6 Fla. L. Weekly Supp. 293a
Contracts — Settlement agreement — Insurance — Personal injury protection — Health care provider/assignee seeking to enforce settlement agreement which insurer sought to void after discovering that it was not the appropriate insurer for the loss at issue — Plaintiff did not detrimentally rely upon insurer’s mistake where plaintiff knew that another company was a potential insurer but chose to pursue its claim only against defendant, and defendant rescinded settlement agreement only six days after settlement negotiations and before any payment had been made, leaving plaintiff with an opportunity to present its claim to the appropriate insurer — Judgment entered in favor of defendant
COMPREHENSIVE HEALTH CENTER, INC., Plaintiff, vs. ARIES INSURANCE CO., Defendant. County Court of the 11th Judicial Circuit in and for Dade County. Case No. 97-11908 SP 23. January 22, 1999. Linda Singer Stein, Judge.
FINAL JUDGMENT FOR DEFENDANT
THIS CAUSE came before the Court for trial. After careful consideration of the evidence, legal authorities and being fully advised, the Court’s findings are as follows.
FINDINGS OF FACT
This is an action by Plaintiff, Comprehensive Health Care Center, Inc., the assignee of Resita Cazeau, to enforce a settlement agreement against Defendant, Aries Insurance Company. Plaintiff alleged that the agreement would have settled Plaintiff’s claim for assigned P.I.P. benefits. Plaintiff’s assignor was a passenger in a vehicle driven by C. Monestime during an accident. Mr. Monastime was insured by the Defendant at the time of the accident. Plaintiff’s assignor obtained treatment from Plaintiff. To assure payment to Plaintiff, Ms. Cazeau filled out an assignment of benefits form.
In October 1996, Defendant received a bill from the attorney for Plaintiff’s assignor in the amount of $2,671 for services rendered by Plaintiff. After receiving Plaintiff’s P.I.P. application, Defendant ran an Autotrack search in an attempt to ascertain whether Aries was the proper insurer. Defendant’s search identified four cars at the assignor’s residence. Defendant’s adjuster testified that Autotrack is not always accurate, so Defendant also relied upon the Assignor’s application, which stated “NA” in the place for listing other vehicles at the household. Indeed, Defendant later determined that Autotrack had been in error, as there was only one vehicle at the assignor’s household. Defendant attempted to obtain a sworn statement from the Assignor three times, but never received a response.
On January 13, 1997, Plaintiff received a letter from Fidelity National Insurance Company, the insurer of the assignor’s brother, requesting arbitration and disputing a portion of the bills. However, Plaintiff was not convinced that Fidelity was the proper insurer because it appeared to the Plaintiff that Defendant was the primary insurer.
Plaintiff demanded arbitration of its claim for benefits due from Defendant in February 1997. After negotiations took place between the parties, on April 29, 1997, Defendant’s adjuster agreed to resolve the claim for $4,000 in benefits and $700 in attorney’s fees. This agreement was memorialized in a fax from Plaintiff’s counsel to Defendant’s adjuster on that same date.
Six days later, on May 5, 1997, and before issuing a settlement check, Defendant attempted to void the settlement agreement on the grounds that Defendant was not the correct insurer. Rather, Defendant then claimed that Fidelity was the appropriate insurer, because Fidelity insured the Assignor’s brother. Defendant made this determination after receiving a phone call from the assignor’s attorney, who informed Defendant that the assignor was pursuing a claim against Fidelity. Plaintiff did not submit its claim to Fidelity.
Plaintiff brought this suit against Defendant, seeking enforcement of the settlement agreement.
LEGAL DISCUSSION
Plaintiff argues, in part, that the settlement must stand even if there is no coverage by Defendant because Defendant made a unilateral mistake. In addition, Plaintiff claims that it detrimentally relied on Defendant’s error.
Defendant contends that it cannot be forced to pay for that which it is not responsible. Defendant relies upon the cases of Emanuel v. U.S. Fidelity & Guarantee Co., 583 So. 2d 1092 (Fla. 3d DCA 1991) and Pennsylvania National Mutual Insurance Co. v. Anderson, 445 So. 2d 612 (Fla. 3d DCA 1984).
In Emanuel, the parties entered into a settlement agreement. Prior to paying, the insurance company discovered that the insured had not paid all of the premiums and, as a result, the policy was not in effect at the time of the accident. The Third District Court of Appeal found that there was no detrimental reliance by the insured with respect to the insurer’s refusal to complete the settlement.
The facts in Anderson are analogous to this dispute. In Anderson, the adjuster inspected the wrong car and settled the claim. “When the error was discovered soon after, however, the insurer stopped payment on the checks.” Id. at 613. The trial court found in favor of the insured. The appellate court, finding that the insurer should not be held liable, reasoned:
Because we both [the majority] consider the carrier’s conduct almost amusingly inept and share what we take to be the trial judge’s reaction that the company should be made to lie in its self-made bed, it is with some regret that we conclude the judgment must be reversed. In our view, the case is, perhaps unfortunately, [footnote omitted] governed by Maryland Casualty Co. v. Krasnek, 174 So. 2d 541 (Fla. 1965), which squarely holds that a party — even an insurance company such as the present appellant — should be relieved of the consequences of a unilateral mistake like the one involved here. . . .First, the plaintiffs did not detrimentally rely upon the mistake since, as they concede, their only action which even arguably so qualifies, a commitment to purchase an expensive replacement vehicle, occurred before they knew of the extent of the carrier’s erroneous largesse. Second, while “some degree of negligence” was undoubtedly involved. . .it surely does not approach the “inexcusable lack of due care” the court indicated was necessary to entitle the plaintiffs to retain their consequent windfall. . .
Id. at 613 (emphasis in original).
Here, Plaintiff did not detrimentally rely upon Defendant’s mistake for two reasons. First, Plaintiff knew that Fidelity was a potential insurer as early as January 1997. Nevertheless, Plaintiff chose to pursue its claim only against Defendant. Second, after Defendant rescinded its settlement agreement, only six days after the settlement negotiations and before Defendant sent any payment, Plaintiff had another chance to present its claim to Fidelity at that time.
In addition, the actions of Defendant here were far less inattentive than those of the insurer in Anderson. Indeed, here, Plaintiff, as well as Defendant believed that Defendant was the correct insurer. Unlike the unfortunate mistake made in Anderson, Aries corrected its error before issuing a settlement check. Just as in Anderson, therefore, the insurer’s conduct does not rise to the level of “inexcusable lack of due care”. See Anderson, 445 So. 2d at 613.
This Court finds that these binding cases apply and, accordingly, FINAL JUDGMENT is entered in favor of Defendant, Aries Insurance Company and against Plaintiff, Comprehensive Health Center, Inc. Plaintiff shall take nothing and Defendant shall go hence without day.
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