Case Title: State Farm Mut. Auto. Ins. Co. v. Curran (with)

Citation: 

Docket Number: 

State: florida

Court: Florida Supreme Court

Date: 2014-03-13T00:00:00Z

Document:
Supreme Court of Florida 
 
 
____________ 
 
No. SC12-157 
____________ 
 
STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, 
 
Petitioner, 
 
 
vs. 
 
ROBIN CURRAN, 
Respondent. 
 
[March 13, 2014] 
 
LABARGA, J. 
 
This case is before the Court for review of the decision of the Fifth District 
Court of Appeal, sitting en banc, in State Farm Automobile Insurance Co. v. 
Curran, 83 So. 3d 793 (Fla. 5th DCA 2011).  In its decision the district court ruled 
upon the following question, which the court certified to be of great public 
importance: 
WHEN AN INSURED BREACHES A [COMPULSORY MEDICAL 
EXAMINATION] PROVISION IN AN UNINSURED MOTORIST 
CONTRACT, (IN THE ABSENCE OF CONTRACTUAL 
LANGUAGE SPECIFYING THE CONSEQUENCES OF THE 
BREACH) DOES THE INSURED FORFEIT BENEFITS UNDER 
THE CONTRACT WITHOUT REGARD TO PREJUDICE, OR 
DOES THE PREJUDICE ANALYSIS DESCRIBED IN BANKERS 
INSURANCE CO. V. MACIAS, 475 So. 2d 1216, 1218 (Fla. 1985), 
 
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APPLY?  IF PREJUDICE MUST BE CONSIDERED, WHO BEARS 
THE BURDEN OF PLEADING AND PROVING THAT ISSUE? 
 
Id. at 806-07.  We have jurisdiction.  See art. V, § 3(b)(4), Fla. Const.  In line with 
the legal analysis we adopt, we clarify the issue presented by rephrasing the 
certified question as follows: 
WHEN AN INSURED BREACHES A COMPULSORY MEDICAL 
EXAMINATION PROVISION IN AN UNINSURED MOTORIST 
CONTRACT, DOES THE INSURED FORFEIT BENEFITS UNDER 
THE CONTRACT WITHOUT REGARD TO PREJUDICE?  IF 
PREJUDICE MUST BE CONSIDERED, WHO BEARS THE 
BURDEN OF PLEADING AND PROVING THAT ISSUE? 
      
We answer the first portion of the certified question in the negative.  As to the 
second portion of the certified question, we hold that the insurer as the defensive 
party pleading an affirmative defense has the burden of pleading and proving 
prejudice.  For the reasons explained below, we approve the decision of the Fifth 
District. 
BACKGROUND AND FACTS 
The facts of this case are fully set forth in the Fifth District’s opinion in 
Curran.  Id. at 794-800.  We briefly summarize the facts here.  This case arose as a 
result of a June 2006 traffic accident involving Robin Curran, insured by State 
Farm Automobile Insurance Company (State Farm), and the underinsured motorist 
who rear-ended Curran’s car.  Subsequently, Curran and the underinsured motorist 
reached a settlement agreement, which was approved by State Farm.  On July 19, 
 
- 3 - 
2007, through counsel, Curran requested her $100,000 underinsured motorist 
policy limits and offered to settle and release State Farm from an uninsured 
motorist (UM) lawsuit if it tendered the policy limits no later than August 18, 
2007.  In the letter to State Farm, Curran indicated that her damages were 
estimated to be $3.5 million because she suffered from reflex sympathetic 
dystrophy syndrome (RSD) type 1.1  On August 17, 2007, State Farm contacted 
Curran’s counsel to schedule a compulsory medical examination (CME) with 
Dr. Joseph Uricchio2
                                         
 
1.  Reflex sympathetic dystrophy syndrome (RSD), also known as complex 
regional pain syndrome, “is an uncommon form of chronic pain that usually affects 
an arm or leg.”  Mayo Clinic, Complex regional pain syndrome, Definition 
(Mar. 31, 2011), http://www.mayoclinic.com/health/complex-regional-pain-
syndrome/ DS00265 (last visited Nov. 5, 2012).  RSD “typically develops after an 
injury, surgery, stroke or heart attack, but the pain is out of proportion to the 
severity of the initial injury, if any.”  Id.  Type 1 RSD “occurs after an illness or 
injury that [did not] directly damage the nerves in [an] affected limb.”  Mayo 
Clinic, Complex regional pain syndrome, Causes (Mar. 31, 2011), 
http://www.mayoclinic.com/health/complex-regional-pain-
syndrome/DS00265/DSECTION=causes (last visited Nov. 5, 2012). 
 pursuant to the terms of the policy, which provide that a 
claimant has the duty to  
2.  Curran’s physician also referred her to Dr. Uricchio independently.  
Curran stated in her deposition that she attempted to schedule an appointment with 
Dr. Uricchio, but she was informed that he was no longer scheduling appointments 
with new patients.  In addition, the trial court took judicial notice that Dr. Uricchio 
had over thirty years of experience as a testifying expert on behalf of insurers.  
State Farm, however, claimed that Dr. Uricchio was an expert on RSD and often 
lectured about RSD on behalf of plaintiffs. 
 
 
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be examined by physicians chosen and paid by us as often as we 
reasonably may require.  A copy of the report will be sent to the 
person upon written request.  The person or his or her legal 
representative if the person is dead or unable to act shall authorize us 
to obtain all medical reports and records. 
 
