1. STATE APPELLATE DECISIONS
    1. FLORIDA
  • State Farm Florida Insurance Company v. Pineres (Fla. 3rd DCA). Trial court’s order compelling appraisal reversed and remand for further proceedings due to confession of error.
  • Steinger, Iscoe & Greene, P.A., et. al. v. Geico General Insurance Company (Fla. 4th DCA). Uninsured motorist/non-party discovery. Upon a preliminary showing that the plaintiff was referred to a doctor by the lawyer (whether directly or through a third party), the defendant is entitled to discover information regarding the extent of the relationship between the law firm and the doctor. Order compelling law firm to produce discovery pertaining to its relationship with treating physician was premature where record did not establish that physician and law firm had a financially beneficial relationship. However, at a minimum, the health care provider must provide financial bias discovery permitted by rule 1.280(b)(5)(A)(iii) as well as any history of referrals between the health care provider and the law firm. If the insurer can establish that the law firm or health care provider referred the plaintiff to the other, more extensive financial bias discovery from both of them may then be appropriate. Petition for certiorari granted, trial court order granting discovery quashed, and cause remanded to trial court for proceedings consistent with opinion.
  1. GEORGIA
  • Landrum et. al. v. Infinity Safeguard Insurance Company, A12A1179 (November 20, 2012). Motor vehicle insurance/coverage. Trial court’s order granting summary judgment in favor of insurer affirmed. The policy’s exclusion for bodily injury to a named insured did not violate public policy. The injured named insured is presumed to have knowledge of the contents of her policy, and cannot void the policy exclusion on the ground that she is an innocent member of the motoring public. The insured’s adult grandson, who drove insured’s vehicle at the time of the accident, was not a relative insured by the policy, and therefore was not an insured facing unfair exposure to unanticipated liability.
  • Maxum Indemnity Company v. Jimenez, et al., A12A0992, (November 20, 2012). Commercial general liability/coverage. Insurer filed an action against its insured and a claimant seeking a declaratory judgment that its commercial general liability (“CGL”) policy did not afford coverage for liability associated with the insured’s negligent pipe installation on a construction project that resulted in property damage to a university dormitory. Trial court granted summary judgment in favor of insured and claimant. Court of Appeals affirmed trial court’s decision holding: 1) the underlying claim fell within the policy’s coverage for “property damage” caused by an “occurrence;” 2) the underlying claim fell within the “insured contract” exception to the “Contractual Liability” exclusion in the policy; and, 3) coverage was not barred under the policy’s “Contractor’s Limitation Endorsement.”
  • Choate Construction Company v. AutoOwners Insurance Company, A12A1045, (November 20 2012). Performance Bond. Trial court’s grant of summary judgment for surety reversed by Court of Appeals. Evidence presented jury questions as to relationship of named principal on the bonds to the underlying subcontract. Furthermore, evidence presented a jury question on whether persons representing principal defrauded obligee, whether the insurer’s agent worked with principal’s representatives to defraud obligee and wrote bond fraudulently, and whether surety intentionally or recklessly misrepresented to obligee one or more material facts when it issued the bonds.
  • Lumpkin County, Georgia v. Georgia Insurers Insolvency Pool, S12A1451 (November 19, 2012). Guaranty Fund/coverage/workers’ compensation. Georgia Supreme Court affirmed trial court’s grant of summary judgment to the Georgia Insurers Insolvency Pool (“GIIP”). The GIIP and the net worth exclusion of OCGA § 33-36-3 (4) (G) apply to counties as “legal entities” under the Georgia Insurers Insolvency Pool Act (“Act”). The Act makes no distinction or exception for public entities such as the County, and there is no evidence to suggest the Legislature intended to exempt the County. No statutory authority for the County’s argument that “net assets” should only refer to “unrestricted net assets.” The County does not possess due process rights to challenge the constitutionality of the Act because constitutional due process of law does not apply to the revenues of a county, since a county is a public corporation existing only for public purposes.
  1. FEDERAL APPELLATE DECISIONS
  • HDI-Gerling America Insurance Company v. Morrison Homes, Inc., and Taylor Morrison Services, Inc. f/k/a Morrison Homes, Inc. (11th Cir. GA). Diversity action seeking a determination of whether property damage alleged in a California class action lawsuit brought by purchasers of homes was caused by an “occurrence” and therefore covered under the terms of builder’s commercial general liability (“CGL Policy”). District Court granted summary judgment to insurer, holding that class-action claims against insured were not based on an “occurrence” as defined in the CGL Policy and because they involved only damage to the “insured’s own work.” The 11th Circuit determined that neither of the requirements used by the District Court in reaching its decision has been authoritatively declared as law by the Georgia Supreme Court. Consequently, the 11th Circuit certified the following questions for resolution by the Georgia Supreme Court: 1) Whether, for an “occurrence” to exist under a standard CGL Policy, Georgia law requires there to be damage to “other property”, that is, property other than the insured’s completed work itself; and 2) If the answer to Question 1 is in the negative, whether for an “occurrence” to exist under a standard CGL Policy, Georgia law requires that the claims being defended not be for breach of contract, fraud, or breach of warranty from the failure to disclose material information.
