Filed: Aug. 30, 2010
Latest Update: Feb. 21, 2020
Summary: [DO NOT PUBLISH] IN THE UNITED STATES COURT OF APPEALS FILED FOR THE ELEVENTH CIRCUIT U.S. COURT OF APPEALS _ ELEVENTH CIRCUIT AUGUST 30, 2010 No. 10-10417 JOHN LEY Non-Argument Calendar CLERK _ D. C. Docket No. 1:09-cv-21400-PCH RAFAEL ABOY, individually and as assignee of Christian Garcia and Jaime A. Garcia, Plaintiff-Appellant, versus STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant-Appellee. _ Appeal from the United States District Court for the Southern District of Florida _ (Augu
Summary: [DO NOT PUBLISH] IN THE UNITED STATES COURT OF APPEALS FILED FOR THE ELEVENTH CIRCUIT U.S. COURT OF APPEALS _ ELEVENTH CIRCUIT AUGUST 30, 2010 No. 10-10417 JOHN LEY Non-Argument Calendar CLERK _ D. C. Docket No. 1:09-cv-21400-PCH RAFAEL ABOY, individually and as assignee of Christian Garcia and Jaime A. Garcia, Plaintiff-Appellant, versus STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant-Appellee. _ Appeal from the United States District Court for the Southern District of Florida _ (Augus..
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[DO NOT PUBLISH]
IN THE UNITED STATES COURT OF APPEALS
FILED
FOR THE ELEVENTH CIRCUIT U.S. COURT OF APPEALS
________________________ ELEVENTH CIRCUIT
AUGUST 30, 2010
No. 10-10417 JOHN LEY
Non-Argument Calendar CLERK
________________________
D. C. Docket No. 1:09-cv-21400-PCH
RAFAEL ABOY,
individually and as assignee of
Christian Garcia and Jaime A. Garcia,
Plaintiff-Appellant,
versus
STATE FARM MUTUAL AUTOMOBILE
INSURANCE COMPANY,
Defendant-Appellee.
________________________
Appeal from the United States District Court
for the Southern District of Florida
_________________________
(August 30, 2010)
Before DUBINA, Chief Judge, CARNES and MARCUS, Circuit Judges.
PER CURIAM:
Rafael Aboy (“Aboy”) appeals the district court’s grant of summary
judgment in favor of Appellee State Farm Automobile Insurance Co. (“State
Farm”) on his assigned third-party bad faith insurance claim. After reviewing the
record and the parties’ briefs, we affirm the district court’s grant of summary
judgment because Aboy has failed to offer any evidence from which a reasonable
jury could infer that State Farm breached its duty to its insured.
I. BACKGROUND
Aboy sustained injuries in a December 1, 2005 car accident caused by
Christian Garcia, son of State Farm policy holder Jaime Garcia. The State Farm
policy provided coverage for up to $15,000 for third-party bodily injuries. Medical
personnel airlifted Aboy to a local hospital following the accident because of
Aboy’s symptoms of paralysis. Aboy received treatment and was released from
the hospital the same day, however.
The next day, Aboy called State Farm to inform it of his injuries and to
request a rental car. By mid-January, State Farm had sent at least one medical
authorization form to Aboy, requesting his response, so that it could verify Aboy’s
injuries.1 Aboy admits that he never provided State Farm with his medical records
1
A State Farm manager testified that it was standard practice for State Farm to send the forms
immediately after speaking with the claimant. The actual correspondence from the first alleged
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or an authorization for their acquisition.
In May, Aboy’s doctor informed him that neck surgery was necessary to
treat his injuries from the auto accident. Aboy admitted that, before May, he was
unaware that his injuries would require surgery. Aboy underwent neck surgery and
his medical expenses climbed over $50,000. Within about one month, after finally
verifying Aboy’s injuries through Aboy’s attorneys, State Farm offered Aboy the
policy limits to settle his claim.
Aboy rejected State Farm’s offer, claiming it was untimely. He filed suit
against the Garcias shortly thereafter, obtained a sizeable judgment, and received
assignment of the Garcias’ bad faith claim against State Farm. The district court
granted summary judgment on Aboy’s assigned bad faith claim in favor of State
Farm.
II. STANDARD OF REVIEW
We review de novo a district court’s grant of summary judgment. Fanin v.
U.S. Dep’t of Veterans Affairs, 572 F.3d 868, 871 (11th Cir. 2009).
III. DISCUSSION
Aboy claims that State Farm breached its duty to its insured by
unnecessarily delaying settlement negotiations and a settlement offer. Aboy notes
contact was not introduced into evidence here. Nevertheless, another authorization form, in
evidence here, was sent about six weeks later.