Further, in a different section, the policy also provided that “[t]here is no right of 
action against [State Farm] until all terms of this policy have been met.” 
After this initial letter, Curran and State Farm exchanged several contentious 
letters regarding attempts by State Farm to schedule the CME.3
                                         
 
3.  A complete discussion of the substance of these letter exchanges is set 
forth in Curran, 83 So. 3d at 795-99.  Most of the letters involved Curran’s 
attempts to condition her attendance at the CME on provisos that would prevent 
State Farm from fully asserting its contractual rights under the policy.  For 
instance, Curran would only submit to a CME if it were the only CME State Farm 
would request both prior to litigation and during potential litigation.  Further, 
Curran sought to limit State Farm’s choice of physicians to conduct the 
examination. 
  Ultimately, 
however, Curran refused to attend a CME despite receipt of a reservation of rights 
letter from State Farm stating that her failure to “assist and cooperate” with the 
insurer may result in a denial of coverage.  Instead, Curran filed suit against State 
Farm.  State Farm answered and asserted an affirmative defense contending that 
Curran was not entitled to coverage under the policy because she breached the 
CME provision, which State Farm characterized as a condition precedent to 
coverage under the policy.  Thereafter, State Farm moved for summary judgment 
on the coverage issue claiming it was entitled to decline coverage as a matter of 
 
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law.  Curran also filed a motion for summary judgment contending that the CME 
provision was not a condition precedent to coverage and that, at worst, her 
complaint was filed prematurely.  Curran further claimed that she did not refuse to 
submit to a CME, but only asserted reasonable requests to protect her own personal 
interests, which requests had been ignored by State Farm.  Following the hearing 
on both motions, the trial court entered its order granting summary judgment in 
favor of Curran.4
Curran’s complaint then proceeded to a jury trial, which culminated in an 
award of $4,650,589 in damages to Curran.  Curran, 83 So. 3d at 800.  The trial 
court entered a judgment against State Farm for the $100,000 UM policy limits and  
State Farm appealed the judgment to the Fifth District.
 
5
On appeal, the Fifth District sitting en banc concluded that under these 
undisputed facts, Curran did not act reasonably in insisting that State Farm 
abandon its contractual rights as a condition to an examination and, consequently, 
 
                                         
 
4.  The trial court found that State Farm’s request for a CME was “not 
unreasonable,” but also found that Curran’s requested conditions were “not 
unreasonable,” except for the condition that State Farm waive further 
examinations.  Thus, the trial court concluded that Curran did not refuse to appear 
for the examination as asserted by State Farm. 
 
5.  The Fifth District initially rendered a panel decision in favor of State 
Farm, finding that Curran refused to attend a scheduled CME prior to filing suit 
and that Curran’s breach prohibited recovery under the policy.  The Fifth District, 
however, granted Curran’s motion for rehearing en banc and withdrew the panel 
opinion.  Curran, 83 So. 3d at 794-95. 
 
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breached the contract when she failed to attend the CME.  It concluded, however, 
that in order “to avoid liability under the insurance policy based on noncompliance 
with the CME clause, it was essential that State Farm plead and prove a material 
breach, which means a breach causing prejudice.” 6
In concluding that State Farm must plead and prove prejudice, the Fifth 
District relied on this Court’s precedent in Bankers Insurance Co. v. Macias, 475 
So. 2d 1216 (Fla. 1985), and Custer Medical Center v. United Automobile 
Insurance Co., 62 So. 3d 1086 (Fla. 2010), for support.
  Id. at 803. 
7
                                         
 
6.  The Fifth District affirmed the trial court’s decision on a different basis.  
Specifically, the trial court granted summary judgment in favor of Curran finding 
that she had not refused to appear for the CME as argued by State Farm.  The Fifth 
District, however, held that she refused to appear, but that State Farm did not prove 
it was prejudiced by Curran’s failure to attend the CME.  Thus, Curran’s breach of 
the CME provision did not result in forfeiture of UM benefits. 
  The district court noted 
 
7.  In Bankers Insurance Co. v. Macias, the Court held that a presumption of 
prejudice arises where an insured fails to give timely notice of an accident to the 
insurer.  475 So. 2d at 1217.  In reaching this result, the Court noted that different 
presumptions arise depending on which duty has been breached.  Specifically, if 
the insured breaches a notice provision, prejudice to the insurer is presumed, but 
may be rebutted, whereas if a cooperation clause has been breached, the insurer 
must show a material failure to cooperate which substantially prejudiced the 
insurer.  Id. at 1217-18.  Further, the Court held that a “failure to cooperate is a 
condition subsequent and it is proper to place the burden of showing prejudice on 
the insurer.”  Id. at 1218. 
In Custer Medical Center v. United Automobile Insurance Co., a case 
primarily discussing the limitations of second-tier certiorari review, we held that an 
insured’s attendance at a medical examination was not a condition precedent to the 
existence of an automobile insurance policy that provided personal injury 
protection benefits.  62 So. 3d at 1100.  The Court reasoned that medical 
examinations in the personal injury protection context, as opposed to the life 
 
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that in Macias, this Court concluded that neither the failure to timely report a claim 
nor the breach of the duty to cooperate gives rise to the automatic forfeiture of 
insurance benefits absent prejudice to the insurer.  Curran, 83 So. 3d at 802.  
Applying Macias to the contractual provision here, the Fifth District concluded that 
the provision was analogous to the claims notice provision discussed in Macias, 
but also overlapped with the insured’s duty to cooperate in that the insurer was 
given the opportunity to obtain evidence from the insured.  Further, the court 
observed that in its reservation of rights letter dated September 18, 2007, State 
Farm treated Curran’s actions as a breach of the duty to cooperate.  However, the 
Fifth District concluded that a determination of whether the CME clause in the 
contract was more analogous to a claims notice provision or a cooperation clause 
was relevant only to the question of who has the burden on the issue of prejudice.  
Curran, 83 So. 3d at 802.  The court then noted that Custer resolved this issue by 
finding that a “CME provision is a ‘condition subsequent,’ the nonoccurrence of 
which is an affirmative defense that the insurer has the burden to plead and prove.”  
See Curran, 83 So. 3d at 802-03 (citing Custer, 62 So. 3d at 1097-99). 
                                                                                                                                   
insurance context, were not scheduled prior to the existence of an automobile 
insurance policy or prior to an injury, but instead occur when the insured has 
sustained an accident after a policy has been issued.  Id. at 1099.  Thus, the Court 
also held that the insurer has the burden of proof on this issue.  Id. at 1100. 
 
