PERRY, J.
This case is before the Court for review of a question of Florida law certified by the Eleventh Circuit Court of Appeals as being determinative of a cause pending in that court and for which there appears to be no controlling precedent. Specifically, the Eleventh Circuit asks "[w]hether, under FLA. STAT. § 627.736, an insurer can require an insured to attend an [examination under oath] as a condition precedent to recovery of [personal injury protection] benefits?" Nunez v. Geico Gen. Ins. Co., 685 F.3d 1205, 1211 (11th Cir.2012). We have jurisdiction. See art. V, § 3(b)(6), Fla. Const.
We answer the certified question in the negative as to section 627.736, Florida Statutes (2008), and confirm our statement in Custer Medical Center v. United Automobile Insurance Co., 62 So.3d 1086, 1091 (Fla.2010), that "[t]he Florida No-Fault statute is mandatory and does not recognize such a condition. It is therefore invalid and contrary to the statutory terms." A recent amendment to section 627.736 provides otherwise, but did not take effect until January 1, 2013, and does not inform or control our disposition of the present case. See ch. 12-197, § 10, at 2737, 2752, Laws of Fla. (now codified in § 627.736(6)(g), Fla. Stat. (2012)).
Merly Nunez's automobile insurance policy with the Government Employees Insurance Company (Geico) included personal injury protection coverage (PIP) and a condition that "[t]he insured or any other person seeking coverage under this policy must submit to examination under oath [EUO
Nunez v. Geico General Ins. Co., 22 Fla. L. Weekly Fed. D295, D295, 2010 WL 1924441, *2 (S.D.Fla. Apr. 13, 2010). The federal district court denied Nunez's motion for reconsideration, whereupon she filed a notice of appeal to the Eleventh Circuit Court of Appeals on July 2, 2010.
While that appeal was still pending, this Court on November 4, 2010, issued its opinion in Custer, stating as to EUOs that "[t]he Florida No-Fault statute is mandatory and does not recognize such a condition. It is therefore invalid and contrary to the statutory terms." 62 So.3d at 1091. In subsequent briefing in the Eleventh Circuit, Nunez and Geico disputed whether this and related statements in Custer amounted to a holding or dicta. Upon examining Custer, the PIP statute, and relevant caselaw, the Eleventh Circuit concluded that Florida law was unclear, and certified the following question to this Court: "Whether, under FLA. STAT. § 627.736, an insurer can require an insured to attend an EUO as a condition precedent to recovery of PIP benefits?" Nunez, 685 F.3d at 1211 (issued April 3, 2012).
About a month later, on May 4, 2012, Governor Rick Scott approved amendments to the PIP statute effective January 1, 2013, including the requirement that insureds seeking benefits under the Florida Motor Vehicle No-Fault Law "comply with the terms of the policy, which include, but are not limited to, submitting to an examination under oath." Ch. 12-197, § 10, at 2737, 2752, Laws of Fla. (now codified in § 627.736(6)(g), Fla. Stat. (2012)).
In disputing the meaning of section 627.736, Florida Statutes (2008), the parties and amici curiae in this case primarily argue in terms of Custer and the 2012 amendment of the PIP statute. We address those arguments in turn below, applying the de novo standard of review. See generally Osborne v. Dumoulin, 55 So.3d 577, 581 (Fla.2011) (recognizing in the present posture of answering a question certified by the Eleventh Circuit that "[t]he determination of the meaning of a statute is a question of law and thus is subject to de novo review").
EUOs were not directly at issue in Custer, in which this Court's primary holding was that the underlying district court of appeal had misapplied the standard of review on second-tier certiorari review of a case involving an insurance company's denial of PIP benefits based on the insured's failure to appear for a medical examination.
Id. at 1094-95. In earlier discussing the letter, the Court explained in a footnote that,
Custer, 62 So.3d at 1089 n. 1 (footnote added); accord at 1095-96 (stating that attendance at a EUO without counsel as a condition precedent to coverage is "contrary to the general principles of law concerning affirmative defenses and conditions precedent, as well as the principles underlying the PIP statute"). In distinguishing a case initially cited by the district court, this Court in Custer stated that "Goldman [v. State Farm General Insurance Co., 660 So.2d 300, 301 (Fla. 4th DCA 1995),] involved a homeowners insurance policy and the insured's failure to attend an examination under oath pursuant to the contractual terms of the policy, which has no application in the statutorily required coverage context. The Florida No-Fault statute is mandatory and does not recognize such a condition. It is therefore invalid and contrary to the statutory terms." Custer, 62 So.3d at 1091.
