Provident Life & Accident Insurance Co. v. Genovese

138 So. 3d 474, 2014 WL 714695, 2014 Fla. App. LEXIS 2576
CourtDistrict Court of Appeal of Florida
DecidedFebruary 26, 2014
DocketNo. 4D12-444
StatusPublished
Cited by9 cases

This text of 138 So. 3d 474 (Provident Life & Accident Insurance Co. v. Genovese) 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
Provident Life & Accident Insurance Co. v. Genovese, 138 So. 3d 474, 2014 WL 714695, 2014 Fla. App. LEXIS 2576 (Fla. Ct. App. 2014).

Opinion

KLINGENSMITH, J.

Appellant, Provident Life and Accident Insurance Company (“Provident”), appeals a final judgment entered after a jury trial, which determined an onset date of disability for Dr. Peter Genovese (“Genovese”). This date differed from the onset date established by a special interrogatory jury verdict in an earlier trial between the [476]*476same parties. The question presented is whether that finding triggered collateral estoppel, thus preventing Genovese from re-litigating the onset date of disability as established in the earlier trial. We find that it does, and reverse. This court will not address the remaining points on appeal as this decision renders them moot.

Genovese obtained a disability policy from Provident that provided for both total and residual disability benefits. Under the terms of the policy, Genovese was entitled to receive lifetime benefits if he became “totally disabled” prior to his sixtieth birthday on November 19, 1997. However, if Genovese became totally disabled on or after his sixtieth birthday, he would be entitled to benefits only until age sixty-five. On November 12, 1997, Genovese submitted a claim for total disability benefits pursuant to his policy. As part of his claim, Genovese furnished Provident with an attending physician’s statement indicating that Genovese’s occupational restrictions and limitations began on November 14, 1997. In his answers to a supplementary statement of claim, Genovese indicated that he was hospitalized on December 8, 1997 and was unable to perform any of his duties at the clinic where he worked.

Almost two years later, Provident filed a declaratory judgment action (“Genovese I”) asserting that a “bona fide dispute” had arisen as to whether Genovese was totally disabled pursuant to the terms and conditions of his policy. Provident asked the court to decide whether Genovese was entitled to total or residual disability benefits, or whether he should return to Provident all benefits “paid to him with reservation of rights, together with unpaid premiums and interest thereon.” Ge-novese then filed a counterclaim against Provident alleging breach of contract based upon Provident’s denial of benefits.

During its rebuttal closing argument at trial, Provident argued that Genovese’s date of disability was December 8, 1997. At the jury charge conference, Provident’s counsel argued that the verdict form should include questions that asked whether Genovese was totally disabled, and, if so, the date on which they find he became totally disabled. Although Genovese argued that establishing a beginning date of disability was not necessary, the court stated that “the jury has to determine based on the facts when [Genovese’s] total disability began.” Soon after, counsel for Genovese suggested the following: “Maybe we can ask the jury a second question. If you find that Doctor Ge-novese was disabled, please tell us on what date he was unable to perform his substantial and material duties of his occupation and leave it to them.” Provident suggested a slight change to the wording of the second question, and Genovese’s counsel responded, “That’s cool, I can live with it. I can live with it.”

The final version of the verdict form read as follows:

We, the jury, return the following Verdict:
1. Was the Defendant/Counter-Plaintiff Peter R. Genovese, M.D., totally disabled and therefore unable to perform the material and substantial duties of his occupation due to sickness?
_YES_NO
If answer to Question # 1 is “No”, your verdict is for the PlaintiffiCoun-ter-Defendant, Provident Life and Accident Insurance Company. You should not proceed further except to date and sign this Verdict Form and return it to the courtroom. If you[r] answer to Question #1 is “Yes,” please answer Question # 2.

[477]*4772. What is the date that Defendant/Counter-Plaintiff Peter R. Genovese, M.D., became totally disabled and therefore unable to perform the material and substantial duties of his occupation due to sickness?

(Emphasis added). Ultimately, the jury found Genovese was totally disabled and assigned the date of disability as December 8, 1997, a date after his sixtieth birthday. Genovese’s post-trial motion to strike this finding from the verdict form was denied, and a final judgment was entered. This judgment did not include the jury’s finding regarding the onset date. Provident paid the judgment and provided Genovese with total disability benefits until his sixty-fifth birthday, advising Genovese that his benefits would be terminated at that time based upon the date of disability determined by the jury in Genovese I.

On November 22, 2002, Genovese filed the action from which this appeal arises; namely, a breach of contract related to Provident’s termination of Genovese’s benefits at age sixty-five (“Genovese II”). Provident raised collateral estoppel as an affirmative defense based upon the jury’s finding in Genovese I of the onset date of Genovese’s disability. Provident also filed a motion for summary judgment on Ge-novese’s breach of contract claim, arguing that the doctrine of collateral estoppel barred Genovese from re-litigating the question of when his disability commenced. In response, Genovese filed a cross-motion for summary judgment, arguing that collateral estoppel did not apply, because the issue of when he became totally disabled was not part of the prior action. In support, Genovese contended that in Genovese I, the date of disability was not framed as an issue in the pleadings, and there was no evidence offered on the issue at trial. After a hearing was held on the motions, the trial judge1 denied Provident’s motion and granted Genovese’s cross-motion. As a result, the case proceeded to trial where Provident’s motion for directed verdict based on collateral estoppel was also denied. The jury in Genovese II ultimately found, by special interrogatory verdict, that Genovese became totally disabled on November 14,1997.2

The doctrine of collateral estop-pel — which is also known as issue preclusion and estoppel by judgment — bars re-litigation of identical issues between identical parties in two proceedings. Topps v. State, 865 So.2d 1253, 1255 (Fla.2004). The doctrine is intended to prevent repetitious litigation of what is essentially the same dispute. Zimmerman v. Fla., Office of Ins. Regulation, 944 So.2d 1163, 1166 (Fla. 4th DCA 2006). For the doctrine to apply, the following elements must be met: (1) an identical issue must be presented in a prior proceeding; (2) the issue must have been a critical and necessary part of the prior determination; (3) there must have been a full and fair opportunity to litigate the issue; (4) the parties in the two proceedings must be identical; and (5) the issues must have been actually litigated. Atria v. Hodor, 790 So.2d 1229, 1230 (Fla. 4th DCA 2001).

Here, there is no question the parties involved in Genovese I and Genovese II are identical. However, Genovese argues his claim in Genovese II was not barred by collateral estoppel because the issue of the [478]*478onset date of disability was not presented in the first trial, it was not a critical and necessary part of the prior determination, he did not have a full and fair opportunity to litigate it, and it was not actually litigated in Genovese I. We disagree.

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Cite This Page — Counsel Stack

Bluebook (online)
138 So. 3d 474, 2014 WL 714695, 2014 Fla. App. LEXIS 2576, Counsel Stack Legal Research, https://law.counselstack.com/opinion/provident-life-accident-insurance-co-v-genovese-fladistctapp-2014.