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Having determined that in order to defeat coverage State Farm had the 
burden to plead and prove that Curran’s breach caused prejudice, the Fifth District 
held that State Farm failed to meet its burden, stating: 
Even had State Farm argued prejudice, the record refutes any such 
allegation, at least to the extent that it would affect entitlement to the 
UM contract benefits.  Immediately upon filing suit (seven days after 
the scheduled examination), Curran offered to submit to a medical 
examination pursuant to Florida Rule of Civil Procedure 1.360 (also 
well before the expiration of the time period under the Civil Remedies 
Notice).  State Farm declined Curran’s offer, electing instead to defer 
an examination until after the court first decided “if your client’s 
failure to cooperate and failure to comply with all policy terms, 
conditions, limits, provisions and applicable Florida law affects 
coverage under the provisions which you now seek benefits.”  After 
the lower court ruled, the record reflects that Curran submitted to a 
CME with Dr. Uricchio.  State Farm elected not to call Dr. Uricchio 
as a trial witness.  There is no indication that the validity of the CME 
was affected by the short lapse of time attributable to Curran or that 
the rule 1.360 examination was materially different from the CME 
State Farm would have performed under the contract.  The effect of 
Curran’s breach was clearly inconsequential as it pertained to the 
merits of her claim for UM benefits. 
 
Id. at 806 (footnote omitted).  The Fifth District then certified a question to this 
Court as one involving great public importance.8
State Farm contends that Curran’s failure to attend a CME is a breach of a 
condition precedent to both coverage and to suit, which constitutes a material 
  Curran, 83 So. 3d at 807. 
                                         
 
8.  The Fifth District also certified conflict with De Ferrari v. Government 
Employees Ins. Co., 613 So. 2d 101 (Fla. 3d DCA 1993), and Goldman v. State 
Farm Fire General Insurance Co., 660 So. 2d 300 (Fla. 4th DCA 1995).  Because 
we granted review based on the certified question, we do not address the certified 
conflict cases. 
 
- 9 - 
breach of the policy resulting in forfeiture of coverage irrespective of any showing 
of prejudice to State Farm.  State Farm also contends that if prejudice is an issue, 
this Court should remand to the trial court so that State Farm has an opportunity to 
prove Curran’s breach resulted in actual prejudice.  Because Curran does not 
contest the Fifth District’s finding that she breached the contract, the pertinent 
issue on appeal is whether the breach of such a provision precludes recovery under 
the policy as a matter of law without regard to whether the breach resulted in actual 
prejudice to the insurer.  For the following reasons, we agree with the Fifth District 
and hold that the forfeiture of benefits under the policy will not automatically 
result upon an insured’s breach of a CME provision unless the insurer pleads and 
proves actual prejudice as an element of its affirmative defense.  In addition, 
because the undisputed facts demonstrate that State Farm was not prejudiced, we 
conclude that it is unnecessary to remand the case for further proceedings relating 
to a determination on the question of prejudice. 
ANALYSIS 
Pursuant to section 627.727(1), Florida Statutes (2007), insurers issuing 
motor vehicle policies in Florida are mandated by statute to offer uninsured 
motorist coverage unless the insured has expressly rejected the coverage.  The 
term “uninsured motor vehicle” includes an underinsured motor vehicle, which 
occurs where the liability insurer has provided lower bodily injury liability limits 
 
- 10 - 
than the damages sustained by the person legally entitled to recover damages.  
§ 627.727(3)(b), Fla. Stat. (2007).  Uninsured motorist coverage is intended to 
protect persons who are legally entitled to recover damages for injuries caused by 
owners or operators of uninsured or underinsured motor vehicles.  Flores v. 
Allstate Ins. Co., 819 So. 2d 740, 744 (Fla. 2002).  In addition, we have stressed 
that the statute is not designed “for the benefit of insurance companies or motorists 
who cause damage to others.”  Young v. Progressive Se. Ins. Co., 753 So. 2d 80, 
83 (Fla. 2000) (citing Brown v. Progressive Mut. Ins. Co., 249 So. 2d 429, 430 
(Fla. 1971)).  Indeed, section 627.727 was intended to place the injured party in 
the same position as he or she would have been had the tortfeasor been insured.  
See Moore v. Allstate Ins. Co., 570 So. 2d 291, 293 (Fla. 1990).  We are mindful 
of these principles when deciding whether an insured’s failure to attend a CME 
prior to filing suit results in automatic forfeiture without regard to prejudice when 
such a breach is raised by an insurer as an affirmative defense. 
Prior to turning to the language of the insurance provisions at issue here, we 
briefly review the role of compulsory medical examinations in the UM coverage 
context.  As was the case here, after an insured has been injured in an accident with 
an uninsured or underinsured motorist, an insured will generally settle a claim with 
the uninsured or underinsured motorist with approval from the insured’s UM 
coverage carrier.  See § 627.727(6)(a), Fla. Stat. (2007) (providing that if an 
 
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injured person agrees to settle a claim with a liability insurer and its insured, and 
the settlement would not fully satisfy the claim for personal injuries so as to create 
an underinsured motorist claim, then written notice of the proposed settlement 
must be submitted to all underinsured motorist insurers that provide coverage).  
The insured then submits a claim for UM benefits to the insurer alleging legal 
entitlement to additional damages because the total loss was not covered by the 
underinsured motorist’s policy.  Here, Curran sent a demand letter to State Farm 
requesting payment of the policy limits. 
As a result of submitting the notice of a claim, the insured then typically has 
a duty under the insurance policy to provide medical bills, medical records, and 
any other information the insurer believes will help with processing the claim.  If 
the UM insurer, after review of information compiled from medical bills, medical 
records, and other information that is provided to substantiate an insured’s claim, 
questions the severity of the injury, it may request a medical examination to aid its 
review of the insured’s claim.9
                                         
9.  Although two doctors diagnosed Curran with RSD and she independently 
attempted to make an appointment with Dr. Uricchio prior to State Farm’s request 
for a medical examination and subsequent suit, State Farm argued in its briefs that 
a medical examination is essential, especially in cases where an insured is claiming 
a significant loss due to complications from injuries, such as RSD, which are 
subjective in nature. 
  Cf. U.S. Sec. Ins. Co. v. Cimino, 754 So. 2d 697, 
701 (Fla. 2000) (noting that, in a personal injury protection benefits context, a 
medical examination is a potential step in the direction of litigation because the 
 