The Eleventh Circuit considered our statements on EUOs in Custer to be dicta. Nunez, 685 F.3d at 1208. Regardless, most reported county and circuit court cases have affirmatively applied Custer in the EUO context. For example, in comprehensively addressing several such cases, one circuit court ruled:
Y & M Med. Ctr. v. State Farm Fire & Cas. Co., 19 Fla. L. Weekly Supp. 380, 380 (Fla. 11th Cir.Ct. Jan. 18, 2012) (parallel citation omitted). Additionally, at least one district court of appeal has cited the EUO language in Custer as authority for denying a petition for writ of certiorari. See United Auto. Ins. Co. v. Two & Two LLC, 82 So.3d 1052 (Fla. 4th DCA 2011). As one court put it, "[r]egardless of whether the Florida Supreme Court's discussion of EUOs in the Custer case is viewed as the holding, an alternative holding, or simply dicta, ... the reasoning [is] persuasive[.]" Mercury Ins. Co. of Fla. v. Dr. Eduardo Garrido, P.A., 18 Fla. L. Weekly Supp. 575, 577 n. 3 (Fla. 11th Cir.Ct. Apr. 7, 2011). More than just persuasive, Custer is correct under the terms of the PIP statute, its underlying purpose of swift and virtually automatic payment to the insured, and relevant caselaw.
Section 627.736, Florida Statutes (2008), is silent regarding EUOs-it does not authorize their use, much less denial of benefits for failure to attend one. As summarized by the Eleventh Circuit in this case:
Nunez, 685 F.3d at 1209. But consistency with certain provisions in the statute is not the test. Rather, as recognized by the Eleventh Circuit, "[c]onditions not expressly addressed in a statute governing insurance coverage are subject to a two part test: (1) `whether the condition or exclusion unambiguously excludes or limits coverage[;]' and (2) `whether enforcement of a specific provision would be contrary to the purpose of the ... statute.'" Id. (quoting Flores v. Allstate Ins. Co., 819 So.2d 740, 745 (Fla.2002)). The parties do not contest the first part of the Flores test, but rather focus on the second part regarding the purpose of the PIP statute.
The dissent asserts that by our adherence to what was said in Custer and Flores, in this case, we are abrogating unambiguous provisions found in section 627.414(3), Florida Statutes (2008). The dissent notes, "[Those opinions] do not so much as acknowledge the existence of section 627.414(3)." Dissenting op. at 399. We respectfully disagree with the dissent's assessment of any abrogation by this opinion. We point out that while Custer and Flores do not address section 627.414(3), those opinions indeed address the conspicuous absence of statutory authority, under the PIP statute, for an insurer to enforce EUO provisions as a condition precedent to its payment of benefits to an insured. Accordingly, we reject the dissent's view that the EUO provision employed by Geico in its PIP policy may be applied pursuant to section 627.414(3). Instead, PIP policy provisions should be promulgated by insurers in a manner that is consistent with the statutory goal under section 627.736 of ensuring "swift and virtually automatic payment" of benefits to insureds under the PIP statute. Majority op. at 397-98.
"Without a doubt, the purpose of the no-fault statutory scheme is to `provide swift and virtually automatic payment....'" Ivey v. Allstate Ins. Co., 774 So.2d 679, 683-84 (Fla.2000) (quoting Gov't Employees Ins. Co. v. Gonzalez, 512 So.2d 269, 271 (Fla. 3d DCA 1987)). Elaborating, this Court has recognized that
Allstate Ins. Co. v. Holy Cross Hosp., Inc., 961 So.2d 328, 332 (Fla.2007). "This last observation is significant because any impediment to the right of the insured to recover in a `swift and virtually automatic' way has the potential for interfering with the PIP scheme's goal of being a reasonable alternative to common law tort principles." Menendez v. Progressive Express Ins. Co., 35 So.3d 873, 877 (Fla.2010).
For this reason, Geico misses the mark in asserting that "EUOs are consistent with the purposes of the PIP statute," which it identifies as "prevention of fraud" and "investigation and payment of claims."
In order to bolster its argument, Geico offers United Automobile Insurance Co. v. Stat Technologies, Inc., 787 So.2d 920, 922 (Fla. 3d DCA 2001), for the proposition that "the policy to ensure swift payment must be balanced against the policy to prevent improper claims." But that balance was stated by the district court in that case in terms of being "obviously contemplated by the legislators in providing insurers with a 30 day investigatory period." Id. (applying that balance to hold that "interest on overdue PIP payments does not commence until the loss accrues, which is 30 days after the insurance company receives notice of a fact of covered loss"). While the district court in Stat Technologies implicitly recognized EUOs as an appropriate investigatory tool for insurance companies, it in no way indicated that they could properly delay or deny PIP benefits based on an insured's failure to comply with a contractual EUO condition.