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that, under Florida law, “[w]here liability is clear, and injuries so serious that a
judgment in excess of the policy limits is likely, an insurer has an affirmative duty
to initiate settlement negotiations.” Powell v. Prudential Prop. & Cas. Ins. Co.,
584 So. 2d 12, 14 (Fla. Dist. Ct. App. 1991). Aboy contends that State Farm
should have known about the severity of his injuries long before it made its
settlement offer in June.
Neither party disputes that State Farm’s insured was clearly liable for
Aboy’s injuries. State Farm contends, however, that for most of the time before it
made its settlement offer, it lacked the information to indicate that a judgment in
excess of the policy limits was likely. Indeed, the facts demonstrate that State
Farm did ultimately discharge its duty under Powell: when it obtained information
about both liability and damages, it initiated settlement negotiations and offered
policy limits to settle the claim.
Aboy’s claim here then rests on his conclusion that State Farm discharged its
duty to the Garcias belatedly. “Bad faith may be inferred from a delay in
settlement negotiations which is willful and without reasonable cause.” Powell,
584 So. 2d at 14. Our task then is to determine whether Aboy has presented any
evidence from which a jury could infer bad faith in State Farm’s delay.
Our review of the record discloses no evidence from which a material
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question of fact arises about State Farm’s diligence and prudence in managing its
insureds’ case. Aboy admits that he neither turned over nor authorized State Farm
to obtain his medical records at any time before he rejected State Farm’s settlement
offer. Furthermore, his own testimony reveals that Aboy himself lacked a full
understanding of his injuries until months after the accident. Once State Farm had
some form of verification regarding Aboy’s injuries—the word of his attorney—it
initiated settlement negotiations promptly.
Aboy contends that State Farm’s knowledge about his initial diagnosis and
transportation to the hospital gave it an awareness that his damages would exceed
the policy limits. State Farm argues that this information is mitigated by its
context—Aboy was released from the hospital the same day and was immediately
healthy enough to request and operate a rental car. Ultimately, Aboy answers the
question about the relative weight of these facts in his Reply Brief by asserting that
“they are facts that a jury must balance.” (Appellant Reply Br. at 5.) If a genuine
issue of material fact exists about whether the evidence showed Aboy’s damages to
exceed the policy limits, then it would be illogical to simultaneously suggest “that
a judgment in excess of the policy limits is likely” in the eyes of the insurer. Cf.
Powell, 584 So. 2d at 14. Aboy implicitly concedes that this information could not
have triggered State Farm’s duty to negotiate under Powell.
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Aboy also asserts that State Farm had a duty to seek out his medical records
and verify his injuries despite his lack of cooperation. He argues that an insurer’s
“fiduciary duty to timely and properly investigate the claim against the insured was
not relieved simply because it was waiting to receive information.” Gutierrez v.
Yochim, 23 So. 3d 1221,1225 (Fla. Dist. Ct. App. 2010). Even ignoring the factual
impossibility entailed in verifying beforehand injuries that were not fully known
until May, Aboy’s reliance on Gutierrez falls flat.
In Gutierrez, the insurer learned that a third-party claimant had “sustained a
significant spinal cord injury” via a paralegal working on behalf of the claimant.
Id. at 1223. Despite obtaining this information within two months of the accident,
the insurer failed to offer a settlement for nearly six months. The insurer claimed
“that it was trying to verify the full extent of the claimant’s injuries and had every
right to wait for the medical information.”
Id. at 1225. The court disagreed,
reasoning that record evidence demonstrated the insurer’s knowledge of the
claimant’s injuries before the medical records arrived.
Id. at 1225–26.
Here, State Farm lacked any actual knowledge of the extent of Aboy’s
injuries until its June conversation with Aboy’s attorneys. Unlike the insurer in
Gutierrez that delayed settlement negotiations pending confirmation of the oral
description of injuries, State Farm acted immediately upon receiving verbal
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information about Aboy’s injuries, offering to settle within days. The record
indicates that Aboy contacted State Farm on multiple occasions during the relevant
period, but failed to provide State Farm with his medical information or access to
it. Nothing in Florida law indicates that an insurer breaches its duty to settle by
delay when the claimant declines to reveal the scope and severity of his injuries.
IV. CONCLUSION
After reviewing the record and the parties’ briefs, we conclude that Aboy
failed to present evidence creating a genuine issue of material fact regarding State
Farm’s discharge of duty to its insured. Aboy withheld for months evidence that
was necessary for State Farm to use in assessing the scope of his injuries. Upon
learning of the likely damages through Aboy’s, State Farm acted promptly to settle.
In doing so, State Farm discharged its duty to its insured.
AFFIRMED.
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