Background
Manuel V. Feijoo, M.D., P.A., appealed from a Miami-Dade County Court judgment in litigation against Progressive Select Insurance Company concerning personal injury protection benefits. The county court proceeding was before Judge Jacqueline Woodward.
The dispute implicated whether submitting to an examination under oath was a condition precedent to receiving PIP benefits under section 627.736(6)(g), Florida Statutes, and the insurance policy. It also implicated whether Progressive’s affirmative defense was pleaded with sufficient ultimate facts to provide notice of the proof on which the insurer intended to rely.
The Court’s Holding
The Third District Court of Appeal affirmed in a per curiam opinion. Citing its prior decisions, the court reiterated that an affirmative defense may support summary judgment when it was pleaded with ultimate facts sufficient to notify the plaintiff of the proof the defendant intended to use to defeat the claim.
The court also relied on precedent holding that submission to an examination under oath is a condition precedent to receiving PIP benefits under section 627.736(6)(g) and the policy at issue. Because compliance is a condition precedent, prejudice is not an element of the insurer’s affirmative defense. The court declined Feijoo’s invitation to recede from its prior precedent in American Integrity Insurance Co. v. Estrada.
Key Takeaways
- Compliance with an examination-under-oath requirement may be a condition precedent to receiving PIP benefits under Florida law and the governing policy.
- An insurer asserting noncompliance with that condition precedent need not establish prejudice as an element of its affirmative defense.
- An affirmative defense is sufficiently pleaded when it alleges ultimate facts that provide notice of the proof the defendant intends to rely upon.
Why It Matters
The decision reinforces the Third District’s existing PIP precedent on examination-under-oath requirements and confirms that failure to satisfy such a condition is not analyzed under a prejudice requirement. It also underscores the importance of pleading enough ultimate facts to give fair notice of an affirmative defense that may later support summary judgment.