Tag Archives: Car Insurance

Sunny South Florida, Out-of-State College Students and the question of Vehicle Insurance Coverage

Spring Break, a time where college students from all over the Country flock down to Florida, known by many as the “Spring Break Capital of the World”, looking to have some fun in the sun.

Florida has many Universities, Colleges and other institutions of higher learning that welcome students from other States to attend.

So the question is, does an out-of-state student who attends University or College in Florida for 2 or 4 years now become a resident of Florida because they have decided to live in Florida during this time? Is that out-of-state student now required to register and license their out-of-state vehicle in Florida and obtain the minimum Florida automobile insurance coverage on that vehicle which is $10,000.00 in Personal Injury Protection and $10,000.00 in Property Damage Liability?

Well yes and no.

If the out-of-state student is planning to domicile themselves in Florida then they are required to license their vehicle in Florida and obtain the minimum insurance in order to operate that vehicle on the roads and highways of the State.

However, if the student maintains their residence in another State while they are enrolled as a full-time student in an “institution of higher learning”, then they are exempt from licensing their vehicle and obtaining the minimum insurance on that vehicle during the duration of their enrollment, as long as they have complied with the licensing and insurance requirements of the State for which they are a resident. One less thing for parents to worry about when they watch their babies leave the nest for the first time.

However, what constitutes an “institution of higher learning”.

The Merriam-Webster Dictionary® defines this term as “a college or university”. But what about a trade school, vocational school or cosmetology school? The Federal Government generally defines an ”institution of higher education” as a public or nonprofit educational institution who only admits students who have a high school diploma or have a recognized equivalent certificate such as a General Educational Diploma (GED); is accredited or has pre-accreditation status; awards a Bachelor’s Degree or a 2-years Associates Degree; or, any school that provides not less than a 1-year training program beyond High School, to prepare students for gainful employment in a recognized occupation.[1]

These are inquiries that an insurance company must properly investigate in an automobile accident claim involving a nonresident student in order to determine whether they would be exempt from maintaining the minimum Florida insurance on their vehicle while in Florida or if the insurer may be required to extend that student the minimum insurance under Florida law.

So would your insured qualify for the exemption as a nonresident student?

This article is not intended to create an attorney-client relationship by offering this information, and anyone’s review of the information shall not be deemed to create such a relationship. The content provided is intended to provide information of general interest to the public and is not intended to offer legal advice about specific situations or problems. You should consult a lawyer with regard to specific law issues that requires attention.

For additional information, please contact Stephen Mellor of Roig Lawyers at 954-354-1541 or by email at smellor@roiglawyers.com. Stephen G. Mellor is a partner in the Deerfield Beach office of Roig Lawyers who primarily focuses on out-of-state policy claims for insurance carriers. 

[1] 20 U.S. Code § 1001

Comments Off on Sunny South Florida, Out-of-State College Students and the question of Vehicle Insurance Coverage

Filed under auto insurance, Claims Handling, Florida, Insurance, Insurance Claims, Insurance Defense, Personal Injury Protection, PIP, PIP/No Fault

Trooper Fired and Arrested for Helping Friend Cover Up Crash

Florida Highway Patrol Trooper David Casillas was arrested on Tuesday, February 28th and charged with organized fraud, filing a false insurance claim and official misconduct after trying to help a friend cover up a traffic crash that occurred in June of 2015. FHP fired Casillas in January as a result of the investigation which lasted over a year.

During the investigation, it was discovered that Casillas had written a false report for a bogus insurance claim submitted by his friend, dentist Jesus Del Valle. The insurance claim was submitted as a result of damage the dentist had done to his vehicle when he sideswiped a landscaping crew and kept driving.

Del Valle’s crash left Yoel Montero, a gardener with Lewis Tree Service, with a traumatic head injury and severe injuries to his right leg. The false insurance claim alleges that the accident happened a week later than it actually happened and that he had crashed the SUV into a palm tree instead of a landscaping crew.

The key to breaking the case was the fact that Del Valle’s 2015 Land Rover needed a new passenger-side mirror which could only be ordered from Range Rover manufacturers. Only one such had been sold in that time period and it was to Del Valle’s mechanic (and friend) Ariel Perera who performed the repair on his vehicle. Perera also allegedly submitted inflated invoices to Del Valle’s insurance company as well as charged the company for replacement parts that were never actually replaced. He is also facing charges with Del Valle and Casilla.

Click here to read the full story.

