4 Fla. L. Weekly Supp. 375a
Insurance — Personal injury protection — PIP policy’s provision requiring insured to submit to recorded statement or examination under oath prior to payment of PIP benefits does not violate Florida’s No-Fault Act — Policy provision for recorded statements in no way precludes prompt recovery — Insured’s failure to submit to recorded statement or examination under oath constituted failure to comply with condition precedent, and therefore insured was precluded from receiving PIP benefits
RONALD BOWMAN, Appellant, vs. ARMOR INSURANCE COMPANY, a Florida corporation, Appellee. 13th Judicial Circuit in and for Hillsborough County, Circuit Civil Division. Appellate Case No. 96-297, Division: B. County Court Case No. 93-7705. December 2, 1996. Appeal from the County Court in and for Hillsborough County. Marva Crenshaw, Judge. Julian A. Sanchez, Attorney for Appellant. Mark E. Pena, Attorney for Appellee.
OPINION AFFIRMING FINAL JUDGMENT
(Manuel Menendez, Jr., Judge.) Ronald Bowman, Appellant, (hereafter Bowman) appeals the decision of the county court granting final summary judgment in favor of Appellee, Armor Insurance Company (hereafter Armor). Specifically, Bowman raises the issues of whether the provision of Armor’s insurance policy requiring an insured to submit to a recorded statement under oath violates Florida’s No-Fault Act, and whether this provision constitutes a condition precedent to the insured receiving benefits under Armor’s insurance policy.
FACTS
On March 18, 1994, Bowman was injured in an automobile accident. Bowman claimed that as a result of the accident he sustained injuries and incurred expenses for the medical treatment of these injuries. Prior to the accident, Armor had issued Bowman an automobile insurance policy which was in effect at the time of the accident.
After the accident, Bowman submitted to Armor a personal injury application and an authorization for medical and wage information. This permitted Armor to obtain medical records pertaining to the injuries sustained in the car accident. On or about April 28, 1994, Bowman then made a claim under his insurance policy for Personal Injury Protection (“PIP”) benefits. Pursuant to a provision in this insurance policy, Armor requested in writing on five different occasions that Bowman submit to a recorded statement. Bowman did not submit to a recorded statement. Consequently, Armor refused to provide PIP benefits to Bowman on the basis that he refused to submit to the contractually obligated recorded statement or evaluation under oath. Thus, Armor asserted Bowman forfeited his rights to receive any benefits under the policy.
On January 6, 1995, Bowman filed a complaint against Armor for payment of PIP benefits. On August 29, 1995, Bowman filed a motion for summary judgment on the basis that as a matter of law, the policy provision requiring the appellant to submit to a recorded statement under oath, prior to payment of PIP benefits, was a violation of the Florida Automobile Reparations Reform Act (“No-Fault”). On November 9, 1996, the county court entered its order denying plaintiff’s motion for summary judgment. The county court found that the submission to a recorded statement was a valid condition precedent to receiving benefits under the subject PIP policy. Thereafter, Armor filed its motion for summary judgment on the grounds that submitting to a recorded statement or examination under oath was a condition precedent to payment of PIP benefits under the subject insurance policy, and accordingly, Bowman’s refusal to submit to a recorded statement or examination under oath forfeits any rights or benefits Bowman would otherwise be entitled to under the policy. On January 9, 1996, the county court entered its Order granting Armor’s motion for summary judgment, and holding that the provision requiring Bowman to submit to a recorded statement or examination under oath was not violative of Florida’s No-Fault Act, and that Bowman’s failure to submit to the same was in non-compliance with a valid condition precedent to receiving benefits under the insurance policy. On January 17, 1996, Bowman filed a Notice of Appeal to the Circuit Court of the Thirteenth Judicial Circuit. The matter is now before this court for review of the lower court decision.
DISCUSSION
Bowman maintains that he was improperly denied PIP benefits, first, because Armor’s provision requiring a recorded statement or an examination under oath violated Florida’s No-Fault Act, and secondly, that his failure to submit to the same should not be construed to be a failure to comply with a condition precedent to receiving PIP benefits under the insurance policy.
I. WHETHER ARMOR’S PROVISION REQUIRING A RECORDED STATEMENT OR AN EXAMINATION UNDER OATH VIOLATES FLORIDA’S NO-FAULT ACT?
