FLA Orthopedics, Inc. v. American Insurance Co.

896 So. 2d 1, 2004 Fla. App. LEXIS 11738, 2004 WL 1780919
CourtDistrict Court of Appeal of Florida
DecidedAugust 11, 2004
DocketNo. 3D03-2704
StatusPublished
Cited by2 cases

This text of 896 So. 2d 1 (FLA Orthopedics, Inc. v. American Insurance Co.) is published on Counsel Stack Legal Research, covering District Court of Appeal of Florida primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
FLA Orthopedics, Inc. v. American Insurance Co., 896 So. 2d 1, 2004 Fla. App. LEXIS 11738, 2004 WL 1780919 (Fla. Ct. App. 2004).

Opinion

PER CURIAM.

This is an appeal from a final summary judgment entered in favor of defendant/ap-pellee, The American Insurance Company (“TAIC”), in a suit alleging negligent misrepresentation and violation of section 626.901, Florida Statutes (1997). We affirm for the following reasons.

FLA Orthopedies, Inc. (“FLA”) is in the business of manufacturing and selling orthopedic safety and support products. It has more than 150 full-time employees. When FLA became dissatisfied with its health insurer’s proposed 22% premium increase, it sought out a new insurance program for its employees. FLA reviewed several different insurance programs, including one offered by Well American Group (“WAG”). WAG sold health insurance plans to various employers in the Miami area. WAG’s plan required the employees to pay monthly premiums and submit their medical bills to WAG in order to obtain reimbursement. FLA’s president instructed the “team” to confirm that WAG carried an errors and omissions insurance policy. This instruction was allegedly given because the president believed that only licensed entities would be provided such coverage.

FLA obtained oral assurances from WAG that it had an errors and omissions policy. In addition, WAG allegedly showed FLA a certificate of insurance.1 Thereafter, FLA contracted with WAG for a group plan with WAG agreeing to provide health insurance coverage for FLA’s employees, in exchange for paid premiums.

Ultimately, WAG became insolvent and failed to reimburse FLA’s employees for their medical expenses. WAG subsequently entered into a consent order with the Florida Department of Insurance wherein WAG acknowledged that it had not been licensed to transact insurance business in Florida, and that it had, in fact, engaged in the unauthorized transaction of insurance in Florida.

FLA first encountered TAIC when FLA, in an effort to recoup some of its losses, filed a claim under WAG’s errors and omissions policy. TAIC engaged in a global mediation with those persons and/or entities making claims under the errors and omissions policy that it had issued to WAG because the totality of the claims exceeded the policy limits. Although FLA participated in this mediation, it elected not to participate in the mediation settlement and opted out of the class action suit which had been filed against WAG.

Instead, FLA sued TAIC alleging that TAIC negligently misrepresented to third parties that WAG “was licensed to transact insurance in the State of Florida” by its issuance of an errors and omissions policy to WAG. TAIC moved for summary judgment claiming that the policy issued to WAG “contained no statements to the effect that WAG was a licensed insurance company” and that the sole purpose of the policy was to provide professional liability coverage to insurance agents and/or insurance brokers. TAIC also pointed to the insurance application executed by WAG, which stated that WAG would be functioning as a managing general agent or “MGA,” a company which sells insurance policies, rather than as an insurance carri[3]*3er. This, TAIC maintained, showed that it only insured WAG in its capacity as a broker or agent, not as an insurance carrier.

FLA argued, in opposition to the motion for summary judgment, that TAIC, by issuing an errors and omissions policy to WAG, had implicitly represented that WAG was legally licensed to transact insurance business within the State of Florida. In support of its argument FLA submitted the affidavit of its expert, who opined in relevant part that:

By issuing a professional liability insurance policy in favor of the Well American Group (“WAG”), who sought to operate as [an] MGA [managing general agent], TAIC was representing to FCA and other similarly situated companies that WAG was in compliance with all legal requirements necessary to operate as an MGA under Florida law.

The affidavit also averred that had TAIC followed standard underwriting policies and procedures, it would have discovered that WAG was not authorized to transact insurance business in Florida. The affidavit also stated that an MGA “has the authority to sell insurance and to issue insurance policies on behalf of the insurance company.” As pointed out by the trial court, however, the affidavit did not claim that an MGA could sell insurance policies as a carrier, as WAG had done.

The trial court entered final summary judgment in favor of TAIC. FLA filed a motion for rehearing, which was denied. This appeal followed.

Florida has adopted the law on negligent misrepresentation as set forth in section 552 of the Restatement (Second) of Torts. See Ragsdale v. Mount Sinai Med. Ctr. of Miami, 770 So.2d 167, 169 (Fla. 3d DCA 2000) (citing Gilchrist Timber Co. v. ITT Rayonier, Inc., 696 So.2d 334 (Fla.1997)). The Restatement provides that a negligent misrepresentation claim arises where:

(1) One who, in the course of his business, profession or employment, or in any other transaction in which he has a pecuniary interest, supplies false information for the guidance of others in their business transactions, is subject to liability for pecuniary loss caused to them by their justifiable reliance upon the information, if he fails to exercise reasonable care or competence in obtaining or communicating the information.
(2) Except-as stated in Subsection (3), the liability .stated in Subsection (1) is limited to loss suffered
(a) by the person or one of a limited group of persons for whose benefit and guidance he intends to supply the information or knows that the recipient intends to supply it; and
(b) through reliance upon it in a transaction that he intends the information to influence or knows that the recipient so intends- or-in a substantially similar transaction.
(3) The liability of one who is under a public duty to give the information extends to loss suffered by any of the class of persons for whose benefit the duty is created, in any of the transactions in which it is intended to protect them.

Restatement (Second), of Torts § 552 (1977), quoted in Ragsdale, 770. So.2d at 169.

Thus, in order to prove its claim under section 552, FLA must establish, among other things, that:

1. TAIC provided false information to FLA in the course of TAIC’s business or a transaction in which TAIC had an economic interest;
2. FLA was a person for whose benefit and guidance TAIC intended to sup[4]*4ply the false information for use in FLA’s business transaction; and
3. TAIC intended the false information to influence FLA in its business transaction.

See Fla. Std. Jury Instr. (Civ.) MI 8.2.

In viewing the undisputed material facts in the light most favorable to FLA, as we must,2 we conclude that FLA cannot establish its claim, as a matter of law, under the test set forth in the Restatement. First of all, TAIC is in the business of selling insurance, and is not in the business of supplying information to third persons about its insureds’ business qualifications. Further, TAIC had no pecuniary interest in its insured’s transactions with FLA. Any information received by TAIC from or about WAG was utilized solely to allow TAIC to underwrite the risk.

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Bluebook (online)
896 So. 2d 1, 2004 Fla. App. LEXIS 11738, 2004 WL 1780919, Counsel Stack Legal Research, https://law.counselstack.com/opinion/fla-orthopedics-inc-v-american-insurance-co-fladistctapp-2004.