal of a trial court’s finding in favor of an apartment complex. According to the record, the apartment complex owns a six-floor building. On the day of the incident, the then seventeen-year-old plaintiff trespassed and gained access to the apartment complex rooftop with the intention to commit suicide. The plaintiff did not complete suicide but endured severe injuries, including the amputation of his leg.

In Florida, premises liability law provides that generally, property owner or occupier has a duty to maintain a premise or property in a reasonably safe way. Additionally, a plaintiff may pursue a negligence per se claim if they establish that the defendant violated an ordinance or law to prevent the type of incident that occurred.

In this case, the plaintiff filed a premises liability lawsuit against the complex, alleging that the defendant owed a duty to prevent suicide on the rooftop. Under the restriction theory of suicide prevention, the theory posits that by eliminating or restricting access to methods by which people attempt suicide, the overall rate of suicide attempts decreases. However, the plaintiff’s complaint does not allege that the defendant breached a specific duty to prevent or guard against his suicide attempt. As such, the trial court concluded that private building owners do not owe a duty to undiscovered trespassers to prevent suicide.

Court Entitles Florida Homeowner to Recover Additional Funds in Insurance Dispute

Published on: February 28, 2022 | by Friedman Rodman Frank & Estrada, P.A.

The District Court of Appeal in Florida issued a decision in an insurance coverage dispute in a case involving the insurance company’s liability provision. According to the facts, the insurance company insured the homeowner’s residence. A failed cast iron sanitary plumbing system in the home caused water to escape and cause damage to the dwelling. The cast-iron pipes deteriorated because of wear and tear, deterioration, and corrosion.

The insurance company permitted coverage for the water damage for $10,000, under the Limited Water Endorsement (LWD) in the policy. The homeowners claimed that the insurance company owed them additional funds for the cost of tearing out and replacing the concrete slab. The owners cited language in the primary policy, which stated that the company covered losses related to water damage, including the cost of tearing out and replacing necessary parts. Finally, the parties agree that the policy does not cover the repair or replacement costs of the corroded pipes.

The parties agree to most of the policy terms; however, they disagree with the liability provision in the LWD endorsement. The company argues that the $10,000 applies to water damage and the related costs, whereas the homeowners contend that the limitation applies only to the water damage.

Florida Teacher Pursues Workers Compensation for Classroom Fall

Published on: February 28, 2022 | by Friedman Rodman Frank & Estrada, P.A.

Recently, the First District Court of Appeal in Florida issued an opinion in an appeal involving claims from a teacher who suffered injuries after falling in a classroom where he worked. According to the record, the teacher sustained injuries after losing his balance because his leg fell asleep. The judge of compensation claims (JCC) denied his claims, reasoning that the teacher’s injury did not “arise out of” his work as a teacher.

The doctor performing the independent medical exam (IME) on behalf of the school district testified that the teacher reported occasional numbness before the accident. However, the numbness the teacher experienced after the fall was not related to any medical illness. Instead, the numbness the teacher experienced before the fall was likely the result of brief nerve compression. The teacher’s expert reached a similar conclusion. In response, the teacher argued that he sufficiently established “occupational causation” because the accident happened in the “course and scope” of his employment.

Florida’s Workers’ Compensation Act compensates an employee’s injury if it stems from an accident that “arises out of the work performed in the course and scope of employment.” Arising out of and in the course of employment refers to where and under what circumstances the incident occurs. Understanding that work causation is not always straightforward when the incident involves an idiopathic condition, the fact remains that there must be a causal connection between employment and injury.

Florida Court Finds Willfully Serving Minors Amounts to Intentional Misconduct

Published on: February 22, 2022 | by Friedman Rodman Frank & Estrada, P.A.

The First District Court of Appeal recently issued an opinion addressing the apportionment of liability stemming from a Florida pedestrian accident. According to the court’s opinion, the underage driver worked at a bar where he received a 50% discount on drinks. After drinking at his place of employment, he drove drunk and proceeded to hit a pedestrian. The pedestrian, who was also underage, was served alcohol at a different bar. The pedestrian filed a lawsuit against both bars to recover damages for her injuries. On appeal, the bar employing the driver argued that they should have asserted a comparative fault defense. The plaintiff asserts that the claim falls under the state’s Dram Shop statute, and therefore the law does not entitle the defendant to this defense.

Florida’s comparative law statute provides that a claimant’s contributory fault reduces their compensation based on their level of fault. However, the law applies to negligence actions, not intentional torts. In this case, the plaintiff cites the state’s Dram Shop statute, which provides that an establishment that sells or provides alcohol to a person will be liable for any injuries or damages resulting from the intoxicated person. The Court reasoned that the dram shop statute does not create a new cause of action; therefore, it does not transform the existing action into an intentional tort.

In light of the finding, the defendant purported to use the “alcohol defense” to thwart liability for the driver’s action. Under the defense, a plaintiff may not recover for damages if:

Fee-Related Disputes Under Florida’s Workers’ Compensation Statute

Published on: February 22, 2022 | by Friedman Rodman Frank & Estrada, P.A.

Recently, an appeals court issued a decision in a Florida workers’ compensation case where the Employer appealed the Judge of Compensation Claims (JCC) order. In this case, the E/C granted the employee/claimant’s request for a one-time physician change. The E/C agreed and scheduled the Claimant with a new physician. The new doctor and E/C completed a new form fee agreement that exceeded the base amount under the workers’ compensation fee schedule. The Claimant argued that the higher-than-schedule fee transformed the physician into an independent medical examiner (IME) instead of a treating physician. As such, the JCC terminated the E/C physician and allowed the Claimant to receive a one-time physician change. The E/C claimed that it was an error to strike the physician based on a fee agreement.

Florida’s workers’ compensation code does not provide JCCs with authority to disqualify a treating doctor because a claimant was dissatisfied with the fee reimbursement agreement between the physician and E/C. Under Florida law, a JCCs role does not extend to resolving disputes about fee arrangements between treating doctors and E/Cs. Further, the workers’ compensation code permits higher-than-fee schedule agreements. Finally, the law does not provide claimants with a recourse for litigating complaints regarding reimbursements before a JCC.

In this case, the court reasoned that the JCC’s authority does not extend to striking a provider’s authorization in light of the law. Moreover, the court recognized that the form used by the E/C and doctor did not include the statutory language that the law requires. However, the E/C and physician amended their agreement before the Claimant‘s rescheduled appointment. Finally, the court found that the workers’ compensation code does not allow claimants to disqualify their E/C-authorized doctor before a JCC. As such, the court reversed the JCC’s final compensation order.