Comments Off on Trooper Fired and Arrested for Helping Friend Cover Up Crash

Filed under Auto Insurance Fraud, Florida, Insurance, Insurance Fraud, Miami-Dade County

Will You Have Coverage When You Cross The Line?

Is an automobile insurance company required to extend Florida Personal Injury Protection (PIP) benefits to an insured who resides in another state?

Well yes and no.

An automobile insurer who sells automobile insurance policies in Florida and the nonresident insured’s state is required to extend the minimum Florida Personal Injury Protection (PIP) benefits of $10,000.00 to the insured if they are involved in a motor vehicle accident in Florida, but only if they qualify under Florida law.

To qualify, the nonresident insured’s vehicle must have been physically located in Florida for 90 nonconsecutive days out of the previous 365 days from the date of the accident. By nonconsecutive days, it means that the insured vehicle could leave Florida and re-enter and still qualify for Florida PIP benefits if the vehicle has been in Florida for longer than 90 days throughout that preceding year.

An insurer is not required to extend the $10,000.00 in Florida PIP benefits to a nonresident insured whose vehicle is not in Florida for longer than 90 nonconsecutive days out of the previous 365 days from the date of the accident.

Most if not all automobile insurance policies have an “Out-of-State Coverage” provision which will detail that insurer’s obligation to comply with a State’s minimum insurance requirements if their nonresident insured becomes subject to the insurance laws of that State. However, some insurance contracts make it the responsibility of the nonresident insured and not the insurer to purchase the required minimum Florida PIP coverage if they plan to stay in Florida for longer than 90-days.

An insurer is not required to extend additional Florida PIP benefits to a nonresident insured that enters Florida and whose insurance policy meets the States minimum PIP or No-Fault requirements.

For Example:

The New York Automobile No-Fault Law requires each insured to carry a minimum of $50,000.00 in No-Fault/ PIP benefits. Thus, if a New York resident drives their vehicle into Florida and is involved in a motor vehicle accident, then they will receive the $50,000.00 in New York PIP benefits as this is greater coverage than the minimum $10,000.00 in PIP benefits which is required under Florida law.

This article is not intended to create an attorney-client relationship by offering this information, and anyone’s review of the information shall not be deemed to create such a relationship. The content provided is intended to provide information of general interest to the public and is not intended to offer legal advice about specific situations or problems. You should consult a lawyer with regard to specific law issues that requires attention.

For additional information please contact Stephen Mellor of Roig Lawyers at 954-354-1541 or by email at smellor@roiglawyers.com.

Comments Off on Will You Have Coverage When You Cross The Line?

Filed under Auto Insurance Fraud, Florida, Insurance, Insurance Claims, Personal Injury Protection, PIP/No Fault

Chiropractor’s Challenge To ‘PIP’ Law Kicked Back By Appeals Court

In a 14-page ruling on Wednesday, February 15th, the 3rd District Court of Appeal upheld part of a 2012 overhaul of the state’s personal-injury protection auto insurance system that limits No-Fault (Personal Injury Protection) benefits to $2,500 for individuals who were not diagnosed with an emergency medical condition. The appeals court overturned a judge’s decision in a Miami-Dade County court citing arguments that the 2012 law overhaul was intended to help prevent fraud in the PIP insurance system, but was unconstitutional.

The ruling was in response to chiropractor Eduardo Garrido’s legal victory against Progressive American Insurance Company. Garrido was seeking a determination that the insurer should pay up to the policy limit of $10,000 in the absence of diagnosis that the patient suffered an emergency medical condition as the result of an automobile accident. He also challenged that it was unconstitutional to bar chiropractors from being able to diagnose patients with having suffered an emergency medical condition. The chiropractor treated a patient after an accident in 2013 and submitted invoices to Progressive who only paid $2,500 of the $6,075 billed. According to Progressive, there had been no determination, other than Dr. Garrido’s, a chiropractor, that the patient suffered an emergency medical condition.

Click here to view the full story.

Comments Off on Chiropractor’s Challenge To ‘PIP’ Law Kicked Back By Appeals Court

Filed under FL Legislation, Florida, Insurance, Insurance Claims, Insurance Defense, Miami-Dade County, Personal Injury Protection, PIP/No Fault

Florida Insurance Commissioner Kevin McCarty resigns

On January 5, 2016, Kevin McCarty resigned as Florida’s top insurance regulator and stated that his departure would be effective May 2, 2016, according to Bradenton Herald. McCarty, 56, is the state’s Insurance Commissioner who decides how much homeowners pay for their property insurance.  He was appointed to the position in 2003 by Governor Jeb Bush and has served under the leadership of three Governors since then. Under Bush tenure, McCarty helped navigate the state through a series of devastating hurricanes while seeking to protect elderly consumers from fraudulent merchants of insurance products.