Bowman asserts that Armor’s recorded statement and examination under oath violates the intent of Florida’s No-Fault Act, because it tolls the thirty day time frame provided in the No-Fault Act, and because it permits an investigative provision which is neither expressly nor impliedly permitted by statute. The Florida No-Fault Act, Section 627.736(4)(b), Florida Statutes, reads in pertinent part:
Personal injury protection insurance benefits paid pursuant to this section shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and the amount of same…. However, any payment shall not be deemed overdue when the insurer has reasonable proof to establish that the insurer is not responsible for the payment, notwithstanding the written notice has been furnished to the insurer.
Bowman provided Armor with written notice of the covered loss and the amount of the bills incurred. Armor did not claim it was not responsible for Bowman’s medical bills. Instead, Armor’s defense for failing to provide PIP benefits was Bowman’s failure to submit to a recorded statement. The insurance policy between Armor and Bowman contains a provision requiring Bowman to submit to a recorded statement or an examination under oath before any PIP benefits are paid. Pursuant to this provision, Armor requested in writing, on five different occasions, that Bowman submit to a recorded statement.
Bowman takes issue with this provision and maintains it violates the intent of the No-Fault Act because the provision tolls the thirty day time period provided in the Act. Bowman argues that by requiring a recorded statement or examination under oath before paying PIP benefits, Armor erroneously ignores the plain meaning and intent of section 627.736(4)(b), which is to guarantee swift payment of PIP benefits, Crooks v. State Farm Mutual Automobile Insurance Company, 659 So. 2d 1266 (Fla. 3d DCA 1995). Bowman adds that the statutory language clearly and unambiguously states that the insurance company has thirty days in which to verify the claim after receipts of the application of benefits, and there is no provision in the statute to toll this time limitation. Dunmore v. Interstate Fire Insurance Co., 301 So. 2d 502 (Fla. 1st DCA 1974).
Armor contends that if Bowman had cooperated, the recorded statement under oath could have completed within the thirty day time frame. As such, Armor asserts that the policy provision requiring an examination under oath does not extend the 30-day provision and thus does not violate the intent of the No-Fault Act. The policy provision merely enables insurance companies to investigate claims. In this regard, insurance companies have a duty to investigate claims to ensure they are obligated to pay benefits under the policy. See Sections 626.877, 627.426(1)(c), Florida Statutes. The purpose of a recorded statement under oath is to enable the insurer to obtain information regarding the claim so that it can properly and fairly evaluate the claim to determine if it is obligated to pay benefits, and of course to protect itself against false or fraudulent claims. Claflin v. Commonwealth Insurance Company, 110 U.S. 81 (1884).
Bowman also asserts that Armor’s recorded statement provision permits an investigative procedure not permitted by the No-Fault Act. Bowman relies upon Florida Statutes, Section 627.736(6)(c), which provides, in pertinent part:
In the event of any dispute regarding an insured’s right to discovery of facts about an injured person’s earnings or about his history, condition, or treatment, or the dates and costs of such treatment, the insurer may petition in a court of competent jurisdiction to enter an order permitting such discovery.
This, Bowman argues, provides a vehicle for an insurer to investigate claims for benefits if the need arises. Armor’s recorded statement provision would allow an insurer to circumvent this framework provided by the No-Fault Act and permit investigative provisions which are expressly and impliedly not permitted by statute.
Armor maintains that Bowman’s reliance upon Section 627.736(6)(c), Florida Statutes, is misplaced. When Section 627.736(6), Florida Statutes is read in its entirety, it is clear that this section would apply only when the insured’s employer disputes the insurer’s right to discovery of facts about the insured. Such a situation is not presented in the instant case, and accordingly Section 627.736(6)(c) is not applicable herein.
It does not appear that the recorded statement provision of Armor’s insurance policy neither attempts in any way to toll the applicable time frames, nor does it allow for an investigative procedure not permitted by the statute. The purpose of the No-Fault Act is to provide “prompt recovery of out-of-pocket losses.” Lasky v. State Farm Insurance Company, 296 So. 2d 9 (Fla. 1974). The No-fault Act specifically defines “prompt” as “within thirty days after the insurer furnishes written notice of a covered loss and amount.” Section 627.736(4)(b), Florida Statutes. The Armor policy provision for recorded statements in no way precludes “prompt recovery.” Moreover, insurance companies have a duty to investigate claims to verify their obligation to pay benefits under a policy. Armor’s policy provision allows it to do so. It does not permit an investigative procedure which is either expressly or impliedly impermissible under Florida law. The recorded statement provision of Armor’s policy merely enables the insurer to obtain information in order to properly and fairly evaluate claims.