- 12 - 
insured is claiming an entitlement to benefits and the insurer is questioning the 
necessity for same).  Thus, a CME is typically requested to provide the insurer 
additional information used to determine whether the insured is legally entitled to 
recover damages after an injury is sustained and a UM claim has been submitted. 
Given this context, we reject the approach State Farm has asked this Court to 
approve.  Specifically, State Farm argues that the provision at issue is a condition 
precedent to coverage and to suit, the breach of which constitutes a material breach 
of the policy resulting in forfeiture of coverage irrespective of any showing of 
prejudice to the insurer.  Curran, on the other hand, argues that the provision is a 
condition subsequent requiring proof of prejudice.  The terms “condition 
precedent” and “condition subsequent” are defined as follows in Florida: 
A condition precedent is one that is to be performed before the 
contract becomes effective.  Conditions subsequent are those that 
pertain not to the attachment of the risk and the inception of the policy 
but to the contract of insurance after the risk has attached and during 
the existence thereof.  A condition subsequent presupposes an 
absolute obligation under the policy and provides that the policy will 
become void, or its operation defeated or suspended, or the insurer 
relieved wholly or partially from liability, upon the happening of 
some event or the doing or omission of some act. 
 
31 Fla. Jur. 2d Insurance § 2686 (2013) (footnotes omitted).10
                                         
10.  The Supreme Court of Nebraska has given examples of conditions 
precedent as the obligation of the applicant to satisfy the requirements of 
insurability, be in good health for life and health insurance policies, pay the 
required premium, and answer all questions in the application to the best of the 
 
 
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Pursuant to the terms of the automobile insurance policy in this case, Curran 
was required to 
be examined by physicians chosen and paid by [State Farm] as often 
as we reasonably may require.  A copy of the report will be sent to the 
person upon written request.  The person or his or her legal 
representative if the person is dead or unable to act shall authorize us 
to obtain all medical reports and records. 
 
Further, a section titled “Suits Against Us” provides in pertinent part that “[t]here 
is no right of action against [State Farm] until all terms of this policy have been 
met.”  According to State Farm, the CME provision is a condition precedent to suit 
and coverage because of the “Suits Against Us” provision.  We disagree.  As 
discussed below, we conclude that a CME provision in the UM context is a post-
loss obligation of the insured and is not a condition precedent to coverage. 
First, in Custer, we held that an insured’s attendance at a medical 
examination was not a condition precedent to the existence of an automobile 
insurance policy that provided personal injury protection (PIP) benefits.  See 62 
So. 3d at 1100.  The Court reasoned that medical examinations in a PIP context are 
not scheduled prior to the existence of a policy or prior to an injury, but instead are 
scheduled after a policy has been issued, injuries have been sustained, and the 
insured has notified the insurer of a loss.  Id. at 1099.  We further noted that “an 
                                                                                                                                   
applicant’s knowledge and belief.  D & S Realty, Inc. v. Markel Ins. Co., 789 
N.W.2d 1, 9-10 (2010). 
 
 
- 14 - 
unreasonable failure to attend a requested medical examination may be a condition 
subsequent that divests the insured’s right to receive further PIP benefits.”  Id. at 
1098-99.  Similarly, as discussed above, compulsory medical examinations in the 
UM coverage context may be requested by insurers after a policy has been issued, 
an insured has sustained an accident or loss, and an insured has submitted a claim 
for UM benefits. 
Second, the “no action” language in the policy applies to every term of the 
policy, regardless of whether the insured’s duties are capable of being performed 
prior to filing an action against the insurer.  Consequently, adherence to State 
Farm’s argument would turn every duty, including the duty to assist and 
cooperate,11 considered a condition subsequent in Macias, into a condition 
precedent to coverage and suit.12
                                         
 
11.  State Farm sent a reservation of rights letter to Curran stating that her 
failure to “assist and cooperate” with the insurer may result in a denial of coverage. 
  Macias, 475 So. 2d at 1218 (failure to cooperate 
is a condition subsequent and it is proper to place the burden of showing prejudice 
on the insurer).  Further, the term “until” suggests that any cause of action filed 
before compliance with all of the terms of the policy is simply premature, which 
generally results in an abatement of the action.  See Bierman v. Miller, 639 So. 2d 
12.  Some tasks that form the duty to assist and cooperate are not necessarily 
capable of being performed prior to filing an action against the insurer.  For 
instance, an insured’s duty to assist an insurer in making settlements and attending 
and getting witnesses to attend hearings and trials are unlikely to be capable of 
performance prior to trial. 
 
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627, 628 (Fla. 3d DCA 1994) (“The proper remedy for premature litigation is an 
abatement or stay of the claim for the period necessary for its maturation under the 
law.” (quoting Angrand v. Fox, 552 So. 2d 1113, 1115 (Fla. 3d DCA 1989))). 
Accordingly, a CME provision in the UM coverage context is not a 
condition precedent to coverage and we find that an insured’s breach of this 
provision should not result in post-occurrence forfeiture of insurance coverage 
without regard to prejudice.  Cf. Macias, 475 So. 2d at 1217-18 (noting that a 
showing of prejudice is relevant when an insured breaches a cooperation clause, 
which is a condition subsequent, or a notice provision); Tiedtke v. Fidelity & Cas. 
Co. of New York, 222 So. 2d 206, 209 (Fla. 1969) (adopting the view that a 
showing of prejudice is relevant when considering whether an insured’s breach of 
a notice provision relieves the insurer of liability). 
 
Having concluded that prejudice is a necessary consideration when the 
insured breaches a CME provision, we also hold that the burden of pleading and 
proving that issue is on State Farm.  State Farm raised this issue as an affirmative 
defense.  “An affirmative defense is a defense which admits the cause of action, 
but avoids liability, in whole or in part, by alleging an excuse, justification, or 
other matter negating or limiting liability.”  St. Paul Mercury Ins. Co. v. Coucher, 
837 So. 2d 483, 487 (Fla. 5th DCA 2002).  “[T]he plaintiff is not bound to prove 
that the affirmative defense does not exist.”  Custer, 62 So. 3d at 1096.  Further, in 
 
