Daniel Ilias v. USAA General Indemnity Company

61 F.4th 1338
CourtCourt of Appeals for the Eleventh Circuit
DecidedMarch 14, 2023
Docket21-12486
StatusPublished
Cited by11 cases

This text of 61 F.4th 1338 (Daniel Ilias v. USAA General Indemnity Company) is published on Counsel Stack Legal Research, covering Court of Appeals for the Eleventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Daniel Ilias v. USAA General Indemnity Company, 61 F.4th 1338 (11th Cir. 2023).

Opinion

USCA11 Case: 21-12486 Document: 44-1 Date Filed: 03/14/2023 Page: 1 of 24

[PUBLISH] In the United States Court of Appeals For the Eleventh Circuit

____________________

No. 21-12486 ____________________

DANIEL ILIAS, Plaintiff-Appellant, versus USAA GENERAL INDEMNITY COMPANY,

Defendant-Appellee.

Appeal from the United States District Court for the Middle District of Florida D.C. Docket No. 8:20-cv-00834-WFJ-TGW ____________________ USCA11 Case: 21-12486 Document: 44-1 Date Filed: 03/14/2023 Page: 2 of 24

2 Opinion of the Court 21-12486

Before WILLIAM PRYOR, Chief Judge, and ROSENBAUM and MARCUS, Circuit Judges. MARCUS, Circuit Judge: On July 29, 2017, Scott Dunbar lost control of his van while driving on a divided highway in Pasco County, Florida. The van jumped the center median and landed directly on top of an oncom- ing car driven by Daniel Ilias. Ilias was seriously injured in the re- sulting wreck. He tore his aorta, broke several bones, and had to spend ten days in the hospital in a medically induced coma. Dunbar’s insurer, USAA General Indemnity Company, im- mediately began investigating. But despite learning that Ilias had suffered grievous injuries, so that his damages would almost surely exceed Dunbar’s $10,000 policy limit, and despite determining that Dunbar was solely at fault for the accident, USAA delayed initiating settlement negotiations for over a month. Then, USAA failed to confirm for Ilias’ attorney, Maryanne Furman, that Dunbar lacked additional insurance coverage with which to satisfy a judgment. Because Furman needed this information to agree to USAA’s set- tlement offer (and release Dunbar from liability), the case did not settle, and Ilias obtained an approximately $5 million judgment against Dunbar in state court. Ilias then commenced this action to hold USAA responsible for the judgment, bringing a single claim for bad faith under Florida common law. USAA moved for summary judgment, arguing that no reasonable jury could find that its conduct amounted to bad USCA11 Case: 21-12486 Document: 44-1 Date Filed: 03/14/2023 Page: 3 of 24

21-12486 Opinion of the Court 3

faith or that its conduct caused the entry of the excess judgment against Dunbar. The district court agreed, and entered final sum- mary judgment for USAA. Ilias now appeals the district court’s order. After thorough review of the record, and with the benefit of oral argument, we conclude that the district court erred and therefore reverse and re- mand this case for trial. I. A. The accident that spurred this case involved three drivers: the insured, Dunbar; the Plaintiff, Ilias; and non-party Zenaida Brignoni. On July 29, 2017, while driving southbound on County Road 1 in Pasco County, Florida, Dunbar lost control of his van and struck Brignoni’s SUV, also traveling southbound. The colli- sion caused Dunbar’s van to veer toward the center median, launch into oncoming traffic, and land directly on top of Ilias’ Honda Pilot. Ilias suffered catastrophic injuries, including a torn aorta and several broken bones. He had to be airlifted from the crash site to the hospital, where he would remain in a medically induced coma in the intensive care unit for ten days before spending another three weeks in the hospital and a rehabilitation facility. Dunbar was also transported to the hospital. He hit his head requiring stitches, and broke his nose in the crash, but he was able to leave later that day. Brignoni sustained some back and neck pain but was able to go home immediately following the accident. USCA11 Case: 21-12486 Document: 44-1 Date Filed: 03/14/2023 Page: 4 of 24

