1. STATE APPELLATE DECISIONS
    1.  FLORIDA
  • Barroso v. Sheridan Health Corp. and Travelers Ins. (1st DCA). Workers’ compensation claimant’s petition for certiorari review to First District Court of Appeal dismissed because claimant failed to establish that pre-trial rulings have caused or will cause irreparable harm that is not remediable on plenary appeal. Irreparable harm is a condition precedent to invoking certiorari jurisdiction, and should be considered first.
  • Bellamy v. Golden Flake Snack Foods, Inc., The Charter Oak Fire Insurance Company, and The Travelers Companies, Inc. (1st DCA). Judge of compensation claims departed from essential requirements of law in granting employer/carrier's motion to compel claimant's attendance at an independent medical examination where employer/carrier had not denied a medical benefit requested by claimant. Employer/Carrier’s unilateral speculative concerns over claimant’s progress with an authorized physician insufficient to create a dispute concerning medical benefits and compel attendance at IME.
  • Starling v. Allstate Property and Casualty Insurance Company (1st DCA). Summary judgment in favor of insurer affirmed and appeal dismissed. Court without jurisdiction where notice of appeal was filed more than 30 days after rendition of final order.
  • Citizens Property Insurance Corporation v. Ifergane (3rd DCA). Where insurer filed declaratory judgment action against husband and wife regarding its coverage obligations, but wife had assigned all her rights and interests in property, including any insurance claims, to husband, trial court did not abuse discretion in dismissing wife as a party. Wife's assignment of insurance claim to husband was valid, and insurer was not entitled to declaratory relief against her because she had no actual, present, adverse, and antagonistic interest in the subject matter of the complaint, which sought to define insurer's obligations with respect to the policy and claim for benefits. Trial court erred in entering summary judgment for husband on issue of coverage where there was genuine issue of material fact as to whether husband was a resident spouse on date of loss, and because assignment did not relieve wife of her post-loss obligations as a named insured under policy. Although wife assigned her right to benefits under policy, she did not assign to husband her obligations under policy and her refusal to submit to a requested examination under oath precludes recovery under policy, because the EUO stands as a condition precedent to coverage.
  • Advanced Chiropractic and Rehabilitation Center Corporation d/b/a Advanced Chiropractive and Rehabilitation Center a/a/o Americo Galindo v. United Automobile Insurance Company (4th DCA). Where insurer appealed to circuit court contending that county court abused its discretion in finding that provider's motion for attorney's fees was timely and in finding excusable neglect sufficient to support granting provider's rule 1.540(b) motion to vacate an order of dismissal, circuit court departed from essential requirements of law, resulting in denial of due process, when it reversed based on evidentiary deficiencies which were neither preserved in county court nor raised in insurer's appeal brief.
  1. GEORGIA
  • No Georgia decisions reported.
  1. FEDERAL DECISIONS
    1. FLORIDA
  • No Florida decisions reported.
  1. GEORGIA 
  • White v. State Farm Insurance Company (11th Cir. GA). Dispute concerning enforceability of insurance policy requirement under Georgia law that lawsuits against the insurance company be brought “within one year of the date of loss or damage.” The case returned to the 11th Circuit after it certified two questions to the Supreme Court of Georgia: (1) whether the Georgia Insurance Commissioner act within his legal authority when he promulgated Ga. Comp. R. & Regs. 120-2-20-.02, such that a multiple-line insurance policy providing first-party insurance coverage for theft-related property damage must be reformed to conform with the two-year limitation period provided for in Georgia’s Standard Fire Policy, Ga. Comp. R. & Regs. 120-2-19-.01?” and (2) Whether this action is barred by the Policy’s one-year limitation period”. See White v. State Farm Fire & Cas. Co., 664 F.3d 860, 865 (11th Cir. 2011). The Supreme Court of Georgia answered “no” to the first question, and “yes” to the second question. See White v. State Farm Fire & Cas. Co.,728 S.E.2d 685 (Ga. 2012). Based on the Supreme Court of Georgia’s opinion, the 11th Circuit affirmed the district court’s grant of summary judgment in favor of insurer.
  1. ADMINISTRATIVE LAW/AGENCY DECISIONS
  • In the Matter of Fredrick Blaine Armold, DOAH Case No. 11-2742PL, DFS Case No. Florida Department of Financial Services Final Order. 113923-11-AG. Final Order issued by the Florida Department of Financial Services suspending insurance agent’s licenses in Florida for a period of three (3) months finding that agent violated Rule 69B-215.210, F.A.C. in the sale of an annuity to senior citizens.
  1.  NOTICES OF ADMINISTRATIVE RULEMAKING PROCEEDINGS
    1. RULE DEVELOPMENT
  • None reported for Florida and Georgia.
  1.  PROPOSED RULES