- 16 - 
Macias, we held that “[a] failure to cooperate is a condition subsequent and it is 
proper to place the burden of showing prejudice on the insurer.”  475 So. 2d at 
1218; accord Ramos v. Nw. Mut. Ins. Co., 336 So. 2d 71 (Fla. 1976) (an insurer 
may not avoid liability under its policy by merely showing the violation of a clause 
requiring assistance and cooperation of the insured without a further showing of 
how this violation prejudiced the insurer).  Accordingly, because the insurer is the 
defensive pleader, it has the burden of pleading and persuasion of each element of 
the defense. 
Given the UM statute’s intended purpose of protecting persons who are 
legally entitled to recover damages for injuries caused by owners or operators of 
uninsured or underinsured motor vehicles, our conclusion that the insurer must 
plead and prove prejudice as an element of its affirmative defense fully comports 
with this purpose.  See Flores, 819 So. 2d at 744 (discussing the intended purpose 
of the UM coverage statute).  It also places the injured party in the same position as 
the injured party would have been had the tortfeasor been insured.  See Moore, 570 
So. 2d at 293.  Further, the insurer still has two remedies for such a breach: (1) it 
may seek to abate the proceedings until the insured has complied with the CME 
provisions; or (2) if the insured’s breach did indeed prejudice the insurer, it may 
assert a breach of the CME requirement as a complete defense to coverage under 
the policy upon proof of the prejudice.  We now turn to State Farm’s argument that 
 
- 17 - 
this Court should remand the case to the trial court for a determination regarding 
prejudice. 
 
We agree with the Fifth District that the undisputed facts demonstrate that 
State Farm was not prejudiced by Curran’s refusal to submit to a CME prior to the 
initiation of litigation.  Although State Farm did not advance a specific argument 
that it was prejudiced below, the record demonstrates that Curran’s refusal to 
submit to a CME did not prejudice State Farm in any fashion.  Shortly after filing 
suit, Curran offered to submit to a medical examination pursuant to Florida Rule of 
Civil Procedure 1.360.  State Farm, however, elected to defer the examination until 
after the trial court determined whether Curran had forfeited coverage under the 
policy.  After the trial court found that Curran had not unreasonably refused to 
attend the examination, Curran attended a CME with Dr. Uricchio, the same expert 
that State Farm requested Curran see prior to litigation.  Dr. Uricchio was not 
called to testify as a trial witness and there is nothing in the record that indicates 
the delayed CME affected the integrity of the evaluation.  Thus, the record is 
devoid of evidence that would suggest that Curran’s refusal to submit to a CME 
prior to suit prejudiced State Farm.  Accordingly, it is unnecessary to remand the 
case for determination of prejudice.  See Tiedtke, 222 So. 2d at 209 (unnecessary 
to remand case for determination of prejudice where record amply establishes no 
prejudice to insurer). 
 
- 18 - 
CONCLUSION 
For the reasons set forth above, we answer the restated certified question by 
holding that an insured’s breach of a CME provision in an uninsured motorist 
policy of insurance does not result in forfeiture of benefits unless the insurer pleads 
and proves it was prejudiced as part of its affirmative defense.  Accordingly, we 
approve the decision of the Fifth District in State Farm Automobile Insurance Co. 
v. Curran, 83 So. 3d 793 (Fla. 5th DCA 2011). 
 
It is so ordered. 
 
PARIENTE and PERRY, JJ., concur. 
LEWIS, J., concurs in result, with an opinion. 
QUINCE, J., concurs in result. 
POLSTON, C.J., dissents with an opinion in which CANADY, J. concurs. 
 
NOT FINAL UNTIL TIME EXPIRES TO FILE REHEARING MOTION, AND 
IF FILED, DETERMINED. 
 
LEWIS, J., concurring in result. 
 
While I concur with the result reached in this case, I write separately 
because I believe this issue is also governed by an additional body of law other 
than that expressed by the majority.  Every motor vehicle liability insurer in this 
State is statutorily mandated to offer uninsured motorist coverage unless the 
insured has expressly rejected the coverage.  See § 627.727, Fla. Stat. (2007).  
When an insured seeks to recover uninsured motorist benefits from its insurance 
carrier, the insured’s uninsured motorist carrier stands in the shoes of the uninsured 
 
- 19 - 
motorist, thereby placing the insurer in a position adverse to the insured.  Diaz-
Hernandez v. State Farm Fire & Cas. Co., 19 So. 3d 996, 999 (Fla. 3d DCA 2009).  
The Legislature intended for this statutorily mandated coverage to broadly protect 
innocent persons who are injured through the negligence of an uninsured motorist, 
and not to benefit insurance companies or motorists who cause damage to others.  
Young v. Progressive Se. Ins. Co., 753 So. 2d 80, 83 (Fla. 2000); see also Salas v. 
Liberty Mut. Fire Ins. Co., 272 So. 2d 1, 5 (Fla. 1972) (noting that “the intention of 
the Legislature, as mirrored by the decisions of this Court, is plain to provide for 
the broad protection of the citizens of this State against uninsured motorists”).  
Furthermore, we have repeatedly recognized that “as a creature of statute rather 
than a matter for contemplation of the parties in creating insurance policies, the 
uninsured motorist protection is not susceptible to the attempts of the insurer to 
limit or negate that protection.”  Salas, 272 So. 2d at 5; see also Mullis v. State 
Farm Mut. Auto. Ins. Co., 252 So. 2d 229, 237-38 (Fla. 1971) (noting that 
uninsured motorist coverage is “not to be ‘whittled away’ by exclusions and 
exceptions”).  For these reasons, provisions in uninsured motorist policies that 
provide less coverage than required by the statute are void as contrary to public 
policy.  Young, 753 So. 2d at 83. 
Here, Curran’s policy with State Farm contained a compulsory medical 
examination provision that allowed State Farm to require Curran to “be examined 
 