After many years of navigating the capital’s perilous political landscape McCarty was viewed as vulnerable after Governor Rick Scott took the oath as governor for the second time. Scott’s office already had a replacement in mind: Ron Henderson, a Louisiana insurance official who was being promoted by Fred Karlinsky, a Tallahassee Lobbyist for insurance interests and Scott supporter. Consumer groups rallied to McCarty’s side as a result of the controversy following Scott’s removal of Gerald Bailey as the state’s top law enforcement official.

McCarty is the state’s first appointed insurance commissioner and director of the state Office of Insurance Regulation. His successor must win the support of both Scott and Jeff Atwater, Chief Financial Officer, in a vote by the Governor and Cabinet.

McCarty’s departure leaves an empty position, one of the most challenging jobs in state government due to the sensitivity surrounding the cost and availability of insurance in a state vulnerable to hurricanes and insurance fraud.

Click here to read article.

Comments Off on Florida Insurance Commissioner Kevin McCarty resigns

Filed under Florida, Insurance, Insurance Fraud

Crash Victims Lose Bad Faith Claim at Eleventh Circuit Court

According to an August 28, 2015, Law360 article, The Eleventh Circuit Court determined that Clarendon National Insurance Company did not act in bad faith when protecting two of its insureds from a $750,000 excess judgment arising from a car accident in 2006. The court found no evidence to suggest such a claim. Carlos Mesa filed claims against the owner, Jary A. Martinez, and driver of the vehicle, Cesar A. Vega Zalaya.

Mesa stated that Clarendon passed up an opportunity to settle with him as well as failed to advise him on ways to avoid an excess judgment. However, the court found that Clarendon National Insurance Company did act in good faith since the company identified the claimants and reached a settlement of $20,000 per accident policy limit soon after realizing that the $10,000 per person limit was not enough to cover the claimant’s damages.

The court sided with the insurance company and not Carlos Mesa, stating that Clarendon may have not been as proactive in advising its insureds of settlement opportunities but not to the level of bad faith.

“Clarendon’s duty of good faith requires that it investigate the facts and give fair consideration to the prospect of a settlement offer that is reasonable under the circumstances, which it did here”, the court said.

Click here for full article. (Subscription required)

Comments Off on Crash Victims Lose Bad Faith Claim at Eleventh Circuit Court

Filed under Eleventh Circuit Court

Orlando PIP Clinic Owner Arrested for Defrauding Insurance Companies

Dr. Troy Godsey and Renata Berriel Deazevedo were arrested in connection with an illegal insurance scheme involving multiple insurance companies and totaling more than $100,000. Godsey, a licensed chiropractor, served as an owner of the clinic, and Deazevedo managed the day-to-day activities of the business.

According to the Florida Department of Financial Services, Godsey and Deazevedo ran Spine Health Solutions PA in Orlando, and provided medical treatments to people who were injured in car accidents. The pair billed insurance companies for reimbursements for “patients” under their Personal Injury Protection coverage. Three insurance companies were billed nearly $300,000 for the alleged treatment of 20 injured individuals.

They both face more than 50 years in prison if convicted under the felony charges, including operating an unlicensed health care clinic, and filing false and fraudulent insurance claims.

Comments Off on Orlando PIP Clinic Owner Arrested for Defrauding Insurance Companies

Filed under Insurance Fraud

Insurance Trade Group Recommends Changes to Florida Insurance Coverage Laws

In a recent article, Property Casualty Insurers Association of America (PCI) advised the State of Florida to address potential insurance coverage issues under Florida law related to Transportation Network Companies (TNCs) such as Uber and Lyft. Insurance trade groups are concerned about the gray area regarding insurance coverage as it relates to TNCs.

The issue centers on when auto insurance coverage provided through transportation network companies begins. According to PCI, “Personal auto insurance policies are not intended for commercial use and will not cover damages if it is determined the driver was using their vehicle for hire.’’ This issue could leave drivers at financial risk if they were in an accident since they may not have the proper insurance coverage when driving for a TNC.

During the 2015 Florida Legislative Session, House Bill 817 and Senate Bill 1298 were introduced to address the insurance coverage issues. However, the sudden end to the legislative session prevented these vital bills from coming to a full vote on the floor.

