I. STATE APPELLATE DECISIONS

A. FLORIDA

  • Advanced Chiropractic and Rehab. Center Corp. v. United Automobile Ins. Co., (Fla. 4th DCA). Insurance/second-tier certiorari review. Denial of petitioner’s untimely request for appellate attorney’s fees. On review under a petition for writ of certiorari, Florida Rule of Appellate Procedure 9.100, a request for attorney’s fees must be included in the petition, response, or reply. Petitioner’s motion for fees was held untimely, since the request was not included in any of those filings.
  • Frisbee, Yankee Trailer Court, LLC, et al. v. Carolina Casualty Insurance Company, et al. (Fla. 5th DCA). Rescission/misrepresentations on application. Error to enter final summary judgment allowing insurer to rescind policy for material misrepresentations on policy renewal application where there were genuine issues of material fact as to whether waiver or estoppel barred rescission, given evidence from which jury could conclude that shortly after insured law firm was sued for malpractice in early 2006, the insurer was made aware of the facts it now claims justify rescission, but insurer did not assert rescission until late 2007, and during interim, insurer defended firm, settled another claim on the policy, and took other actions that were inconsistent with rescission upon which the insured firm relied to its detriment.
  • Vaughan v. Broward General Medical Center, (Fla. 1st DCA). Workers’ compensation. Judge of Compensation Claims (JCC) erred by admitting into evidence, and relying upon, unauthenticated post-treatment correspondence from claimant’s treating physician to support denial of claim for physical therapy, costs, and attorney’s fees where claimant objected to receiving the doctor’s letter in evidence on authentication and hearsay grounds. The correspondence was not a “medical report” under section 440.29(4), Fla. Stat. (2011), and the employer/carrier did not set forth an intent to rely on such a report as required by the statute. The correspondence was hearsay, and the employer/carrier established no hearsay exception applicable to the correspondence.

B. GEORGIA

  • No Georgia state appellate cases reported.

II. FEDERAL APPELLATE DECISIONS

III. ADMINISTRATIVE LAW/AGENCY DECISIONS

  • Order Approving Florida Surplus Lines Service Office Budget and Change to Service Fee. The service fee charged by the Florida Surplus Lines Service Office (“FSLSO”) will increase from 0.1% to 0.2% effective April 1, 2013. All new and renewal policies/certificates with an effective date on or after April 1, 2013 will incur a service fee of 0.2% of the total gross premium as defined in section 626.9325, Fla. Stat. All new and renewal policies/certificates with an effective date prior to April 1, 2013 will incur a service fee of 0.1% of the total gross premium. The service fee percentage charged on the premium is based on the effective date of the policy; the FSLSO service fee is applicable to single state Florida policies only. The service fee for all endorsements, audits, installments, cancellations or return of premium transactions applicable to policies/certificates effective prior to April 1, 2013 will be the same percentage as the inception date of the policy/certificate being endorsed.
  • Bayfront Med. Center, Inc., etc. v. Agency for Health Care Administration, (Fla. Division of Administrative Hearings, Final Order, Case No. 12-2757RU). Medicaid unadopted rule. The practice of the Agency for Health Care Administration (“AHCA”), to decline Medicaid-funded compensation for emergency medical services provided to undocumented aliens once the patients have reached a point of stabilization, and uniformly applying a stabilization criterion to enforce that practice constitutes an unpromulgated rule. AHCA's statements about and application of the "stabilization" standard meet the definition of a rule that has not been adopted pursuant to section 120.54(1). AHCA must immediately discontinue all reliance upon the "stabilization" standard or any substantially similar statement as a basis for agency action.
  • Premier Group Insurance Company v. Office of Insurance Regulation (Fla. Division of Administrative Hearings, Recommended Order, Case No. 12-0439. Case involving amount of federal income tax expense is properly included as an expense in insurer’s excessive profits filings for the years 2005-2007, and in light of that deduction, the refund amount due as excessive profits pursuant to section 627.215, Fla. Stat. (2009). The Florida Office of Insurance Regulation (“OIR”) may not automatically reject deductions for federal income tax expenses; however, Rule 69O-189.007, F.A.C., still requires the insurer to provide an explanation of the methodology used in deriving the expenses, including supporting data. The OIR must then review the methodology and supporting data and determine whether it is reasonable. The Administrative Law Judge determined that the insurer’s methodology used was reasonable because it was dictated by the Legislature for insurers in determining an insurer's allocation of federal income tax for purposes of paying Florida corporate income tax. Taxes apportioned to Florida for purposes of section 220.151, Fla. Stat., are also allocated to Florida, and as such can be deducted as expenses incurred in or allocated to Florida for purposes of section 627.215, Fla. Stat. The Administrative Law Judge recommended that the OIR enter a Final Order finding that $2,406,312.10 may be deducted for federal income tax expense incurred or allocated to Florida for purposes of section 627.215, Fla. Stat., and that the insurer must return $660,907.90 in excessive profits to its policyholders.

IV. NOTICES OF ADMINISTRATIVE RULEMAKING PROCEEDINGS

A. FLORIDA

B. GEORGIA

  • No rulemaking proceedings noticed.

V. MEETING NOTICES OF INTEREST/MISCELLANEOUS