- 20 - 
by physicians chosen and paid by [State Farm] as often as [State Farm] reasonably 
may require.”  No such right exists in any third-party action.  As the plain language 
of the provision indicates, the CME provision does not account for or protect the 
interests, requests, or concerns of the insured.  Rather, this provision attempts to 
vest an insurer with exclusive power to require medical examinations as long as the 
insurer desires medical examinations, with nothing in the provision that limits how 
many medical examinations the insurer can require or under what conditions the 
insurer may require an examination.  See State Farm Mut. Auto. Ins. Co. v. Curran, 
83 So. 3d 793, 801 (Fla. 5th DCA 2011) (noting that the CME provision in 
Curran’s policy provided that it was “not necessary that State Farm agree to any 
proposed condition proffered by Curran” even if the condition was reasonable from 
the standpoint of the insured).   
In effect, this provision could operate to provide State Farm with unfettered 
discretion to require CMEs and empower State Farm with the contractual authority 
to constrict the availability of uninsured motorist benefits by precluding any action 
for such benefits when the insured fails to comply with State Farm’s demands for 
CMEs.  See Majority op. at 4 (noting that State Farm contended “that Curran was 
not entitled to coverage under the policy because she breached the CME 
provision”).  However, nothing in the uninsured motorist statute authorizes an 
insurer to place this type of direct and substantial burden upon the insured or to 
 
- 21 - 
deny coverage on the basis that the insured failed to submit to a compulsory 
medical examination.  Thus, this provision is not authorized by statute, and is 
directly contrary to the statutory purpose of uninsured motorist coverage.  See 
Diaz-Hernandez, 19 So. 3d at 999-1000 (invalidating a contractual provision as 
contrary to the public policy of the UM statute in part because there was “nothing 
in the UM statute” that authorized the insurer to require the insured to join the 
uninsured motorist in the insured’s contractual action against the insurer for UM 
coverage).  Accordingly, I would invalidate the compulsory examination provision 
as contained in Curran’s policy with State Farm along with the asserted result as an 
illegal contractual provision more restrictive than, and not supported by, the 
statutorily mandated uninsured motorist coverage.  See Young, 753 So. 2d at 83 
(holding that “provisions in uninsured motorist policies that provide less coverage 
than required by the statute are void as contrary to public policy”); see also Salas, 
272 So. 2d at 5; Mullis, 252 So. 2d at 237-38.  
 
POLSTON, C.J., dissenting. 
 
I respectfully dissent because the insurance policy at issue unambiguously 
includes a condition precedent that was not satisfied.  The policy plainly conditions 
Curran’s right to sue to recover uninsured motorist (UM) benefits from State Farm 
on her pre-suit submission to a compulsory medical examination (CME).  
 
- 22 - 
Specifically, it requires her to “be examined by physicians chosen and paid by 
[State Farm] as often as [State Farm] reasonably may require” and provides that 
“[t]here is no right of action against [State Farm] until all terms of this policy have 
been met.”  Curran did not attend either CME that State Farm acted in good faith to 
schedule despite Curran’s attempts to “unilaterally change the contract terms under 
the guise of proffered conditions” for the CME.  State Farm Mut. Auto. Ins. Co. v. 
Curran, 83 So. 3d 793, 801-02 (Fla. 5th DCA 2011).13
Under these facts, though State Farm argues for a complete forfeiture of 
benefits, the contract requires dismissal of Curran’s action because she had no right 
to bring it.  Of course, nothing in the contract prohibits Curran from submitting to 
the requested CME and refiling her suit against State Farm, if she may do so within 
the applicable statute of limitations period.   
  
However, instead of concluding that Curran’s failure to comply with the 
contract precludes her from suing State Farm until such time as she satisfies the 
condition precedent, the majority allows her judgment to stand over State Farm’s 
argument that it has no obligation to pay benefits that Curran had no right to sue 
                                         
 
13.  As Judge Monaco explained in his concurring opinion below, the 
“rather transparent motive” for Curran’s behavior was to put State Farm “in a 
position where it could not offer up the policy limits prior to suit, unless it did so 
without having a medical consultation that it had confidence in.  This was about as 
thinly disguised a bad faith trap as is imaginable.”  Curran, 83 So. 3d at 808 
(Monaco, J., concurring).   
 
- 23 - 
for.  To reach this result, the majority imposes an unprecedented requirement that 
the insurance company plead and prove that it is prejudiced by the insured’s failure 
to submit to a CME.  Moreover, the majority erroneously extends its holding to all 
UM policies regardless of what those policies might actually say.  See majority at 2 
(rephrasing the certified question to apply to all UM policies without deference to 
policy language specifying the consequences for failing to submit to a CME); see 
also State Farm Mut. Auto. Ins. Co. v. Menendez, 70 So. 3d 566, 569-70 (Fla. 
2011) (“In interpreting an insurance contract, we are bound by the plain meaning 
of the contract’s text.”).    
 
The linchpin of the majority’s decision is its determination that a CME 
provision is a condition subsequent (akin to a cooperation clause) and not a 
condition precedent.  Every other conclusion—who has the burden to plead and 
prove compliance with the CME provision; whether prejudice to the insurance 
company must result if the insured does not submit to a CME before filing suit; 
and, if prejudice is required, who has the burden to plead and prove it—flows from 
this determination.  Cf. Goldman v. State Farm Fire Gen. Ins. Co., 660 So. 2d 300, 
303-04 (Fla. 4th DCA 1995) (“A substantial line of cases supports the rule that an 
insurer need not show prejudice when the insured breaches a condition precedent 
to suit. . . .  On the other hand, if the provision is a [condition subsequent such as a] 
cooperation clause, the burden would be on the insurer to demonstrate substantial 
 
- 24 - 
prejudice before a breach would preclude recovery under the policy.”) (footnote 
omitted) (citations omitted).  Respectfully, the majority is incorrect on this critical 
issue. 
 
