DINA ABRAMS, ETC.,
v.
CONSTITUTION LIFE INSURANCE COMPANY, ETC.,
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Dina Abrams, as next best friend of Doris Bechhof, appealed a summary judgment denying insurance benefits for assisted living facility services. The court affirmed, holding that the home health care policy unambiguously excluded services provided in assisted living facilities and other institutional settings.
The policy language is clear and unambiguous. The policy covers only home health care services rendered in the policyholder's home, and explicitly excludes assisted living facilities. Therefore, Constitution's denial of benefits was proper, and summary judgment for the defendant was appropriately granted.
[1] An insurance policy that expressly excludes services rendered by an assisted living facility does not cover claims for benefits incurred in such a facility.
[2] A court cannot rewrite the clear and unambiguous terms of a voluntary contract.
Previewing 2 of 3 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“HOME is considered to be Your home where You reside. Home is not a Nursing Care Facility, Hospice Facility, Assisted Living Facility, or a Hospital.”
The explicit policy language defining what "home" means and what it excludes, which is central to the court's finding of no ambiguity.
Previewing 1 of 3 key quotes on this case — the court’s exact language, pinpointed for members.
Join FLexlaw to unlock all legal intelligenceDoris Bechhof purchased a "Home Health Care Limited Benefit Policy" from Constitution Life Insurance Company. When Ms. Bechhof entered an assisted liv…
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HENDON, J.
Dina Abrams (“Abrams”), as next best friend of Doris Bechhof, appeals from an adverse summary judgment.
We affirm. Abrams, daughter of Ms. Bechhof, sued Constitution Life Insurance Company (“Constitution”), for denying benefits pursuant to a “Home Health Care Limited Benefit Policy” purchased by Ms. Bechhof. When Ms. Bechhof entered an assisted living facility, Constitution denied the claims for payment of benefits because the policy only covers home health care services and specifically excludes services rendered by a nursing home, nursing care facility, hospice facility, hospital, or assisted living facility.
The lower court granted summary judgment in Constitution’s favor.
We review this matter de novo. See Kurtz v. AF & L Ins. Co., 211 So. 3d 1115, 1115 (Fla. 3d DCA 2017) (citing to Penzer v. Transp. Ins. Co., 29 So. 3d 1000, 1005 (Fla. 2010) (confirming that “a question of insurance policy interpretation, which is a question of law, [is] subject to de novo review. Abrams characterizes the policy as a “long term health care coverage policy” but it clearly is not. It is a policy that covers home health care services, those services to be rendered in the policyholder’s home. “Home” is defined in the policy as follows: “HOME is considered to be Your home where You reside. Home is not a Nursing Care Facility, Hospice Facility, Assisted Living Facility, or a Hospital.” (emphasis added).
To be sure, the policy clearly notifies the purchaser that “[t]his policy is a LIMITED BENEFIT POLICY and NOT a Long Term Care Insurance as defined by Florida Law.” Abrams argues that the policy language is ambiguous. It is not.
The trial court correctly concluded there was no ambiguity in the policy provisions, as the policy expressly does not cover assisted living facility services. See Pol v. Pol, 705 So. 2d 51, 53 (Fla. 3d DCA 1997) (“It is well established that a court cannot rewrite the clear and unambiguous terms of a voluntary contract.”).
Affirmed.