Life General Sec. Ins. Co. v. Horal, s. 94-1918

Citation667 So.2d 967
Decision Date14 February 1996
Docket Number94-3054,Nos. 94-1918,s. 94-1918
Parties21 Fla. L. Weekly D434 LIFE GENERAL SECURITY INSURANCE COMPANY, Appellant/Cross-Appellee, v. Deborah HORAL, Appellee/Cross-Appellant.
CourtCourt of Appeal of Florida (US)

Consolidated appeals and cross-appeal from the Circuit Court for Palm Beach County; James T. Carlisle, Judge.

Raoul G. Cantero, III, and Jared Gelles, of Adorna & Zeder, P.A., Miami, for appellant/cross-appellee.

Jeffrey M. Liggio of Liggio & Luckman, and Philip M. Burlington of Caruso, Burlington, Bohn & Compiani, P.A., West Palm Beach, for appellee/cross-appellant.

PER CURIAM.

Life General Insurance Company (Life General) appeals the award of health insurance benefits to its insured, Deborah Horal. The appellant contends that the trial court erred in denying Life General's motion to amend its pleadings to include an affirmative defense and counterclaim alleging omissions on Ms. Horal's insurance application.

When applying for the insurance, Ms. Horal denied ill health, and in response to a question concerning prior treatment, she acknowledged a D & C two years before, but indicated that as to results, the D & C was "OK."

The policy was issued, and about a month later the appellee was treated for serious gynecological problems. This lawsuit resulted from the denial of benefits by Life General.

In response to the claim investigation, the treating physician provided only a portion of his records to Life General, and it was only much later, during discovery, that Life General obtained that physician's complete records and learned that Ms. Horal had been treated for similar problems a few months before applying for the insurance. Ms. Horal's deposition testimony, given earlier in the lawsuit, did not reveal that prior treatment.

When Life General learned of the prior treatment, it moved to amend its pleadings to assert an affirmative defense based on the omissions by Ms. Horal in the insurance application, and to assert a counterclaim for recision of the insurance contract. The court denied the motion, finding that "through the exercise of reasonable diligence the insurance company could have found out about [the omission] and they certainly had the right to go and look and did not."

The case proceeded to trial at which time Life General renewed its motion to amend, without success. The motion was also renewed several times during trial, and was denied.

The appellant suggests that the trial court was without discretion to deny the motion. It reasons that since its answer set forth affirmative defenses to which the appellee did not reply, it was entitled to amend its answer "as a matter of course at any time before a responsive pleading is served...." Fla.R.Civ.P. 1.190(a).

Rule 1.100(a) includes the provision, "If an answer ... contains an affirmative defense and the opposing party seeks to avoid it, the opposing party shall file a reply containing the avoidance." Further, a portion of rule 1.140(a)(1) states, "If a reply is required, the reply shall be served within 20 days after service of the answer." Since no reply was ever served, the appellant urges, it still had the absolute right to amend its answer.

The...

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  • Boca Burger, Inc. v. Forum
    • United States
    • Florida Supreme Court
    • September 29, 2005
    ...also cited a bankruptcy case which he claimed was to the same effect. He then added that our decision in Life General Security Insurance Co. v. Horal, 667 So.2d 967 (Fla. 4th DCA 1996), "suggests that leave to amend or attempting to amend a complaint at the eleventh hour would cause prejudi......
  • Boca Burger, Inc. v. Forum, Case No. SC01-1830 (FL 7/7/2005)
    • United States
    • Florida Supreme Court
    • July 7, 2005
    ...also cited a bankruptcy case which he claimed was to the same effect. He then added that our decision in Life General Security Insurance Co. v. Horal, 667 So. 2d 967 (Fla. 4th DCA 1996), "suggests that leave to amend or attempting to amend a complaint at the eleventh hour would cause prejud......
  • Greenfield v. Manor Care, Inc.
    • United States
    • Florida District Court of Appeals
    • December 24, 1997
    ...have been given to appellant to attempt to state a cause of action against that defendant. See generally Life Gen. Sec. Ins. Co. v. Horal, 667 So.2d 967, 969 (Fla. 4th DCA 1996)(leave to amend should be granted unless the privilege has been abused, there is prejudice to the opposing party, ......
  • Dimick v. Ray
    • United States
    • Florida District Court of Appeals
    • December 27, 2000
    ...discretion. See N. Am. Speciality Ins. Co. v. Bergeron Land Dev., Inc., 745 So.2d 359 (Fla. 4th DCA 1999); Life Gen. Sec. Ins. Co. v. Horal, 667 So.2d 967, 969 (Fla. 4th DCA 1996). Florida Rule of Civil Procedure 1.190(a), which governs amendments prior to trial, provides in pertinent part ......
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