4 Opinion of the Court 21-12486

USAA first learned of the accident the day it occurred. Within two days, it had assigned a liability adjuster to investigate. The adjuster tried to contact Dunbar and the other drivers in- volved in the accident, requested a copy of the police report, and sent Dunbar an “excess letter” explaining that his potential liability for the damages from the accident could exceed his policy’s limits -- up to $10,000 per person for bodily injuries and up to $20,000 per accident. The letter stated: “It’s also important to let us know im- mediately if you have an umbrella or other liability policy that may provide coverage for your claim.” Dunbar gave USAA a statement on August 3. Though he didn’t remember much, USAA was able to confirm that he had been injured and escalated the claim to an injury adjuster. The next day, USAA learned from a personal injury firm hired by Ilias’ wife that Ilias had been hit head-on and was still hospitalized. On August 8, Ilias’ attorney spoke with USAA again. The attorney informed USAA that Ilias had suffered a torn aorta, a frac- ture to the right knee, and several leg fractures, and that he had just gotten out of the ICU (ten days after the accident). USAA then spoke with Brignoni’s daughter and Dunbar. Brignoni’s daughter told USAA that Brignoni “went home and has some back and neck pain.” She also said that the driver of the “Silver SUV” -- Ilias -- had a broken leg, and that the officer at the scene believed the accident to be Dunbar’s fault. As for Dunbar, USAA informed him that if he were found liable, there “could be a possible excess” because there were injuries alleged, and Dunbar’s bodily injury and USCA11 Case: 21-12486 Document: 44-1 Date Filed: 03/14/2023 Page: 5 of 24

21-12486 Opinion of the Court 5

accident coverage limits were only $10,000 and $20,000, respec- tively. At this point, based on the information it had gathered re- garding the extent of Ilias’ injuries and extended hospital stay, USAA elevated Ilias’ claim to a more experienced adjustor, John Raymond. On August 10, Ilias terminated the attorneys hired by his wife and retained a new lawyer, Furman. Furman visited Ilias in the hospital and concluded that his damages were “pretty signifi- cant” and likely exceeded Dunbar’s $10,000 policy limit. The next day, Furman faxed a letter to USAA to notify it that she now repre- sented Ilias. She also requested, “[p]ursuant to Florida Statute § 627.4137,” a sworn statement from USAA providing information regarding Dunbar’s USAA insurance policy, as well as the “name and coverage of any other known insurer.” (emphasis in original). Raymond responded with a sworn statement of USAA’s coverage a few days later, but he did not provide the name or coverage in- formation of any other insurer or indicate whether USAA was aware of any other coverage. Raymond also called Furman on Au- gust 11 to discuss the case but did not reach her. On August 14, Raymond received and reviewed a copy of the police report for the accident. The report concluded that Dun- bar was solely at fault because he had been driving in a “[c]areless or [n]egligent [m]anner” and had been traveling 70 miles per hour in a 45-mile-per-hour zone. The report also noted that Dunbar and Ilias were both transported by EMS to Bayonet Point Regional Medical Hospital, and described Ilias’ “[i]njury [s]everity” as USCA11 Case: 21-12486 Document: 44-1 Date Filed: 03/14/2023 Page: 6 of 24

6 Opinion of the Court 21-12486

“[i]ncapacitating.” Upon reviewing the report, Raymond deter- mined that USAA would be accepting liability for Ilias’ claim -- but he did not convey this to Furman. Nor did Raymond consider ten- dering the $10,000 policy limit to Ilias at this point. Raymond and Furman next spoke on August 22, but they only discussed Ilias’ property damage claim based on the damage to his vehicle. This would be the last time Raymond and Furman spoke, since Raymond retired on August 30. Raymond called Fur- man that day but was unable to reach her. Furman returned Ray- mond’s call the next day, but, unsurprisingly, did not reach him. Furman missed an additional call from a different USAA adjuster the next week, though she was not informed that Raymond had retired.

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Bluebook (online)
61 F.4th 1338, Counsel Stack Legal Research, https://law.counselstack.com/opinion/daniel-ilias-v-usaa-general-indemnity-company-ca11-2023.