Florida High Court, Legislators Duel Over Prerequisites to PIP Benefits – Nunez v. Geico

Florida’s Personal Injury Protection (PIP) system is designed to quickly provide benefits for a person injured in an automobile accident, regardless of fault. The state’s high court recently ruled in Nunez v. Geico that this means obstacles to recovery like an insurer’s requirement that a person seeking PIP benefits first submit to examination under oath is unlawful. The victory for insured persons was brief, however, as the law has since been amended to make such requirements valid.

Merly Nunez was injured in a Florida car accident in September 2008. She sought PIP benefits from her insurer, Geico. The company refused to pay, asserting that Nunez failed to submit to an examination under oath (EUO) prior to seeking benefits, as required under the terms of her policy. Nunez then filed a class action against Geico on behalf of herself and other similarly situated persons, claiming that the insurer violated Florida’s PIP statute (section 627.736, Florida Statutes (2008)).

A federal district court dismissed the lawsuit, concluding that the law’s specific language did not bar an insurer from requiring the EUO before paying out PIP benefits. The trial judge observed that Nunez “fails to cite any case, and the Court has found none on its own research, which states that an insurer was precluded from denying an insured benefits, based on the insured’s refusal to attend an EUO.” The U.S. Court of Appeals for the 11th Circuit found that the question was unsettled under Florida law and certified it for resolution by the state’s highest court.

Shortly after the case was certified, Governor Rick Scott approved amendments to the PIP statute, effective Jan. 1, 2013. The amendments provided that a person seeking benefits must comply with the terms of the insurance policy, including an examination under oath requirement, if applicable. This change did not bear on Nunez’s particular claims, however. “Because Nunez’s policy with Geico was issued in 2008, her accident was in 2008, and she filed her class action complaint in 2009, this amendment does not directly apply to the present case, and Geico does not contend otherwise,” the state Supreme Court explained.

The Court went on to rule that Geico’s EOU requirement violated the PIP statute, as in effect at the time Nunez sought PIP benefits. Specifically, the Court observed that the law’s stated purpose is to provide for “swift and virtually automatic payment” to those eligible for PIP benefits. “Such delay and denial based on the EUO condition in the present case has certainly kept Nunez from recovering in a ‘swift and virtually automatic’ way – approximately four years have passed since she filed her claim, and she has still not received PIP benefits,” the Court concluded.

The South Florida car accident attorneys at Anidjar & Levine help clients throughout the region navigate the legal system after a crash. We have significant experience representing clients in car accident cases and insurance disputes, including in Ft. Lauderdale, Pompano Beach and Hialeah. Call us at 800-747-3733 for a free consultation.

Related blog posts:

Insurance Issues in Florida Car Accident Lawsuits – Goheagan v. American Vehicle Insurance Company

Court Rejects Bad Faith Claim Against Insurance Company in Fatal Car Crash – Novoa v. Geico

Florida Court Rules on Medication Records Access in Car Accident Case – Poston v. Wiggins