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After battling auto insurance companies for more than 20 years on behalf of people who have been hurt in car, truck, motorcycle, and bicycle accidents across the State of Florida, I am not often surprised yet still continually amazed by the tactics utilized by the insurance industry to avoid paying legitimate claims to the injured. Equally baffling is the willingness of our courts to serve as co-conspirators in depriving innocent injured accident victims of their rights to obtain justice in terms of compensation for their medical bills, lost wages, and pain and suffering. Para leer en español haga clic aquí.

THE POLICY EXCLUSIONS GAME

One of the most common strategies is the “policy-exclusion” game, which involves the microscopic fine print contained in the pages of insurance policies–written by lawyers but incomprehensible to most customers, agents, and even judges. For example, every insurance policy I have read contains a clause providing that “family members residing in the same household” as the policy holder are excluded from coverage in the event of an accident. Take for instance the recent case of James Motzenbecker versus State Farm.

The case stems from injuries Adam Smith sustained in Sarasota, Florida, while driving the Motzenbeckers’ 1988 Nissan in 2006, when he alleges the brakes in the Nissan failed. At the time of the crash, he was driving the car with the Motzenbeckers’ permission, and his lawsuit against them claimed they failed to properly maintain the car’s brakes, which led to the accident.

DECLARATORY JUDGMENT ACTIONS IN FLORIDA

The Nissan was insured with State Farm, who after being notified by the Motzenbeckers of the lawsuit, filed their own lawsuit against the Motzenbeckers, claiming that they had no obligation to defend them for Smith’s accident because he was a “permissive driver.” This type of lawsuit by an insurance company against its own customer to determine if coverage exists is called a declaratory judgment.

State Farm claimed that since Mr. Smith was driving the Nissan with the consent of the Motzenbeckers, he was excluded under the “household exclusion,” which stipulates in pertinent part “. . . no coverage for any bodily injury to any member of an insured’s family residing in the insured’s household,” which would be considered to include a permissive driver.

In response to State Farm’s lawsuit, the Motzenbeckers filed a counterclaim against State Farm to force it to defend and indemnify the family for Smith’s accident. The trial court initially agreed with the family, by entering a judgement in their favor, but State Farm succeeded in getting the judge to rehear their argument and vacate the judgment based upon the newly-decided Florida Supreme Court case of State Farm v. Menendez, which excludes claims by permissive drivers.

FLORIDA’S APPELLATE COURTS LOVE TO HELP THE AUTO INSURANCE POLICY EXCLUSIONS

Of course an appeal followed, which is rarely a good sign for a plaintiff in a Florida personal injury case. The family argued that it would be against public policy to exclude coverage for claims such as this for legitimately injured people–such as cases where drivers intentionally cause an accident.

However, the 2nd District Court of Appeal found that household exclusions do not “contravene public policy” and are thus “valid and enforceable,” relying upon the newly-decided Menendez case that found excluding household members appropriate. In the Menendez case, a granddaughter driving her grandparents’ car injured herself, her parents, and her grandparents. And, even though she did not live with her grandparents and therefore was not a member of their household, our Supreme Court still excluded her as an insured because she was driving the car with the grandparents’ permission.

PUBLIC POLICY?

This case is a strong reminder of how powerful the insurance industry is in Florida in terms of how it can affect both the statutes and the court’s interpretations in its favor. There are two victims here: One, Mr. Smith, who innocently got behind the wheel of a dangerous and improperly maintained car that caused him a serious injury. And secondly, the Motzenbeckers, who were deprived of the protection and piece of mind they purchased when they bought the policy from State Farm in the first place. But State Farm utilized complex legalese and a strong and willing ally in Florida’s court system to prevent him from obtaining compensation from a policy that he did not even purchase.

One would think that public policy should protect injured victims, not the powerful.

Our personal injury lawyers in Miami are passionate about providing assistance to car accident victims across the State of Florida. We have over 25 years of combined legal experience in holding insurance companies like Allstate, State Farm, and Progressive accountable for paying the full value of our clients’ claims. We provide a free initial consultation to anyone who has been involved in a car, truck, motorcycle, or bicycle accident in Jacksonville, Tampa, Ft. Myers, and from Palm Beach to Key West.

For a legal consultation, please email me, Spencer Aronfeld, or call our office 305-441-0440 or 866-597-4529 today.