PCI, along with other trade groups, hopes to see this insurance coverage issue resolved by the Florida Legislature and hopes to see progress in the upcoming legislative session. California, Colorado and most recently Georgia have adopted insurance coverage parameters to address the insurance gap related to TNCs.

Comments Off on Insurance Trade Group Recommends Changes to Florida Insurance Coverage Laws

Filed under FL Legislation

Florida Insurance Fraud Education Committee (FIFEC) Conference

Roig Lawyers attorneys and healthcare policy advisor will speak at 23rd annual Florida Insurance Fraud Education Committee (FIFEC) Conference on June 12, 2015 in Orlando, FL.  Nelson C. Bellido, Dennis La Rosa, Miguel Roura, and Diego Arredondo will present “Mechanisms Available to Adjusters During Review for Regulatory and Compliance Issues”.  The presentation will focus on recent developments in the law, insurance adjuster review process for regulatory compliance issues, administrative regulation and the relationship to PIP under §627.732(11), and PIP amendments and licensing issues.

FIFEC is a non-profit corporation comprised of special investigative unit investigators, law enforcement personnel and dedicated individuals whose purpose is to organize and present an annual statewide educational seminar related to deterring, detecting, investigating and prosecuting insurance fraud. FIFEC is proud of its mission to provide insurance fraud education and training by giving grants to the law enforcement and criminal justice community that attend what is now known as the annual FIFEC Conference.

About Roig Lawyers

Roig Lawyers is a multi-practice Florida Litigation firm with an unfaltering growing presence in the legal market celebrating 15 years of service, with more than 100 attorneys in 6 offices in Deerfield Beach, Miami, Orlando, West Palm Beach, Tampa, and Tallahassee. Roig Lawyers offers unparalleled legal representation in the areas of commercial litigation, construction, corporate law, real estate, banking and finance, labor and employment, and all phases of insurance defense litigation.

For more information about Roig Lawyers, visit www.roiglawyers.com.

Comments Off on Florida Insurance Fraud Education Committee (FIFEC) Conference

Filed under Insurance Fraud

Allstate battles in Appellate courts

Allstate is under fire in various courts addressing the language of its policy following the Florida Supreme Court’s ruling in Geico Gen. Ins. Co. v. Virtual Imaging Services, Inc., 141 So.3d 147 (Fla.2013). In Virtual Imaging, the Court ruled in favor of Virtual Imaging finding that GEICO had not made the election in the policy that they would use the Medicare fee schedules of Florida’s PIP statute to reimburse the medical providers.

Multiple appellate courts have been asked to address the issue of the language in Allstate Insurance Co.’s policy regarding its election to use the Medicare fee schedules to limit benefit reimbursements. The various Appellate courts are addressing the following question: “Did Allstate provide the requisite notice that it would use the fee schedule payment limitations authorized by Subsection 5(a)(2)?”

The following cases are under review throughout Florida’s Appellate courts:

Allstate v. Stand-Up MRI

Case No. 1D-14-1213

First District Court of Appeal

This case includes several consolidated county court appeals. Allstate is the Appellant, and former Judge Gary Farmer represents the Plaintiffs. The First DCA ruled in favor of Allstate in March (see earlier post titled, 1st DCA Upholds Allstate Use of Medical Fee Schedules). On April 24, the First DCA denied Appellee’s April 2nd motion for rehearing, rehearing en banc and certification.

Allstate v. Markley Chiro.

Case No. 2D-14-3818 in the Second District Court of Appeal on cert. question of great public importance

Allstate is Appellant

The case was fully briefed in February, 2015 and argument is requested.

Fla. Wellness v. Allstate

Case No. 3D-15-0151

Third District Court of Appeal

There are five consolidated county court appeals. Allstate is the Appellee. Marlene Reiss represents the Plaintiffs/Appellants. The briefing has not yet begun.

Ortho. Specialists v. Allstate

Case No. 4D-14-0287

Fourth District Court of Appeal

There are several consolidated county court appeals. Allstate is the Appellee. Former Judge Gary Farmer represents the Plaintiffs. The appeal was argued on April 14th.

Florida Wellness v. Allstate

Case No. 15-11590

The U.S. Court of Appeals for the Eleventh Circuit

The federal district court’s summary judgment order is being appealed by Plaintiff South Florida Wellness. Allstate is the Appellee. The briefing has not yet begun.

Comments Off on Allstate battles in Appellate courts

Filed under Case Law, Fla. Stat. 627.736 (2008)