Priority Medical Rehabilitation Inc. v. United Automobile Insurance Company

In a recent Dade County case, the court ruled in order for a family member who lives with a named insured to be afforded PIP benefits in the state of Florida, the applicant or insured must disclose that family member at the time of application for auto insurance. If the insured fails to do so, the auto insurer can keep your premium and deny PIP benefits to the undisclosed family member.

In Priority Medical Rehabilitation Inc. v. United Automobile Insurance Company, the insured failed to disclose that her son resided in her household at the time that she applied for auto insurance. As a result, the insurer denied PIP coverage for the son’s medical expenses when he was injured in a motor vehicle accident. A healthcare provider, as an assignee, sued the insurer for breach of contract. However, the county court entered summary judgment for the insurer, and the circuit court affirmed.

The failure to disclose that the son was a member of the insured’s household precluded coverage for the son but not the insured. As a result, the insurer was entitled to retain the premium, which was calculated based upon the risk disclosed in the application.

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