Raul A. Pelaez v. Government Employees Insurance Company

13 F.4th 1243
CourtCourt of Appeals for the Eleventh Circuit
DecidedSeptember 20, 2021
Docket20-12053
StatusPublished
Cited by19 cases

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

Opinion

USCA11 Case: 20-12053 Date Filed: 09/20/2021 Page: 1 of 22

[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: USCA11 Case: 20-12053 Date Filed: 09/20/2021 Page: 2 of 22

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

2 USCA11 Case: 20-12053 Date Filed: 09/20/2021 Page: 3 of 22

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.

3 USCA11 Case: 20-12053 Date Filed: 09/20/2021 Page: 4 of 22

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

4 USCA11 Case: 20-12053 Date Filed: 09/20/2021 Page: 5 of 22

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.”

5 USCA11 Case: 20-12053 Date Filed: 09/20/2021 Page: 6 of 22

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

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13 F.4th 1243, Counsel Stack Legal Research, https://law.counselstack.com/opinion/raul-a-pelaez-v-government-employees-insurance-company-ca11-2021.