The error originates from the majority’s definition of a condition precedent 
as a condition that must be performed before a contract becomes effective.  See 
majority at 12.  By defining a condition precedent this way, the majority implies 
that every other type of condition is a condition subsequent that the insurance 
company must plead and prove to avoid liability.  See id.  However, this is 
incorrect because Florida also recognizes “a condition precedent to performance 
under an existing contract.”  Mitchell v. DiMare, 936 So. 2d 1178, 1180 (Fla. 5th 
DCA 2006); see also Black’s Law Dictionary 334 (9th ed. 2009) (defining a 
“condition precedent” as “[a]n act or event, other than a lapse of time, that must 
exist or occur before a duty to perform something promised arises”).  Further, this 
Court has consistently recognized that the party seeking to avoid a condition 
precedent to the other party’s duty to perform has the burden to plead and prove its 
satisfaction.  See, e.g., Bankers Ins. Co. v. Macias, 475 So. 2d 1216, 1218 (Fla. 
1985) (“The burden should be on the party seeking an avoidance of a condition 
precedent.”); see also Saris v. State Farm Mut. Auto. Ins. Co., 49 So. 3d 815, 818 
(Fla. 4th DCA 2010) (recognizing that the insured’s duty to “submit to a physical 
 
- 25 - 
examination” is a duty that “relate[s] to the insured’s burden to establish that he is 
entitled to coverage”). 
In addition to case law, treatises recognize that there are conditions 
precedent to the right to sue to recover contract benefits, not just to the contract’s 
existence.  See, e.g., Lee R. Russ & Thomas F. Segalla, Couch on Insurance § 
196:23 (3d ed. 2012) (addressing the consequences of failing to comply with 
“condition[s] precedent to recovery or to suit”).  For instance, one insurance 
treatise has explained that “[t]he CME requirement” at issue here “is analogous to 
the requirement for an examination under oath and is deemed a condition 
precedent to suit and to the recovery of benefits under the policy where the policy 
so provides” through a no-action provision.  2 Automobile Liability Insurance § 
26:17 (4th ed. 2013) (emphasis added).  See also 8-31 Corbin on Contracts § 31.1 
(2012) (explaining that a no-action provision is “[a] very common method” of 
creating a condition precedent to suit for recovery of contract benefits); Robert H. 
Jerry, II & Douglas R. Richmond, Understanding Insurance Law 589 (5th ed. 
2012) (“The insured’s submission to an examination under oath when requested by 
an insurer is a valid condition precedent to coverage.”).   
Here, by virtue of the contract’s plain language, Curran’s submission to a 
CME was a condition precedent to her right to sue for UM benefits and, as a 
necessary corollary, a prerequisite to State Farm’s duty to provide coverage under 
 
- 26 - 
the policy by paying those benefits.  See S. Home Ins. Co. v. Putnal, 49 So. 922, 
932 (Fla. 1909) (recognizing that an insured’s refusal to submit to an examination 
under oath required by a fire insurance policy “will preclude the insured from 
recovering upon the policy, where it provides that no suit can be maintained until 
after a compliance with such condition”); Shaw v. State Farm Fire & Cas. Co., 37 
So. 3d 329, 331 (Fla. 5th DCA 2010) (“It is undisputed that a provision in an 
insurance policy that requires the insured to submit to an [examination under oath] 
qualifies as a condition precedent to recovery of policy benefits.”); Starling v. 
Allstate Floridian Ins. Co., 956 So. 2d 511, 513-14 (Fla. 5th DCA 2007) (barring 
recovery under a property insurance policy because the insured failed to submit a 
proof-of-loss form, which was a “condition precedent to maintaining suit”); see 
also  20 John A. Appleman & Jean Appleman, Insurance Law and Practice § 
11416 (2013) (“A plaintiff must, in order to recover under a policy, plead and 
prove the performance of all conditions precedent to recovery. . . . and, if there is a 
condition precedent, the party in whose favor the condition exists is not liable to an 
action until that condition has been met.”) (footnote omitted). 
Therefore, under the plain language of the policy, any time before filing this 
suit, Curran could have submitted to the requested CME.  However, by filing suit 
without satisfying this condition (or pleading and proving facts excusing her failure 
to do so), Curran discharged State Farm’s obligation to perform under the contract 
 
- 27 - 
(at least with respect to this action).  See Restatement (Second) of Contracts § 225 
(1981) (“Performance of a duty subject to a condition cannot become due unless 
the condition occurs . . . .  [T]he non-occurrence of a condition discharges the duty 
when the condition can no longer occur.”); see also Kinman v. State Farm Mut. 
Auto. Ins. Co., 411 F. App’x 261, 261 (11th Cir. 2011) (concluding the trial court 
did not err by finding the insured was “not entitled to coverage under the uninsured 
motorist provision” because the “policy required him to submit to the [medical 
examination] and he unreasonably refused to do so”); Orozco v. State Farm Mut. 
Auto. Ins. Co., 360 F. Supp. 223, 224 & n.3 (S.D. Fla. 1972) (concluding a UM 
policy’s physical examination requirement was a “condition[] precedent to the 
imposition of liability upon the [insurer]” where the policy contained a no-action 
clause prohibiting suit “unless, as a condition precedent thereto,” the insured fully 
complied with the policy’s terms). 
Contrary to the majority’s suggestion otherwise, Curran’s duty to submit to a 
CME is not the same as the duty to cooperate that we have previously held is a 
condition subsequent.  See majority at 15-16.  First, and most importantly, 
Curran’s policy says these duties are different because it addresses her duty to 
“cooperate” and “assist” in “making settlements[,] securing and giving evidence[, 
and] attending and getting witnesses to attend hearings and trials” separately from 
her duty to submit to a CME.  Further, a duty to cooperate with the insurance 
 
- 28 - 
company while litigation is pending is markedly different from a CME requirement 
designed to give the insurance company the opportunity to investigate a claim and, 
if it is meritorious, pay benefits without resort to litigation.  Finally, the majority’s 
concern that recognizing the CME requirement as a condition precedent would, 
because of the no-action provision, turn every other contractual duty into a 
condition precedent is unfounded.  See majority at 14 & n.12.  If a duty is 
incapable of being performed before suit is filed, its performance cannot be a 
condition precedent to suit.  However, here, submission to the CME clearly could 
and should have occurred presuit, independent of Curran’s duty to cooperate 
during litigation.  See Soronson v. State Farm Fla. Ins. Co., 96 So. 3d 949, 952 
(Fla. 4th DCA 2012) (using a plain language analysis to conclude that an insurance 
policy’s notice and proof-of-loss requirements were conditions precedent to suit, 
not cooperation clauses). 
Because the CME provision is a condition precedent, prejudice to State 
Farm as a result of its breach is immaterial, and the correct result is that no action 
lies against State Farm as the contract provides.  See Goldman, 660 So. 2d at 303 
(“[A]n insurer need not show prejudice when the insured breaches a condition 
precedent to suit.”); see also Lee R. Russ & Thomas F. Segalla, Couch on 
Insurance § 196:2 (3d ed. 2012) (“[B]reach of a true condition precedent bars 
recovery without regard to prejudice.”) (citing Goldman, 660 So. 2d at 300); 31A 
 
