GARRETT E. MOSURE, JR., AS EXECUTOR OF THE ESTATE OF BONNIE K. MOSURE, APPELLANT/CROSS-APPELLEE,
v.
MUTUAL HOSPITAL INSURANCE, INC., MUTUAL MEDICAL INSURANCE, INC., D/B/A BLUE CROSS-BLUE SHIELD OF INDIANA, A FOREIGN CORPORATION, APPELLEES/CROSS-APPELLANTS
AI-generated. These summaries, headnotes, and key points are machine-generated and may contain errors or omissions. Always verify against the full opinion text below. Not legal advice.
This case concerns whether an executor of an estate was entitled to prejudgment interest on a health insurance claim for nursing home care that the insurer wrongfully denied. The court held that prejudgment interest should accrue from the date the claim was wrongfully denied until the judgment is satisfied, and remanded for recalculation of damages under the policy's 730-day limitation.
The executor is entitled to prejudgment interest from October 11, 1977 (when the claim was denied) until the judgment is satisfied at six percent per annum through June 30, 1982, and twelve percent from July 1, 1982 onward. Additionally, the damage award must be limited to 730 days of skilled nursing care as restricted by the policy terms.
[1] An insurance policy's exclusion of "custodial" care does not apply when the care required is of a nature and degree beyond merely custodial.
[2] Prejudgment interest should be awarded until the date of final judgment, not merely until the date of the trial court's initial factual determination.
Previewing 2 of 4 headnotes on this case. FLexlaw’s editorially structured points of law — every proposition, pinpointed — are reserved for members.
Join FLexlaw to unlock all legal intelligence“The trial court's factual determination, which we do not disturb, was that the nature and degree of care Bonnie required was not merely 'custodial' and fell within the policy's terms.”
Establishes that the court upheld the trial court's core finding that the nursing home care was covered under the policy
Previewing 1 of 3 key quotes on this case — the court’s exact language, pinpointed for members.
Join FLexlaw to unlock all legal intelligenceBonnie K. Mosure was covered by a health insurance policy from her deceased husband's employment with General Motors. She required intermittent hospit…
The full statement of facts, procedural history, and disposition for this case are member content.
Join FLexlaw to unlock all legal intelligence© FLexlaw, Inc. — AI-generated enrichments are proprietary. All rights reserved.
Explore caselaw by topic → Browse Prejudgment Interest cases and more on FLexlaw
PER CURIAM.
The appellant, Garrett E. Mosure, is the son of Bonnie K. Mosure and the executor of her estate. Bonnie was the beneficiary of a health insurance policy originating in her deceased husband’s employment by General Motors. Bonnie suffered from a variety of ailments requiring intermittent hospitalization and ultimately, nursing home care. The policy excluded “custodial” care from coverage and the carrier declined payment of the nursing home’s charges. Bonnie died in 1977.
The trial court’s factual determination, which we do not disturb, was that the nature and degree of care Bonnie required was not merely “custodial” and fell within the policy’s terms.
The trial court’s final judgment awarded the executor prejudgment interest for the period from October 11, 1977, to June 30,1980, at the rate of six percent per annum. The executor has appealed that aspect of the judgment claiming entitlement to prejudgment interest to the moment of the final judgment, i.e., July 18, 1986. He is correct. We also find that the appellees have correctly contended on cross-appeal that the appellant’s damages are limited by the policy to 730 days of skilled nursing care.
The trial court’s award erroneously exceeds the policy’s restricted coverage.
We reverse the final judgment and remand this matter for the entry of an amended final judgment reflecting the appropriate damages. Finally, the trial court shall award prejudgment interest to the executor at the rate of six percent for the period from October 11, 1977 to June 30, 1982, and at the rate of twelve percent from July 1, 1982 until the judgment is satisfied consistent with Argonaut Insurance Co. v. May Plumbing Co., 474 So. 2d 212 (Fla.1985).
RYDER, A.C.J., and CAMPBELL and FRANK, JJ., concur.