State Farm Fire & Cas. Co. v. Kambara
| Decision Date | 10 January 1996 |
| Docket Number | No. 94-1478,94-1478 |
| Citation | 667 So.2d 831 |
| Parties | 21 Fla. L. Weekly D156 STATE FARM FIRE & CASUALTY COMPANY, Appellant, v. Michael KAMBARA, Appellee. |
| Court | Florida District Court of Appeals |
Appeal from the County Court for Palm Beach County; Jeffrey J. Colbath, Judge.
Richard H. Gaunt, Jr. of Gaunt, Pratt & Radford, P.A., West Palm Beach, for appellant.
David J. Glatthorn of David J. Glatthorn, P.A., West Palm Beach, and Jane Kreusler-Walsh of Jane Kreusler-Walsh, P.A., West Palm Beach, for appellee.
Appellant, State Farm Fire & Casualty Company (State Farm), appeals from a judgment awarding appellee, Michael Kambara (Kambara), attorney's fees under section 627.428(1), Florida Statutes (1993), after he was forced to litigate his entitlement to receive medical payments coverage under a premises liability policy. This appeal is before us on a certified question from the county court to determine whether Kambara is an omnibus insured for purposes of an award of statutory attorney's fees. We accept jurisdiction pursuant to Florida Rule of Appellate Procedure 9.030(b)(4)(A). Because Kambara received first-party benefits under an omnibus clause of an insurance policy, we find he fits within the definition of an omnibus insured and is therefore entitled to statutory attorney's fees.
In awarding fees, the county court determined that Kambara as a claimant for "Med Pay proceeds of a premises liability policy of insurance is an omnibus insured and is entitled to an award of attorney's fees." However, the county court certified the following question as being of great public importance: 1
Is a claimant for Med Pay provisions of a premises liability policy of insurance an omnibus insured (entitling him/her to an award of attorney's fees) or a third party claimant who would not be entitled to an award of attorney's fees?
Kambara was a resident of an apartment complex which was insured by a premises liability policy issued by State Farm. After Kambara received injuries on the premises, he sought reimbursement of his medical expenses pursuant to the medical payments coverage portion of the premises liability policy which provided in pertinent part:
We will pay medical expenses for bodily injury caused by an accident on your premises you own or rent, on ways next to the premises you own or rent, or because of your operations. The accident must take place in the coverage territory during the policy period.
When State Farm denied payment on the claim, Kambara filed suit seeking reimbursement for his medical expenses pursuant to the policy's med pay provisions. The parties subsequently stipulated to his entitlement to the benefits, but not to statutory attorney's fees.
Subsection 627.428(1), in its present form, provides:
Upon the rendition of a judgment or decree by any of the courts of this state against an insurer and in favor of any named or omnibus insured or the named beneficiary under a policy or contract executed by the insurer, the trial court or, in the event of an appeal in which the insured or beneficiary prevails, the appellate court shall adjudge or decree against the insurer and in favor of the insured or beneficiary a reasonable sum as fees or compensation for the insured's or beneficiary's attorney prosecuting the suit in which the recovery is had.
(Emphasis added).
In Wilder v. Wright, 278 So.2d 1, 3 (Fla.1973), our supreme court held that the purpose of section 627.428 was "to discourage the contesting of valid claims of insureds against insurance companies ... and to reimburse successful insureds reasonably for their outlays for attorney's fees when they are compelled to defend or to sue to enforce their contracts." In Wilder an injured party had successfully sued both the insured and the insurer for damages resulting from the insured tortfeasor's negligence (at a time when joinder of insurance companies was permissible). The injured party then sought attorney's fees, not in his status as an insured but as a "named beneficiary" under the statute. Our supreme court rejected an expansion of the term "named beneficiary" to an injured party who occupied a third-party beneficiary relationship under the insurance policy.
In Roberts v. Carter, 350 So.2d 78 (Fla.1977), our supreme court again reiterated that an injured third party could not recover statutory attorney's fees for successful litigation of a liability insurance coverage dispute. The plaintiff was not seeking first-party benefits under the contract, but sought to establish the existence of liability insurance coverage which would then pay any judgment that the plaintiff obtained as a result of the insured's (tortfeasor's) liability.
The statute does not define "omnibus insured" and Florida cases construing the statute have not defined the term specifically. 2 However, omnibus insured is a term frequently used to refer to an individual insured under an omnibus clause of an insurance policy. The term "omnibus insured" was also used in Prygrocki v. Industrial Fire and Casualty Insurance Co., 407 So.2d 345 (Fla. 4th DCA 1981), decision approved, 422 So.2d 314 (Fla.1982), to refer to a pedestrian struck by a motor vehicle and entitled to the personal injury protection coverage of the policy insuring the motor vehicle. Our court determined that Prygrocki, a pedestrian, was entitled to attorney's fees as an omnibus insured because he fit squarely within the classification of individuals set forth in the insurance policy as entitled to medical payments under the personal injury coverage. Our supreme court in Industrial Fire & Casualty Insurance Co. v. Prygrocki, 422 So.2d 314 (Fla.1982), approved of our court's more expansive definition which did not limit insureds to "contracting insureds" or "named beneficiaries." Noting that "it is essential to give the statute its true meaning," our supreme court expressly rejected the more restrictive reading of the statute expressed by the third district in Fernandez v. Alonso, 375 So.2d 8 (Fla. 3d DCA 1979):
To limit attorney's fees under section 627.428(1) to those who have directly contracted with an insurer and paid the premiums for an insurance policy, and to extend Roberts beyond the third-party claimant situation and preclude omnibus insureds from seeking attorney's fees both misconstrues Roberts and erroneously interprets the statute.
At the time of this court's decision in Prygrocki, section 627.428(1) referred only to "an insured...
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