Raul A. Pelaez v. Government Employees Insurance Company

13 F.4th 1243
Court of Appeals for the Eleventh Circuit·Decided September 20, 2021·No. 20-12053·Published·Cited by 19 cases

Opinion

[PUBLISH]

IN THE UNITED STATES COURT OF APPEALS

FOR THE ELEVENTH CIRCUIT

No. 20-12053

D.C. Docket No. 8:19-cv-00910-JSM-JSS

RAUL A. PELAEZ, as Limited Guardian of the Person and Property of John Poul Pelaez, ward, and Michael Adam Conlon, Jr.,

Plaintiff - Appellant,

versus GOVERNMENT EMPLOYEES INSURANCE COMPANY, Defendant - Appellee.

Appeal from the United States District Court for the Middle District of Florida

(September 20, 2021)

Before BRANCH, GRANT, and ED CARNES, Circuit Judges. ED CARNES, Circuit Judge:

This is a Florida bad faith insurance case. The insurer promptly offered to settle a bodily injury claim for the $50,000 policy limits. Pointing to overbroad language in a suggested release form, which the insurer made clear it was willing to modify, the claimant appeals from the district court’s rejection of his attempt to obtain a $14,900,000 bad faith judgment from the insurer.

I.

On April 13, 2012, Michael Conlon had just turned eighteen and was driving his mother’s car to the high school prom when he turned into a median and in front of John Pelaez who was on a motorcycle. The motorcycle hit Conlon’s car with such force that it spun the car 180 degrees, and the impact injured Pelaez seriously enough that he was airlifted to the hospital. GEICO had issued Conlon’s mother a policy covering her car and Conlon as an additional driver. From the scene, Conlon reported to GEICO that there had been an accident damaging the car and it needed to be towed. He didn’t report at that time there had been any injuries.

On April 16, which was the next business day, GEICO assigned a claims adjuster to the incident and also received information about how to contact two detectives who were investigating the crash. On April 17 GEICO interviewed Conlon, who suggested Pelaez may have been speeding. He also disclosed for the first time that Pelaez had been injured, rendered unconscious, and airlifted to a hospital. On April 18 GEICO learned the speed limit in the crash area was low (35

miles per hour), the skid marks left by the motorcycle were long (67 feet), and Conlon had not been cited for the accident. Those three facts led GEICO to preliminarily conclude that Pelaez likely had been speeding and was contributorily negligent.

On April 23, which was ten calendar days after the crash and seven days after GEICO assigned an adjuster to work the claim, it received a letter of representation from Pelaez’s attorney. The letter requested certain statutory insurance disclosures but did not make any settlement demands. That same day GEICO received from Conlon’s mother photos of the crash scene, and it received from Pelaez’s fiancée a copy of the police report about the crash. The police report indicated Conlon had failed to yield the right of way, a witness had reported Pelaez didn’t appear to be speeding, and Pelaez had suffered head and other major injuries.

On April 24, the very next day and only eleven days after the crash, GEICO decided to proactively tender to Pelaez its bodily injury policy limit of $50,000, even though it had not received a settlement demand from Pelaez’s attorney. On April 25, less than two weeks after the accident, GEICO’s claims adjuster called Pelaez’s attorney’s office to offer the bodily injury policy limit and ask that GEICO be allowed to inspect the motorcycle so that the company could make an offer on the property damage claim for the motorcycle.

The next day, April 26, which was thirteen calendar days (nine business days) after the accident, a GEICO field adjuster hand delivered to Pelaez’s attorney’s office a bodily injury claim “tender package.” The package contained: a cover sheet that listed the package’s contents and described an enclosed check as “representing tender of the per person policy limit under Bodily Injury Liability coverage”; a $50,000 check inscribed with the notation “[t]ender of per person BI limits”; and a proposed form release of “all claims.” The package also contained two letters from GEICO’s claims adjuster to Pelaez’s attorney. One letter set out the insurance policy’s relevant details, including the fact that there were two separate $50,000 coverage limits, one for bodily injury and another for property damage.

The other letter in the tender package was also from the claims adjuster to the attorney. It discussed the release. The proposed form release in the package was titled “Release of All Claims” and purported to release Conlon and his mother (the named insured) “from any and all claims, demands, damages, actions, causes of action, or suits of any kind or nature whatsoever, on account of all injuries and damages, known and unknown, which have resulted or may in the future develop as a consequence of” the crash. The accompanying letter from the claims adjuster to Pelaez’s attorney explained that “[n]ot all release forms precisely fit the facts

and circumstances of every claim” and asked Pelaez’s attorney to call “immediately” if he had “any questions about any aspect of the release.”

That letter also invited Pelaez’s attorney to edit the release by sending GEICO “any suggested changes, additions or deletions with a short explanation of the basis for” them or, if he preferred, to send GEICO an entirely new release of his choosing. The letter made this request of Pelaez’s attorney concerning the proposed release: “If you feel that there is any aspect of the enclosed document, which does not reflect our settlement of your claim(s), please contact me immediately so that we can see that the document is revised to reflect the exact terms of our agreement.”

On April 27, which was a Friday and the day after the tender package had been delivered to him, Pelaez’s attorney wrote to GEICO’s claims adjuster. His letter noted (again) his representation of Pelaez and asked (again) for statutorily required disclosures. It also acknowledged GEICO’s desire to inspect the motorcycle. The attorney agreed to cooperate with that but stated he couldn’t give “unilateral access” to the motorcycle because he was “evaluating a product liability action.” His letter asked who from GEICO would be attending the inspection of the motorcycle and when they would be available, but he didn’t disclose its location other than saying it was “being held locally.”

One thing that the attorney’s April 27 letter didn’t do is respond to the tender package or GEICO’s offer of settlement. Or to the invitation for him to suggest changes to the proposed release or submit one himself. He didn’t even mention GEICO’s settlement offer or proposed release.

GEICO received that letter from Pelaez’s attorney the following Monday, April 30. Throughout the remainder of that week, GEICO tried to find out through Pelaez’s attorney where the motorcycle was so that it could complete an estimate and adjust the property damage claim. Pelaez’s attorney steadfastly avoided disclosing where the motorcycle was. But at the end of the week, on Friday, May 4, he wrote to GEICO and rejected the $50,000 tender of the full policy limits on the bodily injury claim.

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Raul A. Pelaez v. Government Employees Insurance Company, 13 F.4th 1243 (11th Cir. 2021).

13 F.4th 1243 (Raul A. Pelaez v. Government Employees Insurance Company) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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