Rader v. Allstate Ins. Co.

789 So. 2d 1045, 2001 Fla. App. LEXIS 7843, 2001 WL 609894
CourtDistrict Court of Appeal of Florida
DecidedJune 6, 2001
Docket4D00-1492
StatusPublished
Cited by4 cases

This text of 789 So. 2d 1045 (Rader v. Allstate Ins. 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
Rader v. Allstate Ins. Co., 789 So. 2d 1045, 2001 Fla. App. LEXIS 7843, 2001 WL 609894 (Fla. Ct. App. 2001).

Opinion

789 So.2d 1045 (2001)

Dominique RADER, Petitioner,
v.
ALLSTATE INSURANCE COMPANY, Respondent.

No. 4D00-1492.

District Court of Appeal of Florida, Fourth District.

June 6, 2001.
Rehearing Denied August 6, 2001.

Gary M. Farmer, Jr. of Gillespie, Golden, Kronengold & Farmer, P.A., Fort Lauderdale, for petitioner.

Jacqueline G. Emanuel of Riley, Knoerr & Emanuel, Fort Lauderdale, for respondent.

TAYLOR, J.

Petitioner, Dominique Rader, seeks certiorari review of a decision of the circuit court, sitting in its appellate capacity, that affirmed dismissal of her complaint against Allstate Insurance Company (Allstate) for personal injury protection ("PIP") benefits. We deny the petition and approve the circuit court's opinion.

On April 5, 1996, petitioner was injured in an automobile accident. Between May and August of 1996, petitioner obtained medical treatment from various health care providers and received payment from Allstate for medical benefits under its PIP policy. Later, upon Allstate's request, petitioner submitted to an independent medical examination (IME). The IME physician concluded that petitioner had reached maximum medical improvement and that further medical treatment was not reasonable or necessary. By letter dated August 27, 1996, Allstate advised petitioner that it was discontinuing further medical benefits, effective September 2, 1996.

After receiving the letter, petitioner filed suit against Allstate in county court, alleging that she needed additional medical care and treatment for her injuries. Allstate *1046 moved to dismiss petitioner's complaint and for a more definite statement. The trial court granted both motions but gave petitioner leave to file an amended complaint. Petitioner filed an amended complaint, alleging that she needed additional medical care and treatment and that Allstate's refusal to pay more benefits constituted an anticipatory breach of the PIP policy. Allstate moved to dismiss the amended complaint on the grounds that petitioner failed to meet the conditions precedent to an action under Florida Statute section 627.736(4)(b), because she did not allege that she actually obtained any treatment and incurred any bills that were submitted to Allstate and denied after September 2, 1996.

The trial court granted Allstate's motion to dismiss the amended complaint with prejudice, agreeing that petitioner failed to "allege that she has submitted reasonable proof of losses and the amount of the expenses or losses incurred which have not been paid by [Allstate]." The court further explained that:

F.S. section 627.736(4) provides that PIP benefits are due and payable as loss accrues, upon receipt of reasonable proof of such loss and the amount of the expenses and loss incurred. Subsection (b) of said statute provides that an insurer has thirty days within which to pay such benefits after it is furnished with written notice of a covered loss and the amount of same. Plaintiff has not alleged that any such benefits are outstanding.

The court concluded that, "[a]s a matter of law, Rader did not comply with the conditions precedent to maintain an action for PIP benefits as set forth in F.S. section 627.736(4)(b)." In dismissing petitioner's amended complaint with prejudice, the court stated that "this Order shall not be construed to bar Plaintiff from bringing an action against Defendant should she in the future meet the conditions set forth in F.S. § 627.736(4)." The court denied petitioner's motion for leave to file a second amended complaint to plead a cause of action for declaratory relief. Petitioner appealed both orders to the circuit court.

The case was assigned to a single circuit court judge for appellate review. Petitioner moved to assign the appeal to a three-judge panel. The assigned circuit judge denied petitioner's motion, ruling "that it has no authority by either local rule or the Florida Rules of Appellate Procedure to impanel a three-judge panel to hear said appeal."

On appeal to the circuit court, petitioner contended that the trial court erred in dismissing her amended complaint. She argued that Allstate's letter advising that it would no longer pay benefits constituted a repudiation and anticipatory breach of its contractual obligation under the policy and gave rise to a cause of action for breach of contract. Petitioner maintained that she should not be forced to incur personal liability for medical treatment associated with her injuries, when Allstate had unequivocally indicated it would not pay these bills.

Relying on Cruz v. Union General Insurance, 586 So.2d 91 (Fla. 3d DCA 1991), Allstate responded that the trial court correctly dismissed the amended complaint with prejudice, because an insured under an automobile policy has a right to be compensated only for medical benefits that have already accrued and cannot seek declaratory relief regarding future medical expenses. The circuit court affirmed the trial court's dismissal of the amended complaint, stating:

The Court below did not err in dismissing the Amended Complaint, which alleged an anticipatory breach of contract. Although the insurer's letter stating that it would not pay for further medical *1047 treatment may be an anticipatory breach of contract, such breach only relieves the Plaintiff from the condition precedent of submitting her claims to the Appellee 30 days prior to filing suit. Peachtree Casualty Ins. Co. v. Walden, 759 So.2d 7 (Fla. 5th DCA 2000).
The alleged anticipatory breach did not relieve the Plaintiff of the necessity of incurring and alleging damages in order to state a cause of action for breach of contract. Miller v. Nifakos, 655 So.2d 192 (Fla. 4th DCA 1995); Plowden & Roberts, Inc. v. Conway, 192 So.2d 528 (Fla. 4th DCA 1966). The Plaintiff failed to allege that she sustained any damages as a result of the Defendant's alleged breach. Further, a plaintiff cannot obtain a judgment for insurance benefits which have not as yet accrued. Aetna Life Ins. Co. v. Smith, 345 So.2d 784 (Fla. 4th DCA 1977): Cruz v. Union Gen. Ins., 586 So.2d 91 (Fla. 3d DCA 1991); Monsanto Co. v. Fuqua, 280 So.2d 496 (Fla. 1st DCA 1973); Walden. Since the Plaintiff did not incur any medical expenses which the Defendant did not reimburse, and any damages the Plaintiff might have sustained as a result of the alleged anticipatory breach are too speculative to sustain an action for breach of contract, this Court declines the opportunity to affirm the dismissal but remand with instructions to allow the Plaintiff to amend her complaint. Augustine v. Southern Bell Tel. & Tel. Co., 91 So.2d 320 (Fla.1956) distinguishing Byers v. Southern Bell Tel. & Tel. Co., 73 So.2d 875 (Fla.1954)(dismissal appropriate where on the face of the complaint damages are too speculative to be recoverable).
The Court understands the Appellant's frustration at the inability to obtain relief for the insurer's alleged anticipatory breach. However, if she had incurred reasonable, necessary, and related medical expenses after the insurer's letter, she would have had a cause of action against the Appellee for those claims without submitting them to the insurer and waiting 30 days.

On rehearing, the circuit court clarified that its opinion did not remand the case to allow petitioner an opportunity to file a "futile amendment" seeking declaratory relief, since "the plaintiff did not incur medical expenses after the letter and cannot sustain an action for breach."

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Bluebook (online)
789 So. 2d 1045, 2001 Fla. App. LEXIS 7843, 2001 WL 609894, Counsel Stack Legal Research, https://law.counselstack.com/opinion/rader-v-allstate-ins-co-fladistctapp-2001.