I. STATE APPELLATE DECISIONS
- Beavers v. Carpenter Contractors of America (Fla. 1st DCA). Workers’ compensation. Judge of compensation claims (“JCC”) erred in denying claimant’s request that pain management with a particular doctor be continued or reauthorized, and in ruling that the doctor was properly deauthorized by the employer/carrier under section 440.13(2)(d), Fla. Stat. (2010), which gives the carrier the right to transfer care to another doctor if an independent medical examination determines that the employee is not making appropriate progress in recuperation. The court held that a claimant who has reached maximum medical improvement cannot be “in recuperation,” under section 440.13(2)(d), as a matter of law, where the treatment being provided is not curative.
- Westphal v. City of St. Petersburg (Fla. 1st DCA). Workers’ compensation; unconstitutionality of 104 week limitation on temporary disability payments. The Court held that section 440.15(2)(a), Fla. Stat. (2009), is unconstitutional under article I, section 21, of the Florida Constitution, as applied to Westphal and others similarly situated, by limiting them to no more than 104 weeks of temporary disability benefits, because treating physicians had not yet certified maximum medical improvement necessary to apply for permanent disability benefits, even though they were totally disabled, incapable of engaging in employment, and ineligible for any compensation under Florida’s Workers’ Compensation law for an indeterminate period. The ruling is prospective only, and does not apply to proceedings that became final prior to the date of the decision.
- Turner v. Williamson, et al. (Ct. of App. Ga., A12A2534). Enforcement of settlement agreement. Trial court order denying Appellant’s motion to enforce insurance policy limits settlement reversed. The insurer claims handler’s written and oral communications in response to claimant’s settlement offer demonstrated an unequivocal acceptance of the terms of the offer: execution of a limited liability release in accordance with O.C.G.A. §33-24-41.1 in exchange for policy limits. The insurer claims handler’s written and oral communication contained no language conditioning acceptance upon execution of the particular release form provided with a subsequent letter. While the release provided may have included additional terms not acceptable to claimant, mere inclusion of a release form unacceptable to claimant does not alter the fact that a meeting of the minds had occurred with regard to the terms of the settlement.
II. FEDERAL APPELLATE DECISIONS
- Flintlock Construction Services, LLC v. Well-Come Holdings, LLC, et al. (11th Cir. Ga.). Commercial general liability insurance. Summary judgment for insurance carrier affirmed, despite claimant’s argument that the carrier was estopped to deny coverage, which the claimant presented in its brief opposing summary judgment in the trial court but not plead in its complaint. The court held that, at the summary judgment stage, the proper procedure for plaintiffs to assert a new claim is to amend the complaint in accordance with Fed. R. Civ. P. 15(a), which the claimant/plaintiff did not do.
- Great American Assurance Co. v Elliot (11th Cir. Fla.). Property/casualty insurance. Summary judgment for insurer affirmed, finding no duty to defend or indemnify insured sued in a civil action for his murder of the plaintiffs’ mother.
III. ADMINISTRATIVE LAW/AGENCY DECISIONS
- In the Matter of Richard Edward Carter, Case No. 118324-11-AG, Final Order. Florida Department of Financial Services (“FDFS”) revokes agent’s licenses due to sale of annuities based on violations of sections 626.611(5) (willful misrepresentation of insurance policy or contract); 626.611(7) (demonstrated lack of fitness or trustworthiness to engage in business of insurance); 626.611(9) (fraudulent or dishonest practices); and, 626.9541(1)(e)1.(publishing, disseminating, circulating, or delivering any false statement), Fla. Stat.
- No Georgia agency decisions reported.
IV. NOTICES OF ADMINISTRATIVE RULEMAKING PROCEEDINGS
- Rule 59G-5.020, F.A.C. – Medicaid Provider Requirements. Notice of Change to proposed Rule 59G-5.020, F.A.C. published to expand references of forms and handbooks adopted by the rule.
- Rule 59G-4.320, F.A.C. – Medicaid/Florida Medicaid Therapy Services Coverage and Limitations Handbook. Rule development workshop to discuss additional changes to the handbook scheduled on March 21, 2013, 10:30 a.m. to 11:30 a.m., Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Conference Room A, Tallahassee, FL.
- Rule 69O-149.003, F.A.C. - Reasonableness of Benefits in Relation to Premiums. The Final Public Hearing on the adoption of proposed amendments to Rule 69O-149.003, F.A.C. has been changed from March 7, 2013 to April 2, 2013, 9:00 a.m., during a regular meeting of the
Financial Services Commission, Cabinet Meeting Room, Lower Level, The Capitol, Tallahassee, FL.
- No Georgia rulemaking proceedings reported.
V. MEETING NOTICES OF INTEREST/MISCELLANEOUS
- Florida Office of Insurance Regulation Releases 2013 Report of Life Insurance Limitations Based on Foreign Travel Experiences to the Florida Legislature. The report details implementation of the “Freedom to Travel Act,” which was passed in 2006 and codified into law at section 626.9541(1)(dd), Fla. Stat. The legislation placed limitations on insurance companies’ ability to deny coverage or increase premiums for life insurance based on past or future foreign lawful travel.
- Florida Chief Financial Officer Atwater Sets Quarterly Rate of Interest Payable on Judgments and Decrees. Chapter 2011-169, Laws of Florida, amended Section 55.03(1), Fla. Stat. to require the Chief Financial Officer to set the rate of interest that shall be payable on judgments and decrees on a quarterly basis rather than an annual basis. The interest rate for the quarter beginning April 1, 2013 has been set at 4.75 percent per annum or a daily rate of .0130137 percent (.000130137 expressed as a decimal). Current and historical interest rates are available at http://www.myfloridacfo.com/aadir/interest.htm.
- Florida Commission on Hurricane Loss Projection Methodology Telephone Conference. March 7, 2013, 2:00 p.m. (ET) to conclusion of the meeting; Room 116 (Hermitage Conference Room), 1801 Hermitage Blvd., Tallahassee, FL. Persons wishing to participate may dial (888) 670-3525, conference code 7135858151. The purpose of the meeting is to discuss the Professional Team's report on Risk Management Solutions RiskLink 11.0.SP2 computer model. In addition, other general business of the Commission may be addressed. A copy of the agenda may be obtained by contacting Donna Sirmons at (850)413-1349, or [email protected].
- Florida Department of Financial Services, as Receiver for National Title Insurance Company Issues Request for Proposal for a Loss Portfolio Transfer. Proposals should be submitted to the Receiver no later than 5:00 p.m., on March 29, 2013.
- Florida Workers' Compensation Insurance Guaranty Assoc., Inc. Audit Committee Meeting. March 12, 2013, 2:00 p.m., Tallahassee, FL. The Audit Committee will meet regarding the general business of the Association, including, but not limited to the Audit Report and Charter/Checklist. A copy of the agenda may be obtained by contacting Cathy Irvin at (850)386-9200.
- Florida Workers' Compensation Insurance Guaranty Assoc., Inc. Board Meeting. March 14, 2013, 2:00 p.m., Tallahassee, FL. The Board will meet regarding the general business of the Association, including, but not be limited to, Minutes, Receiver's Report, Legal Report, Claims Report, Operations Report and Financial Reports. A copy of the agenda may be obtained by contacting Cathy Irvin, (850)386-9200.