FLORIDA

  • Rule 59G-13.088, F.A.C. - Developmental Disabilities Consumer Directed Care Plus. The Agency for HealthCare Administration noticed changes to the Developmental Disabilities Medicaid Waivers Consumer Directed Care Plus Program Coverage, Limitations, and Reimbursement Handbook, July, 2012.
  • Rule 59G-13.086, F.A.C. - Developmental Disabilities Waiver Disposable Incontinence Medical Supplies Fee Schedule and Minimum Quality Standards. The Agency for Health Care Administration gives notice that subsection (3) of the proposed rule is changed to add an effective date of July 1, 2013.
  • Rule 69O-142.011, F.A.C. – Financial Services Commission/Office of Insurance Regulation – Insurer Conduct Penalty Guidelines. Public hearing on October 23, 2012, at 9:00 a.m. during a regular meeting of the Financial Services Commission, Cabinet Meeting Room, Lower Level, The Capitol, Tallahassee, FL, concerning proposed repeal of Rule 69O-142.011, Florida Administrative Code, published on July 20, 2012 in Vol. 38, No. 29, of the Florida Administrative Weekly. No notice of change was published. Agenda to be posted at http://www.myflorida.com/myflorida/cabinet/mart.html. The agenda should be available approximately one week before the cabinet meeting.
  • Rule 69O-148.001, F.A.C. – Funding of Preneed Contracts With Life Insurance or Annuities. The Florida OIR seeks repeal of Rule 69O-148.001, F.A.C., which addresses the sale of life and annuity products by agents to fund preneed funeral contracts. The rule currently limits the amount of insurance that may be written at $7,500, which conflicts with section 626.785, Fla. Stat. that permits coverage up to $12,500. The remainder of the rule has essentially the same substantive content as the statute and is unnecessary. If requested in writing, the Florida OIR will hold a public hearing on October 17, 2012, 9:30 a.m., 116 Larson Building, 200 East Gaines Street, Tallahassee, FL.

GEORGIA

  1. MEETING NOTICES OF INTEREST/MISCELLANEOUS
  • Agency For Health Care Administration Assisted Living Workgroup – on September 21, 2012, 2:00 p.m. – 4:00 p.m., Conference Call: 1(888) 670-3525, Code: 625 643 6859. General subject matter to be considered: to conduct a meeting of the Assisted Living Workgroup members for examination of the regulation and oversight of assisted living in Florida and develop recommendations to improve the state’s ability to monitor quality and safety in assisted living and ensure the well-being of their residents. A copy of the agenda may be obtained by contacting: Ron Heredia, (850) 412-4304, Ronald.Heredia@ahca.myflorida.com. The agenda will also be posted at: http://ahca.myflorida. com/SCHS/CommiteesCouncils/ALWG/index.shtml (7) days prior to the meeting.
  • Agency For Health Care Administration Assisted Living Workgroup – on September 24, 2012, 2:00 p.m. – 4:00 p.m., Conference Call: 1(888) 670-3525, Code: 625 643 6859. General subject matter to be considered: to conduct a meeting of the Assisted Living Workgroup members for examination of the regulation and oversight of assisted living in Florida and develop recommendations to improve the state’s ability to monitor quality and safety in assisted living and ensure the well-being of their residents. A copy of the agenda may be obtained by contacting: Ron Heredia, (850) 412-4304, Ronald.Heredia@ahca.myflorida.com. The agenda will also be posted at: http://ahca.myflorida. com/SCHS/CommiteesCouncils/ALWG/index.shtml (7) days prior to the meeting.
  • Agency For Health Care Administration Assisted Living Workgroup – on September 27, 2012, 10:00 a.m. – 12:00 Noon, Conference Call: 1(888) 670-3525, Code: 625 643 6859. General subject matter to be considered: to conduct a meeting of the Assisted Living Workgroup members for examination of the regulation and oversight of assisted living in Florida and develop recommendations to improve the state’s ability to monitor quality and safety in assisted living and ensure the well-being of their residents. A copy of the agenda may be obtained by contacting:Ron Heredia, (850) 412-4304, Ronald.Heredia@ahca.myflorida.com. The agenda will also be posted at: http://ahca.myflorida. com/SCHS/CommiteesCouncils/ALWG/index.shtml (7) days prior to the meeting.
  • Florida OIR Deputy Insurance Commissioner, Michelle Robletto presents at the Florida Association of Health Plans.
  • Premier Group Insurance v. Office of Insurance Regulation, DOAH Case No. 12-000439. Formal Administrative Hearing on September 13, 2012 to challenge the Florida OIR’s Notice of Intent to order insurer to return excess profits pursuant to section 627.215, Florida Statutes, which requires workers’ compensation insurers, and certain other insurers, to return any “excessive profits” earned by the insurer to their policyholders. Specifically, dispute between the Florida OIR and the insurer concerns the appropriate amount of federal income tax expense that the insurer may deduct in its excess profits filing. The appropriate methodology to allocate federal income tax expense was not at issue in prior DOAH Case Number 12-1201RU and was not addressed in the Final Order entered in that case. The Division of Administrative Hearings will issue a Recommended Order within 30 days after the hearing or receipt of the hearing transcript, unless waived by the parties.
  • Citizens Property Insurance Company Public Rate Hearing Agenda.
  • Florida Department of Financial Services as Receiver - Florida Preferred Property Insurance Company. FDFS as Receiver mailed Notices of Determination to all known claimants. All classes were evaluated and the amount recommended along with the class assignment are identified in the notice. Objection Filing Deadline is October 26, 2012.