Are Examinations Under Oath Required for Insurance Payouts?

By Robyn Hagan Cain on April 10, 2012 | Last updated on March 21, 2019

The Eleventh Circuit Court of Appeals certified a question to the Florida Supreme Court this week that could affect insurance claims in Florida.

The question is whether, under Florida Statute 627.736, an insurer can require an insured to attend an examination under oath (EUO) as a condition precedent to recovery of personal injury protection (PIP) benefits?

The question came up in an insurance claim dispute between Merly Nuñez and Geico Insurance Company.

Nuñez, who has a Geico insurance policy that provides for PIP benefits, suffered injuries in a car accident. Geico denied Nuñez's claim for medical expenses associated with the accident. Nuñez said Geico denied coverage because she failed to attend an EUO, and that EUOS are impermissible conditions precedent to PIP coverage based on the Florida Supreme Court's decision in Custer Med. Ctr. v. United Auto. Ins. Co. Geico contends that an EUO is a legal prerequisite to receiving benefits under its policy.

Nuñez filed a class action lawsuit against Geico. The district court dismissed the lawsuit with prejudice on Geico's 12(b)(6) motion. She appealed to the Eleventh Circuit Court of Appeals on the issue of whether Florida's PIP statute permits EUOs as a prerequisite to PIP benefits. Though the district court found that there was no language in the PIP statute prohibiting an insurer from requiring an EUO, Geico advised the appellate court that recent, conflicting interpretations of Custer warranted further review.

Geico filed a motion to certify the question of Custer's precedential value and effect to the Florida Supreme Court; the Eleventh Circuit Court of Appeals granted the motion on Tuesday, and delayed judgment in the appeal.

The answer to this question will impact insurance claims in Florida, so we'll keep you posted on the Florida Supreme Court's response.

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