II. WHETHER BOWMAN’S FAILURE TO SUBMIT TO A RECORDED STATEMENT OR EXAMINATION UNDER OATH CONSTITUTES A FAILURE TO COMPLY WITH A CONDITION PRECEDENT THUS PRECLUDING BOWMAN FROM RECEIVING BENEFITS UNDER THE INSURANCE POLICY?
Bowman contends that submitting to a recorded statement or examination under oath should not be construed as a condition precedent to receiving benefits under his insurance policy. Bowman asserts that all the cases cited by Armor in its motion for summary judgment are inapplicable to the instant case because they do not specifically address PIP/No-Fault policies but rather, pertained to homeowner policies.
Armor asserts it is well established that, as a condition precedent to coverage under an insurance policy, an insured must submit to a statement under oath or be forever barred from recovery under that policy. Goldman v. State Farm Fire General Insurance Company, 660 So. 2d 300 (Fla. 4th DCA 1995). See also, American Reliance Insurance Company v. Riggins, 604 So. 2d 535 (Fla. 3d DCA 1992) (insured absolutely required under policy to submit to statement under oath); Stringer v. Fireman’s Fund Insurance Company, 622 So. 2d 145 (Fla. 3d DCA 1993), rev. den. 630 So.2d 1101 (Fla. 1993) (the failure to submit to a statement under oath is a material breach of the insurance policy which will relieve the insurer of the obligation to pay under the policy); Jimenez v. State Farm Fire and Casualty Company, 2 F.L.W. Supp. 20 (11th Cir. Ct. 1993) (insurer entitled to judgment as a matter of law when insured fails to submit to statement under oath). While these cases involve homeowner’s policies, Armor argues they are nonetheless applicable because of the inherent similarities of homeowners and PIP policies. First, PIP/No-Fault policies and homeowner’s policies both provide first party coverage. Secondly, PIP/No-Fault policies and homeowners’ policies both set out time limits in which an insurer must pay the insured’s claim. Third, the public policy of encouraging the prompt payment of claims is found in both PIP/No-Fault policies and homeowners’ policies. Moreover, Goldman does not distinguish the statement under oath as a condition precedent for different types of insurance policies. 660 So. 2d at 300-306. In addition, Armor asserts that the court in Goldman specifically recognized that examinations under oath were analogous to the insured’s requirement to submit to a medical exam in a No-Fault case. Id. at 303.
It is well-established in Florida law that as a condition precedent to coverage under a homeowner’s policy an insured must submit to a statement under oath or be forever barred from recovery under that policy. While this precedent is derived from cases dealing with homeowner’s policies, their rationale is likewise applicable and instructive in the subject case. Equally instructive is the language of Sturgis v. Fortune Insurance Company, 475 So.2d 1272 (Fla. 2d DCA 1985), which does deal with No-Fault Insurance. “[O]nce the requirements of the No-Fault Act were met the parties were free to contract between themselves as to any additional responsibility.” Id. at 1273. Armor’s policy in the instant case meets all the requirements of the No-Fault Act. It also contains certain additional provisions, including the statement under oath requirement. However, this does not render the policy inconsistent or in conflict with the provisions of the No-Fault Act. Under the facts presented in the instant case, the insured was required to submit to a statement under oath as a condition precedent to coverage under a PIP/No-Fault policy. His failure to do so forever bars recovery under that policy.
CONCLUSION
Bowman, was properly precluded from receiving PIP benefits for his injuries under his PIP policy with Armor because he failed to submit to a recorded statement or examination under oath. Armor’s provision requiring a recorded statement or examination under oath did not violate Florida’s No-Fault Act. Bowman’s failure to submit to the recorded statement or examination under oath amounts to a failure to comply with a condition precedent to receiving benefits under the insurance policy. The decision of the County Court is AFFIRMED.
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