Essex Ins. Co. v. Mercedes Zota

466 F.3d 981, 2006 U.S. App. LEXIS 25255, 2006 WL 2847811
CourtCourt of Appeals for the Eleventh Circuit
DecidedOctober 6, 2006
Docket05-13457, 05-14671
StatusPublished
Cited by18 cases

This text of 466 F.3d 981 (Essex Ins. Co. v. Mercedes Zota) 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
Essex Ins. Co. v. Mercedes Zota, 466 F.3d 981, 2006 U.S. App. LEXIS 25255, 2006 WL 2847811 (11th Cir. 2006).

Opinion

CARNES, Circuit Judge:

This case involves an insurance coverage dispute arising in Florida, the proper resolution of which depends on unsettled state law. The answers to the state law questions at the core of the case are sufficiently unclear and difficult that we think the proper course is to certify them to the Florida Supreme Court, which can provide authoritative answers.

I.

Mercedes Zota was injured when she fell from scaffolding while painting a mural on the second story ceiling of a home under construction in Lighthouse Point, Florida. Zota was performing work as a salaried employee of Perla Lichi Designs and the President of Trompe L’Oeils ‘R’ Us when she was injured. Trompe L’Oeils and Perla Lichi Designs had contracted with Lighthouse Intracoastal, Inc., the owner of the premises where Zota was injured, to paint the ceiling of that residence. After the incident, Zota and her husband, Miguel Zota, brought a negligence action against: Lighthouse; Bro-ward Executive Builders, Inc., the general contractor for the project; and Jack Farji, a fifty percent shareholder of Lighthouse and the owner of Broward. Lighthouse’s insurer, the Essex Insurance Company, then filed this action seeking declaratory relief against Lighthouse, Broward, Farji, and the Zotas. It sought a determination and declaration of its rights and obligations with respect to the defendants in the negligence action.

II.

The facts relevant to the insurance dispute are these. Lighthouse, which is in the business of building “spec homes,” secured various types of insurance to cover its activities as a home builder. Part of its insurance coverage is a surplus lines insurance policy issued by MacDuff Underwriters, Inc. for Essex Insurance (Essex policy). MacDuff is the surplus lines agent for Essex. The surplus lines policy in question was delivered by MacDuff to R.A. Brandon & Company. Brandon is Lighthouse’s producing agent, which means that it has undertaken to secure the various types of insurance that Lighthouse wanted. When it secured insurance policies for Lighthouse, Brandon received copies of the policies, reviewed them for accuracy, and then provided them to Lighthouse. Brandon received a copy of the Essex policy, but Brandon, Essex and MacDuff all failed to provide a copy of it to Lighthouse.

III.

In the district court, both Essex and the defendants filed motions for summary judgment in this declaratory action. Essex contended that the terms of Lighthouse’s policy preclude coverage. The defendants contended that Essex had violated Florida Statutes §§ 626.922 and 627.421 by not delivering the policy to *983 Lighthouse and, therefore, Essex was precluded from denying coverage. As a fallback position, the defendants contended that the Zota incident was covered under the policy anyway. The district court agreed with the defendants’ first contention and granted their motion for summary judgment, declaring that Essex was precluded from denying coverage because it had failed to deliver the policy to the insured, as required by Florida Statutes §§ 626.922 and 627.421.

The defendants subsequently filed a motion for attorney’s fees under Florida Statute § 627.428. The district court granted that motion and entered a judgment for fees and costs against Essex and in favor of Lighthouse, Broward and Farji. Essex has appealed both orders.

IV.

Central to the legal dispute is Florida Statute § 626.922, which provides as follows:

Upon placing a surplus lines coverage, the surplus lines agent shall promptly issue and deliver to the insured evidence of the insurance consisting either of the policy as issued by the insurer or, if such policy is not then available, a certificate, cover note, or other confirmation of insurance. Such document shall be executed or countersigned by the surplus lines agent and shall show the description and location of the subject of the insurance; coverage, conditions, and term of the insurance; the premium and rate charged and taxes collected from the insured; and the name and address of the insured and insurer. If the direct risk is assumed by more than one insurer, the document shall state the name and address and proportion of the entire direct risk assumed by each insurer. A surplus lines agent may not delegate the duty to issue any such document to producing general lines agents without pri- or written authority from the surplus lines insurer. A general lines agent may issue any such document only if the agent has prior written authority from the surplus lines agent. The surplus lines agent must maintain copies of the authorization from the surplus lines insurer and the delegation to the producing general lines agent. The producing agent must maintain copies of the written delegation from the surplus lines agent and copies of any evidence of coverage or certificate of insurance which the producing agent issues or delivers. Any evidence of coverage issued by a producing agent pursuant to this section must include the name and address of the authorizing surplus lines agent.

Fla. Stat. § 626.922(1). Also relevant to the dispute is Florida Statute § 627.421, which provides: “Subject to the insurer’s requirement as to payment of premium, every policy shall be mailed or delivered to the insured or to the person entitled thereto not later than 60 days after the effectuation of coverage.” Fla. Stat. § 627.421(1).

The district court interpreted these two statutory provisions to require delivery of the policy directly to the insured. Because the policy was delivered only to Lighthouse’s producing agent, Brandon, and never delivered directly to Lighthouse, the court held that Essex had failed to comply with these statutes. The court concluded that as a penalty or sanction for its failure to comply with the delivery provisions Essex could not use the language of the policy against Lighthouse to bar coverage.

Section 626.922(1) requires that the surplus lines agent, MacDuff in this case, deliver evidence of the insurance to the insured. Florida law appears to provide that, “delivery of an insurance policy to an agent constitutes delivery to the insured.” Reliance Ins. Co. v. D’Amico, 528 So.2d *984 533, 534 (Fla. 2d DCA 1988); see also Prudential Ins. Co. v. Latham, 207 So.2d 733, 735 (Fla. 3d DCA 1968); United Nat’l Ins. Co. v. Jacobs, 754 F.Supp. 865, 869 (M.D.Fla.1990). However, the district court noted that § 626.922 was amended in 1998 and it pointed out that none of the relevant decisions addressed the post-amendment version of § 626.922. The court then concluded that the plain language of § 626.922 requires delivery directly to the insured, and delivery to the insured’s agent will suffice only where there is a written delegation of authority to do that.

By its terms, the first sentence of § 626.922(1) requires a surplus lines agent to issue and deliver evidence of insurance to the insured. Fla. Stat. § 626.922

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Cite This Page — Counsel Stack

Bluebook (online)
466 F.3d 981, 2006 U.S. App. LEXIS 25255, 2006 WL 2847811, Counsel Stack Legal Research, https://law.counselstack.com/opinion/essex-ins-co-v-mercedes-zota-ca11-2006.