Washington National Ins. Corp. v. Ruderman, 117 So. 3d 943 (Fla. 2013)
In a 3-1-3 split, Justices Labarga, Pariente, and Perry (in what was referred to as the “majority” opinion) held that an ambiguous insurance contract should always be construed against the insurer without ever resorting to extrinsic evidence. Justice Lewis “concur[red] in the result.” Chief Justice Polston, Justice Quince and Justice Canady (in the “minority” opinion) held that extrinsic evidence should be considered before resorting to strictly construing the insurance contract against the drafter.
A number of insureds filed a class-action suit in a Florida federal district court against Pioneer Life Insurance Company (later succeeded by Washington National Insurance Corporation), seeking reimbursement of certain home health care expenses. The dispute between the insureds and the insurer centered upon whether the insurance policy’s “Automatic Benefit Increase Percentage” provision applied only to the daily benefit amount, or also to per-occurrence and lifetime maximum benefit amounts.
The federal district court ruled the policy ambiguous, construed the policy in favor of the insureds, and granted them summary judgment. The insurer appealed to the 11th Circuit.
The 11th Circuit agreed the policy was ambiguous but stated that “the correct approach under Florida law in resolving the ambiguity in the policy is unclear.” It certified four questions to the Florida Supreme Court. It first asked the Florida Supreme Court if the policy was ambiguous. But another question would be of particular significance:
B. If an ambiguity exists in this insurance policy—as we understand that it does—should courts first attempt to resolve the ambiguity by examining available extrinsic evidence?
The “majority” decision: Three justices ruled the policy ambiguous.
They then took up the extrinsic evidence question. They determined the 11th Circuit’s confusion arose from its reading of Excelsior Insurance Co. v. Pomona Park Bar & Package Store, 369 So. 2d 938 (Fla. 1979), in which the Florida Supreme Court had held, “Only when a genuine inconsistency, uncertainty, or ambiguity in meaning remains after resort to the ordinary rules of construction is the rule apposite.” The Ruderman majority explained that a number of opinions issued since Excelsior provide a black-letter rule “that where a contract of insurance is ambiguous, it is to be liberally construed in favor of coverage and strictly against the insurer.” The majority concluded that, in this case, “because the policy is ambiguous it must be construed against the insurer and in favor of coverage without resort to consideration of extrinsic evidence.”
Justice Lewis “concur[red] in result,” without any further explanation.
The remaining three justices ruled that the policy was not ambiguous. But they held that if it were ambiguous, “it is well-settled Florida law that parties may attempt to resolve an ambiguity through available extrinsic evidence before applying the last-resort principle of construction against the drafter.” They cited a number of cases supporting their conclusion that extrinsic evidence may be considered because interpretation of an insurance policy is governed by contract law. They also held that the procedure of construing an ambiguity against the drafter is “not to be resorted to unless necessary.” Ultimately, the “dissent” concluded that “well-settled Florida law allows the use of available extrinsic evidence to construe an ambiguous insurance contract, and no justification has been given for receding from our precedent.”
With the Florida Supreme Court split in this manner, it is unclear whether the “majority’s” holding is limited to this case or has precedential value for other cases. At the very least, both opinions provide persuasive arguments that may be useful in future cases.