DARRIN P. GAYLES, District Judge.
Kenneth Dye ("Plaintiff") is 68 years old. (See Class Action Complaint ("Complaint") at ¶ 16) [D.E. 1-2]. Plaintiff retired from employment in 2004 and has no intention to re-enter the workforce. (Id.) Plaintiff was the holder of a private automobile insurance policy with United Services Automobile Association ("USAA") that renewed every six months. (Id. ¶ 17). Plaintiff maintained his policy for at least ten years, from 2004 through February, 2014. (Id. ¶ 18).
Plaintiff's policy states that the personal injury protection ("PIP") component of the policy "covers you, your family members and certain others, for bodily injuries resulting from auto accidents without regard to fault." ("Policy") ([D.E. 4-1 at 59]).
In 2014, Plaintiff filed his Complaint in the Circuit Court of the Eleventh Judicial Circuit in and for Miami-Dade County, Florida. The Complaint sets forth three counts. Count I seeks a declaratory judgment regarding the validity of the Policy and USAA's policies in general where the policy holder is a retiree paying premiums for wage loss coverage that is unavailable. (Id. ¶¶ 34, 37). Count II alleges that USAA breached the Policy and its insurance contracts with members of the putative class by charging retirees for wage loss premiums even though USAA would never be required to cover those wage loss claims. (Id. ¶ 41). Finally, Count III brings an equitable claim for assumpsit seeking to disgorge USAA of the wage loss premiums paid Plaintiff and members of the putative class who have automobile policies with the company. (Id. ¶ 50). Plaintiff alleges that he and others like him have conferred a benefit on USAA to which it is not entitled. (Id.). Plaintiff
USAA removed the action to this Court on diversity grounds and pursuant to the Class Action Fairness Act. (See [D.E. 1]). On July 3, 2014, USAA moved to dismiss the Complaint for failure to state a claim.
"To survive a motion to dismiss, a complaint must contain sufficient factual matter, accepted as true, to `state a claim to relief that is plausible on its face.'" Ashcroft v. Iqbal, 556 U.S. 662, 678, 129 S.Ct. 1937, 173 L.Ed.2d 868 (2009) (quoting Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570, 127 S.Ct. 1955, 167 L.Ed.2d 929 (2007)). Although this pleading standard "does not require `detailed factual allegations,' ... it demands more than unadorned, the defendant — unlawfully-harmed-me accusations." Id. (alteration added) (quoting Twombly, 550 U.S. at 555, 127 S.Ct. 1955).
Pleadings must contain "more than labels and conclusions, and a formulaic recitation of the elements of a cause of action will not do." Twombly, 550 U.S. at 555, 127 S.Ct. 1955 (citation omitted). Indeed, "only a complaint that states a plausible claim for relief survives a motion to dismiss." Iqbal, 556 U.S. at 679, 129 S.Ct. 1937 (citing Twombly, 550 U.S. at 556, 127 S.Ct. 1955). To meet this "plausibility standard," a plaintiff must "plead[] factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged." Id. at 678, 129 S.Ct. 1937 (alteration added) (citing Twombly, 550 U.S. at 556, 127 S.Ct. 1955). When reviewing a motion to dismiss, a court must construe the complaint in the light most favorable to the plaintiff and take the factual allegations therein as true. See Brooks v. Blue Cross & Blue Shield of Fla. Inc., 116 F.3d 1364, 1369 (11th Cir.1997).
All of Plaintiff's claims stem from his allegations that an insurance carrier has a duty to: (i) examine each of its policies, (ii) determine case-by-case whether the policy holder is retired, and (iii) to remove wage loss coverage from the policy for the policy holder. The Court finds that Plaintiff's claims fail as a matter of law.
As a preliminary matter, Plaintiff cannot maintain this action against USAA because there is no statutory duty for carriers to determine the employment statuses of their policy holders. The Florida legislature has determined that insurers must include PIP coverage in their policies as a part of Florida's Motor Vehicle No-Fault Law. See Fla. Stat. § 627.7311. Under Florida law, "[a]n insurance policy ... must provide personal injury protection to the named insured, relatives residing in the same household, persons operating the insured motor vehicle, passengers in the motor vehicle, and other persons...." Fla. Stat. § 627.736(1) (emphasis added). Personal injury protection consists of medical benefits and disability benefits. Id. Disability benefits entitle an insured to "[s]ixty percent of any loss of gross income and loss of earning capacity from [an] inability to work proximately caused by [an] injury
So that policy holders can make informed decisions about their coverage, PIP insurers must offer policy holders the option to modify their policies at each renewal period. See generally Fla. Stat. § 627.739. The statute imposes a duty on PIP insurers to give notice to its policy holders that they may exclude coverage for loss of income and loss of earnings. To comply with the statute, carriers must "offer coverage wherein, at the election of the named insured, the benefits for loss of gross income and loss of earning capacity described in s. 627.736(1) shall be excluded." Id. § 627.739(3) (emphasis added). The ability to modify the PIP component of an insurance policy must be presented to the policyholder in writing "in clear and unambiguous language at the time the initial application is taken and prior to each annual renewal...." Id. § 627.739(5). Importantly, an insurer may opt to provide notice "using form of notice approved by the office," or by providing the notice in the form set forth in the statute. Id.
