STATE FARM MUTUAL AUTO INS CO
v.
COMPLETE CARE REHABILITATION INC

11th Cir. Ct. App. Div. | 2014-11-24
No. 2014-000065-AP-01
1 FLCA 3887 Eleventh Judicial Circuit Court, Appellate Division (2014)

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Synopsis

State Farm appealed a trial court order compelling discovery of its adjuster's notes in a breach of contract action for PIP benefits. The appellate court reversed, holding that claims file materials are not discoverable when the issue of coverage remains unresolved, citing Castle Key Insurance Co. v. Benitez.


Holding

The appellate court held that claims file materials, including adjuster's notes, are not discoverable prior to the resolution of coverage issues. The determinative factor is the type of action brought—here a breach of contract claim rather than bad faith—and whether coverage remains in dispute.


Headnotes

[1] Claims file material is not discoverable prior to the resolution of whether coverage exists in a breach of contract action.

[2] Notes within an insurer's claims file are encompassed by case law prohibiting the disclosure of claims file material.

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Key Quotes

“because the trial court order at issue directed the production of Castle Key's 'claims file' when the issue of coverage existed, it departed from the essential requirements of the law”

Establishes the core principle that claims file materials cannot be discovered when coverage is disputed

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Facts & Procedural History

State Farm and Complete Care Rehabilitation were involved in a dispute over PIP (Personal Injury Protection) benefits under an insurance policy. The t…

The full statement of facts, procedural history, and disposition for this case are member content.

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Opinion of the Court

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TRIAL COURT

L CASE NO; 12-739 SP 25 if COMPLETE cARE REHABILITATION, INC., Appellee/Respondent. T / Opinion filed. On Appeal from the County Court for Miami-Dade County, Florida, Patricia Marine- Pedraza, Judge. Scott A. Cole, Esquire and Daniel M. Schwarz, Esquire of Cole, Scott & Kissane, P.A., for Appellant. Marlene S. Reiss, Esquire of Marlene S. Reiss, Esquir

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e, ., for Appellee. Before PRESCOTT, FIGAROLA and SANTOVENIA, JJ. [*3] ii l SANTOVENIA, Judge. Before this court is the issue of whether the trial court correctly ordered that State Far1n’s adjuster’s notes be produced through discovery in a breach of contract action for PIP benefits notwithstanding State Farm’s claim of privilege. L The trial court is to be commended for conducting an in camera inspection of the adjuster’s notes at issue in this appeal before ordering that they be produced. However, on the basis of Castle Key Ins. C0. v. Benitez, 124 So. 3d 379 (Fla. 3d DCA 2013), we are compelled to reverse‘. In Castle Key, supra, the Third District held that claims file material was not discoverable prior to the resolution of whether coverage existed, stating that “because the trial comt order at issue directed the production of Castle Key’s ‘claims file’ when the issue of (\I\'(l'Q'I"I3(T 1:“-n1 Q nvrlcnn rlcnqnwl-rc -pv-no-v\ +1-an cnflncu-v\+-Inl 1-nr1\1-:1<¢uw-v\4uv\+n npilan 1.111 UU VULLL5 J.DlJLll.\-I-\.r1 \.l.\/llill LB JJ.\)'111 U.1\.r UDDUIILIGI 1\J\1LLll.\-¢1l.1\-JILD U1 U..l\J 10-W. ifD OD .___ C5 === gr E?€ C ,_ b-J4; CO .< 3d at 380. In so holding, the court cited Nationwide Insurance Co. ofFlorida v. Demmo, 57 So. 3d 982, 984 (Fla. 2d DCA 2011) for the proposition that “[i]n considering objections to discovery requests for claims file materials, the “detenninative issue” is “what type of action” the insured has brought. Id. at 380. Further, the Castle Key court made clear that “[t]he case law prohibiting the disclosure of “claims file” material. . .c1early encompasses items such as notes in the claims file. . .”. Id. at FN1. 1 The opinion in Castle Key was issued on October 23, 2013 and was thus in effect when the court below issued its November 4, 2013 order on in camera inspection (Which was re-issued on February l, 2014). There is no indication in the record below or in the briefs on appeal that Castle Key was brought to the trial court’s attention and it is likely that the trial court Was not aware of that decision prior to its November 4, 2013 order on in camera inspection. [*4] _.______.______\:f.______ In Demmo, supra. , the court stated: It appears . . . that the trial court focused on the question of what is and what is not work product with regard to the doctmients sought. But that is not the determinative issue. Rather, the issue turns on what type of action Dernmo has brought. Here she is not pursuing a bad faith claim, but rather seeks relief for breach of contract. “A trial court departs from the essential requirements of the law in compelling disclosure of the contents of an insurer's claim file when the issue ofcoverage is in dispute and has not been resolved.” 57 So. 3d at 984 (emphasis in original). The statement of claim in the present case alleges a breach of policy action with no allegations of bad faith. Further, coverage was still at issue when the adjuster’s notes in question were ordered to be produced. See generally American Bankers Ins. C0. of Fla. v. I/Vheeler, 711 So. 2d 1347 (Fla. 5th DCA 1998) (where in its answer to the complaint, insurer denied that additional sums were covered under its policy, the issue of coverage was still partially pending). Accordingly, Castle Key precludes production of the adjuster’s notes at issue. As such, this matter is REVERSED and REMANDED to the trial court for proceedings consistent with this opinion. PRESCOTT and FIGAROLA, JJ, Concur.

Footnotes
0 This cause having been brought to this Court by appeal, and after due consideration the court having issued its opinion; YOU ARE HEREBY COMMANDED that such further proceedings be had in said cause in accordance with the opinion of this COURT attached hereto and incorporated as part of this order, and with the rules of procedure and laws of the STATE OF FLORIDA. Lower Tribunal Case Number(s): 12-000739-SP 25 V WITNESS the Honorable Abby (3/namon, Administrative Judge oftheAppellate Division ofthe Circuit Court ofthe Eleventh Judicial Circuit ofFlorida and the seal ofthe said Circuit Court at Miami, this 3"‘ day of April, 2015. By: A True Copy Attest M COU N7;. U1 MARLENE S. REISS, ESQ. MUNIR D. BARAKAT, ESQ. SCOTTA. COLE, ESQ.

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