Such delay and denial based on the EUO condition in the present case has
We therefore reject Geico's assertion that "EUOs do not interfere with the PIP statute's objective of requiring swift payment of benefits." As the present case and the above examples amply illustrate, enforcing EUO conditions clearly can and do cause delay and denial of benefits in contravention of the purpose of the PIP statute. See, e.g., Cruz v. State Farm Mut. Auto. Ins. Co., 466 Mich. 588, 648 N.W.2d 591, 598 (2002) (holding under similar Michigan law that "a no-fault policy that would allow the insurer to avoid its obligation to make prompt payment upon the mere failure to comply with an EUO would run afoul of the statute and accordingly be invalid").
"As a creature of statute rather than a matter for contemplation of the parties in creating insurance policies, the uninsured motorist protection is not susceptible to the attempts of the insurer to limit or negate that protection." Flores, 819 So.2d at 745 (emphasis deleted) (quoting Salas v. Liberty Mut. Fire Ins. Co., 272 So.2d 1, 5 (Fla.1972)). The same is true for PIP protection. See Flores, 819 So.2d at 744-45 (recognizing that PIP insurance is likewise statutorily required); Vasques v. Mercury Cas. Co., 947 So.2d 1265, 1269 (Fla. 5th DCA 2007) (applying this aspect of Flores in the PIP context). Accordingly, enforcement of EUO conditions to delay or deny benefits negates statutory PIP protection and is invalid. See Vasques, 947 So.2d at 1269 ("[E]xclusions that are inconsistent with the purpose of the [PIP] statute are invalid."). This is especially true considering that "Florida's no-fault laws are construed liberally in favor of the insured." Fla. Med. & Injury Ctr., Inc. v. Progressive Express Ins. Co., 29 So.3d 329, 341 (Fla. 5th DCA 2010).
This Court in Flores recognized that, because PIP is a statutorily mandated coverage, "analogies to cases interpreting coverages that are not statutorily mandated, such as provisions in fire, life, and property insurance policies, may not necessarily be illuminating in guiding our analysis." 819 So.2d at 745. As in the Eleventh Circuit, "[m]any of the cases cited by Geico
Nunez, 685 F.3d at 1209-10. Much the same is true in Geico's brief in this Court, where it relatedly asserts that "Florida courts have recognized the validity of EUOs in the specific context of PIP benefits." But most of those cases simply presumed the validity of EUO's without addressing the issue at hand. As explained by the Eleventh Circuit,
The court in Shaw clearly stated that an EUO is a condition precedent to recovery of benefits if the insurance policy requires the insured to submit to an EUO. Id. at 331. However, the court did not distinguish the statutory coverage at issue in that case from other
Nunez, 685 F.3d at 1210. The Eleventh Circuit thus concluded that, "[b]ased on the dicta in Custer, it could be that the Florida Supreme Court may not follow the appellate court's statement in Shaw." Id. The Eleventh Circuit's speculation is correct. Based on the analysis above, we hold in alignment with Custer that EUO conditions are invalid as contrary to the terms of section 627.736, Florida Statutes (2008). We disapprove Shaw to the extent it holds otherwise.
In an apparent response to Custer, the Legislature amended the PIP statute in 2012 to include the requirement that insureds seeking benefits under the Florida Motor Vehicle No-Fault Law "comply with the terms of the policy, which include, but are not limited to, submitting to an examination under oath." Ch. 12-197, § 10, at 2752, Laws of Fla. (now codified in § 627.736(6)(g), Fla. Stat. (2012), effective January 1, 2013). Because Nunez's policy with Geico was issued in 2008, her accident was in 2008, and she filed her class action complaint in 2009, this amendment does not directly apply to the present case, and Geico does not contend otherwise. Rather, Geico argues that "[w]here, as here, a statutory amendment is enacted `soon after controversies as to the interpretation of the original act arise,' the amendment may be viewed as a `legislative interpretation of the original law and not as a substantive change thereof.'" (quoting Lowry v. Parole & Probation Comm'n, 473 So.2d 1248, 1250 (Fla.1985)).
But, while several of the cases cited by Geico in this context involve subsequent amendments to statutorily created insurance laws, those amendments generally favored the insured, not the insurer. See Ivey v. Chicago Ins. Co., 410 So.2d 494, 497 (Fla.1982) (finding subsequent amendment to the uninsured motorist statute to be a clarification of Legislature's intent to allow insured "to stack the uninsured motorist coverage of policies of which she is a beneficiary when determining whether another party is an uninsured motorist"); Vasques v. Mercury Cas. Co., 947 So.2d 1265, 1270 (Fla. 5th DCA 2007) (finding that the PIP statute validated its holding that "[t]o allow insurers to deny coverage of PIP benefits where someone other than the claimant makes a false statement for the purpose of defeating coverage would violate the well-articulated public policy considerations giving rise to personal injury protection benefits in this state"); but see Millennium Diagnostic Imaging Ctr., Inc. v. Sec. Nat'l Ins. Co., 882 So.2d 1027, 1029-30 (Fla. 3d DCA 2004) (affirming dismissal of insured's complaint that the higher "limiting charge" PIP fee schedule applied, finding that subsequent amendment to PIP statute "shows that the purpose of the amendment was to clarify that the [lower] [`]participating fee['] schedule was the proper fee schedule under the original statute").