As discussed above, Plaintiff cannot maintain this action against USAA as a matter of law because USAA has no duty to exclude wage loss coverage for retirees, absent a request from its insured. Therefore, the Plaintiff cannot prevail against his insurer because it has adhered to the requirements of the statute.
The Court has subject matter jurisdiction due to the diversity of Plaintiff and USAA. "Federal law applies to procedural matters and Florida law applies to substantive matters." Miami Yacht Charters, LLC v. Nat'l Union Fire Ins. Co. of Pittsburgh Pennsylvania, No. 11-21163-CIV, 2012 WL 1416428, at *1 (S.D.Fla. Apr. 24, 2012). A federal court is authorized "to declare the rights and other legal relations
"[T]o state a claim for declaratory judgment, a party must identify a genuine dispute over the existence or non-existence of some right or status." Id. at *2 (quoting Kelner v. Woody, 399 So.2d 35, 37 (Fla. 3d DCA 1981)). Importantly, "[d]eclaratory relief is not available to settle factual issues upon which coverage questions turn under an insurance contract which is clear and unambiguous." Id. (citing Travelers Ins. Co. v. Emery, 579 So.2d 798, 801 (Fla. 1st DCA 1991)). Instead, "[t]he party moving for declaratory judgment must identify some provision of the insurance contract as to which it is in doubt and therefore requires clarification." Id. (citing Tobon v. American Sec. Ins. Co., No. 06-61912-CIV, 2007 WL 1796250, at *2 (S.D.Fla. Jun. 20, 2007)).
Plaintiff alleges that when USAA improperly charged him and members of the putative class insurance premiums for wage loss coverage, USAA placed the validity of its entire insurance contract into doubt. (Complaint ¶ 34). It did not. As noted above, USAA has a legal duty to its PIP policy holders to: (1) provide PIP coverage that includes coverage for lost wages, and (2) notify policy holders in writing at each renewal period that they have the option to exclude lost wage coverage if they are retired or otherwise unemployed. The Florida legislature did not impose a duty on insurers to make wage loss elections (or exclusions) on a policy holder's behalf absent a request from its insured. Nor does this Court find that such an undertaking would be practicable. While it is true that individuals may be eligible to retire at 65 of years of age, it is quite possible that retirees may be younger or older than 65. It is also possible that persons 65 years of age or older may choose not to retire. Moreover, because retired individuals may choose to reenter the workforce at any time, retirement itself is a fluid status that can change from renewal period to renewal period. The Court finds that the framework set up by the Florida legislature was designed to accommodate this very problem by placing the onus on the policy holder to either elect or exclude wage loss coverage. It is improper for the Court to second guess the clear and unambiguous intent of the legislature, which is set forth in the statute. Accordingly, Count I of the Complaint must be dismissed.
"To survive dismissal for breach of contract, a plaintiff must allege (1) the existence of a contract, (2) a breach of the contract, and (3) damages resulting from the breach." Zarrella v. Pacific Life Ins. Co., 755 F.Supp.2d 1231, 1241 (S.D.Fla. 2011) (citing Textron Fin. Corp. v. Lentine Marine, Inc., 630 F.Supp.2d 1352, 1356 (S.D.Fla.2009) (citing Rollins, Inc. v. Butland, 951 So.2d 860, 876 (Fla. 2d DCA 2006))). While the Court must accept a Plaintiffs factual allegations as true on a motion to dismiss, a claim must fail if "no construction of the factual allegations will support a cause of action." Id. (citations omitted).
Here, Plaintiff alleges that USAA breached the insurance contract because it
Plaintiff's claim for assumpsit is an equitable action at common law akin to a claim for unjust enrichment. Berry v. Budget Rent A Car Systems, Inc., 497 F.Supp.2d 1361, 1369 (S.D.Fla.2007). "[S]uch a claim is generally an action at law to enforce a quasi-contract." Id. However, claims for assumpsit "cannot exist where payment has been made for a benefit conferred." Id. In Count III, Plaintiff alleges that it paid USAA for wage loss coverage. (Complaint ¶ 46). However, notably devoid from Plaintiffs allegations are any statements that USAA failed to provide an automobile insurance policy that included the wage loss coverage required by Florida law in exchange for his premium payments. In fact, as discussed above, USAA clearly provided Plaintiff with the benefits and the notices that it was required to provide by law in exchange for Plaintiffs payment of policy premiums. There is no set of facts that Plaintiff has alleged (or can allege) that would entitle him to relief in this instance.
Because the Court finds that Plaintiff cannot individually maintain any of the claims in this action against USAA as a matter of law, his class allegations must necessarily fail.
For the foregoing reasons, it is hereby