  1. ADMINISTRATIVE LAW/AGENCY DECISIONS
  • Georgia Department of Insurance Bulletin, BULLETIN 12-EX-2, Regarding Georgia State Board of Workers’ Compensation Revised Form (WC-10) for Election or Rejection of Workers’ Compensation Coverage. The Department issued Bulletin 12-EX-2 to provide notice and direction to the industry concerning transition to use of Revised Form WC10. The major change on the new form (WC-10) is the inclusion of a requirement for notarized certification. The Department has required that each carrier receiving Bulleting 12-EX-2, must provide a copy to all agents or licensed producers (for the Workers’ Compensation Assigned Risk Plan), including any non-resident agent writing a risk in Georgia, with whom the company transacts business in the State of Georgia. To facilitate the transition to use of Revised Form WC10, the Department and the Georgia State Board of Workers’ Compensation have agreed to the following: 1) any old form executed and submitted to a carrier or State Board (if applicable) prior to the October 1, 2012 effective date shall remain in full effect and shall apply to any subsequent renewal. Old forms will be honored and new forms will not have to be executed unless an election or rejection of an individual changes or a new carrier is selected by the employer; 2) both old and new forms will be eligible for use for new policies issued from October 1, 2012 to December 31, 2012. Any new business written during this time period may use either form and be in compliance; and, 3) any new business written January 1, 2013 and after shall be on the new form. If no changes are made either by changing an election or rejection of an individual or by changing carriers, then the old forms will be grandfathered and deemed in full effect on subsequent renewals.
  1. NOTICES OF ADMINISTRATIVE RULEMAKING PROCEEDINGS
    1. FLORIDA
  1. GEORGIA
  1. MEETING NOTICES OF INTEREST/MISCELLANEOUS
  • Department of Health - Division of Children’s Medical Services. On December 7, 2012, 1:00 p.m. – 4:00 p.m., Capital Circle Office Center, 4025 Esplanade Way, Room # 301, Tallahassee, FL. The Florida KidCare Coordinating Council, an advisory body appointed by the Florida Department of Health, will meet to discuss Florida KidCare, the state children’s health insurance program. The Council is charged with making recommendations concerning the implementation and operation of the program. A copy of the agenda may be obtained by contacting: Gail Vail, Department of Health, (850) 245-4200, ext. 2238, Gail_Vail@doh.state.fl.us.
  • FDFS - Division of Workers’ Compensation. Meeting of Three-Member Panel (consisting of the Chief Financial Officer and two (2) appointees of the Governor) on December 11, 2012, 1:00 p.m., Room 116, Larson Bldg., 200 E. Gaines St., Tallahassee, FL. Pursuant to section 440.13(12)(a), Fla. Stat., the Three-Member Panel will consider: 1) adoption of a methodology for reimbursing hospitals 60% and 75% of usual and customary charges for outpatient services; 2) re-adoption of the schedule of per-diem rates for hospital inpatient care or a revision to the current schedule of rates; 3) re-adoption of the ambulatory surgical center schedule of rates; and, 4) re-adoption of the 2012 Health Care Provider Reimbursement Manual, which is still pending ratification by the Legislature; Additionally, the Three-Member Panel will review and issue the 2013 Biennial Report to the President of the Senate and the Speaker of the House of Representatives.
  • Citizens Property Insurance Corporation - Depopulation Committee Meeting. On December 13, 2012, 2:00PM (EDT), Peabody Hotel, 9801 International Drive, Orlando, FL. Items of discussion include, but are not limited to, committee updates. For additional information please go to www.citizensfla.com or, call Jill Stafford at 1-800-807-7647.
  • Citizens Property Insurance Corporation - Finance and Investment Committee. On December 13, 2012, 4:30PM (EDT), Peabody Hotel, 9801 International Drive, Orlando, FL. Items of discussion include, but are not limited to, committee updates. For additional information please to www.citizensfla.com, or call Jill Stafford at 1-800-807-7647.
  • FDFS, as Receiver of Intercontinental Marine Service Corporation d/b/a First Warranty Group of Florida ("IMSC"), Mailed Notices of Determination to All Known Claimants (“Notices”). On November 20, 2012, the FDFS mailed Notices of Determination to all known claimants. The FDFS only evaluated Classes 1 and 2 and identified a recommended amount along with the class assignment in the Notice. Insufficient funds prevented FDFS from evaluating Classes 3 through 11 resulting in the “Amount Recommended Claimant” field in the Notice left blank. The objection filing deadline is January 15, 2013.
  • Florida Office of Insurance Regulation (“Florida OIR”) Announces Approval of Reduced Cost Mortgage Title Insurance Product. The Florida OIR has approved a new product, Mortgage Priority Guarantee policy, to be used when lenders amend an existing mortgage loan agreement in order to help assist a homeowner remain in their home and prevent a foreclosure of the property. The Florida OIR has approved three companies to sell this form of insurance in Florida: Old Republic National Title Insurance Company (Minnesota), Westcor Land Title Insurance Company (California), and WFG National Title Insurance Company (South Carolina).
  • Georgia Department of Insurance Consumer Alert Regarding Nationwide Insurance Company Data Breach. Nationwide Insurance Company notified the Georgia Office of Insurance that a portion of their computer network was criminally attacked by individuals who gained unauthorized access to personal and private information of approximately 28,467 Georgia members and/or potential policyholders. Nationwide has implemented a corrective action plan with the Department that includes: 1) written notice to the members and applicants regarding the improper disclosure of their private information; 2) dedicated toll-free number to answer questions from members and applicants. The Nationwide number is 800-760-1125; and, 3) offer affected members and applicants free credit monitoring and identity theft protection services from Equifax for at least one year.