Florida Appellate Court Rules in Favor of Carrier in Dispute Over PIP Exclusion

Following a motor vehicle accident, Florida’s Fifth District Court of Appeal recently reversed a summary judgment against an insurance carrier regarding a dispute over a PIP exclusion for a vehicle owned by an insured but not insured by the carrier.

In Star Casualty Insurance Co. v. Jacksonville Chiropractic Inc., Star Casualty Insurance Co. issued a 2012 automobile insurance policy to Marie and Fritzner St. Hilaire, which insured a 2007 Ford Taurus owned and titled to Fritzner St. Hilaire only. In July 2013, the insurance broker for the St. Hilaires submitted a request to Star to remove the Taurus from the policy and to add a different vehicle, a Mercury Villager, which was also owned by the insureds.

In December 2013, the St. Hilaires were involved in an automobile accident while Mr. St. Hilaire was driving the Taurus and Ms. St. Hilaire was a passenger. In January 2014, the Taurus was added back to the Star policy as an insured motor vehicle.

After the accident, Ms. St. Hilaire received treatment at Jacksonville Chiropractic, which submitted its bills to Star for reimbursement under the policy’s personal injury protection coverage (PIP). Star denied coverage and payment of PIP benefits based on an exclusion that stated:

This insurance does not apply: 1. To you or a relative while occupying a motor vehicle owned by you and which is not an insured motor vehicle under this policy.

The policy also defined “You” to include the spouse, if a resident of the same household.

Under an assignment of benefits executed by Ms. St. Hilaire, Jacksonville Chiropractic brought suit against Star for breach of contract. Star moved for summary judgment on grounds that the Taurus was not insured by Star at the time of the accident and thus the exclusion applied. Jacksonville Chiropractic filed a competing motion for summary judgment, arguing the exclusion did not apply because Ms. St. Hilaire was not a legal owner of the Taurus, and there was no evidence that Mr. St. Hilaire intentionally removed the Taurus from the Star policy.

The trial court agreed with Jacksonville Chiropractic, granting its summary judgment and further awarded Jacksonville Chiropractic attorneys’ fees as the prevailing party. Star appealed.

The Fifth District Court of Appeal reversed, holding that the trial court misconstrued the exclusion. As a preliminary issue, the court noted the exclusion in the Star policy was appropriate, as it tracked the language of the exclusion permitted by statute under Florida Statutes section 627.736(2)(a).

The court then turned to whether the exclusion applied to Ms. St. Hilaire. Although only her husband was the legal title owner of the Taurus, the court found that the exclusion still applied to Ms. St. Hilaire because she was the spouse and resided with Mr. St. Hilaire, thus qualifying as “you” under the policy. Thus, it did not matter that Ms. St. Hilaire was not the legal title owner of the vehicle because her husband, with whom she was, was the legal owner. Accordingly, the court held that the exclusion applied.