Of these cases, Vasques (which this Court cited in Custer) is most on point insofar as, like the present case, it involves the denial of a PIP claim. The district court in that case held:
Vasques, 947 So.2d at 1269 (citations omitted). It likewise makes no sense that mandated PIP coverage could evaporate simply because, as in the present case, the insured failed to attend an EUO that was neither required under the then-applicable statute nor authorized thereunder as a basis for denial of benefits.
We therefore find that the 2012 amendment at issue amounts to a substantive change, not just a legislative clarification, of the PIP statute, especially considering the careful examination that applies in this context and our responsibility to construe the provisions of Florida's No-Fault Act liberally in favor of the insured. Id. We accordingly hold that the 2012 amendment does not inform or control our disposition of the present case. We do not otherwise comment on the applicability or validity of the 2012 amendment.
In sum, we hold in alignment with Custer that EUO conditions are invalid as contrary to the terms of section 627.736, Florida Statutes (2008). We disapprove Shaw to the extent it holds otherwise. We also hold that the 2012 amendment at issue substantively changed, not just legislatively clarified, section 627.736, and that the amendment therefore does not inform or control our disposition of the present case. We accordingly answer the certified question in the negative and return this case to the Eleventh Circuit Court of Appeals. We also provisionally grant Nunez's motion for appellate attorney's fees and remand
It is so ordered.
PARIENTE, LEWIS, QUINCE, and LABARGA, JJ., concur.
POLSTON, C.J., dissents.
CANADY, J., dissents with an opinion, in which POLSTON, C.J., concurs.
CANADY, J., dissenting.
Because I conclude that Geico was authorized by Florida law to include the policy provision regarding examinations under oath, I dissent.
Geico's authority to include this policy provision flows directly from section 627.414, Florida Statutes (2008), concerning "[a]dditional policy contents," which states that a "policy may contain additional provisions not inconsistent with this code and which are ... (3) [d]esired by the insurer and neither prohibited by law nor in conflict with any provisions required to be included therein." (Emphasis added.) Neither the majority nor the appellant have articulated any reason for concluding that this broadly applicable statutory provision has no force with respect to personal injury protection (PIP) policies. And neither the majority nor the appellant have provided any explanation of why Geico's examination under oath (EUO) policy provision goes beyond what is permitted by the statutory provision.
The majority's only consideration of section 627.414(3) comes in connection with the recitation of a portion of the opinion of the Eleventh Circuit Court of Appeals that quotes the text of the statute. Having set forth the text of section 627.414(3) and recognizing the requirement of "consistency" that it embodies, the majority brushes the statute aside. According to the majority, "consistency with certain provisions in the [PIP] statute is not the test." Majority op. at 393. The majority thus effectively abrogates the unambiguous statutory enactment contained in section 627.414(3). Rather than applying this statute, the majority relies largely on what the Court has previously said in Custer Medical Center v. United Automobile Insurance Co., 62 So.3d 1086 (Fla.2010), and Flores v. Allstate Insurance Co., 819 So.2d 740 (Fla. 2002). Of course, neither case contains any holding that governs the result here. And with respect to any comments they contain relevant to the question at issue here, both Custer and Flores suffer from the glaring deficiency that they do not so much as acknowledge the existence of section 627.414(3), much less provide any analysis of its application to PIP policies.
When the EUO provision is evaluated under the authorization contained in section 627.414(3), no basis can be found for determining that the EUO provision is inconsistent with the insurance code, prohibited by any provision of law, or in conflict with any provisions required to be included in the policy by the PIP statute. Accordingly, the EUO provision constitutes additional policy content that falls within the scope of section 627.414(3).
The majority makes much of the potential for unreasonable application of an EUO policy provision, but in this case we are not presented with the issue of whether Geico applied the EUO provision in an unreasonable manner. The issue, rather, is the purely legal question of whether the EUO provision in the PIP policy is invalid on its face. The fact that a policy provision might be abused by an insurer seeking to apply it unreasonably is not a proper basis for declaring the policy provision invalid on its face.
I would rephrase the certified question as follows: "Does Florida law permit an insurer to include in a PIP policy a provision requiring that those seeking coverage under the policy submit to examination under oath as reasonably required by the insurer?" And I would answer this question in the affirmative.
POLSTON, C.J., concurs.