- 29 - 
Fla. Jur. 2d Insurance § 3233 (2013) (“Policy provisions requiring insureds to 
submit to an examination under oath (EUO) are conditions precedent to a suit, 
rather than cooperation clauses, and thus, a failure to comply precludes an action 
on the policy by the insured regardless of a showing of prejudice by the insurer.  
The refusal of the insured to submit to an EUO when required to do so is also a 
material breach of the policy, which will justify the insurer’s denial of recovery.”) 
(footnotes omitted). 
Several courts have prevented plaintiffs who failed to submit to the presuit 
CMEs required by their insurance policies from recovering UM benefits.  For 
example, the Third District held that an insured who filed suit without submitting 
to a medical examination that was “a condition precedent to coverage” could not 
maintain her action for UM benefits regardless of whether her failure to submit to 
the examination prejudiced the insurance company.  De Ferrari v. Gov’t Emps. Ins. 
Co., 613 So. 2d 101, 103 (Fla. 3d DCA 1993).  Similarly, the Fourth District held 
that an examination under oath requirement was “a condition precedent to suit” 
under a homeowner’s policy and that the insured’s failure to submit to the 
examination before filing suit “preclude[d] an action on the policy regardless of a 
showing of prejudice by the insurer.”  Goldman, 660 So. 2d at 306.  Also, the 
District Court for the Northern District of Florida concluded that an insured 
materially breached a fire insurance policy by filing suit without submitting to a 
 
- 30 - 
required examination under oath.  Laine v. Allstate Ins. Co., 355 F. Supp. 2d 1303, 
1304 (N.D. Fla. 2005).  In granting summary judgment for the insurance company, 
the federal court rejected the argument that an insured’s failure to appear for an 
examination excuses the insurance company’s obligation to pay benefits only if it 
prejudiced the insurance company, concluding that argument is “subject to 
considerable doubt” under Florida law, which is concerned with the “materiality of 
the breach, not prejudice.”  Id. at 1306 (citing Goldman, 660 So. 2d 300; Stringer 
v. Fireman’s Fund Ins. Co., 622 So. 2d 145 (Fla. 3d DCA 1993); De Ferrari, 613 
So. 2d 101).14
In this case, I reject State Farm’s argument for a total forfeiture of benefits 
based on the plain language of the policy.  Specifically, the policy provides that 
Curran has “no right of action” against State Farm “until” the CME requirement is 
satisfied.  Therefore, because Curran sued without first submitting to the requested 
CME, I would require dismissal.  Cf. Clark v. Sarasota Cnty. Pub. Hosp. Bd., 65 F. 
 
                                         
 
14.  The Fifth District acknowledged conflict between the decision on 
review and Goldman and De Ferrari.  See Curran, 83 So. 3d at 807.  However, the 
majority elected not to address the issue.  See majority at 8 n.8.  In doing so, it 
ignored decisions supporting a contrary result, one of which—De Ferrari—
expressly and directly conflicts with the decision on review.  See 2 Automobile 
Liability Insurance § 26:17 (4th ed. 2013) (recognizing that the Fifth District’s 
decision in Curran “depart[s] from the rule” that a “CME requirement . . . is 
deemed a condition precedent to suit and to the recovery of benefits under the 
policy where the policy so provides [and it] does not require the insurer to show 
that it was prejudiced by the breach”) (footnotes omitted).   
 
- 31 - 
Supp. 2d 1308, 1310, 1312 (M.D. Fla. 1998) (recognizing that Florida’s statutory 
medical malpractice presuit requirements are conditions precedent to suit and that, 
under Florida law, claims filed absent compliance with these requirements must be 
dismissed with or without prejudice, depending on whether the defects can be 
cured before the statute of limitations runs).   
Instead of enforcing the contract’s plain language, the majority relies on this 
Court’s decisions in Macias, 475 So. 2d 1216, and Custer Medical Center v. United 
Automobile Insurance Co., 62 So. 3d 1086 (Fla. 2010), to hold that compliance 
with any CME requirement in any UM policy is a condition subsequent and, 
therefore, any insured who files suit without first submitting to a CME is precluded 
from recovering benefits only where the insurance company pleads and proves 
prejudice.  See majority at 13-15, 18.  Respectfully, neither decision compels nor 
supports the majority’s holding.   
In Macias, this Court held that a provision in a PIP policy requiring the 
insured to give notice of an accident was a condition precedent to a claim instead 
of a condition subsequent.  475 So. 2d at 1218.  We explained that, under our 
precedent regarding notice provisions, “[i]f the insured breaches the notice 
provision, prejudice to the insurer will be presumed, but may be rebutted by a 
showing that the insurer has not been prejudiced by the lack of notice.”  Id. (citing 
Nat’l Gypsum Co. v. Travelers Indem. Co., 417 So. 2d 254 (Fla. 1982); Tiedtke v. 
 
- 32 - 
Fid. & Cas. Co. of N.Y., 222 So. 2d 206 (Fla. 1969)).  Therefore, we concluded 
that “[t]he burden should be on the insured” as “the party seeking an avoidance of 
a condition precedent” to establish “lack of prejudice where the insurer has been 
deprived of the opportunity to investigate the facts and to examine the insured.”  
Id.   
While Macias says that its holding “should apply to claims under a PIP 
policy just as well as to claims under other policies,” Macias involved the breach 
of a notice provision.  Id.  Accordingly, our district courts have expressly declined 
to extend Macias to breaches of presuit examination requirements serving different 
purposes than notice provisions.  See De Ferrari, 613 So. 2d at 103 (“[P]rejudice is 
not at issue when an insurer’s reasonable request for [a medical examination] is 
refused by an insured.  The Macias case in no way created a new duty to establish 
prejudice, where none previously existed.”); see also Goldman, 660 So. 2d at 304, 
306 (holding that an examination under oath provision was “a condition precedent 
to suit and that [the insured’s] noncompliance precludes an action on the policy 
regardless of a showing of prejudice by the insurer” after noting that Macias did 
not decide this issue). 
However, even if Macias applied to the breach of an examination provision, 
thereby making prejudice an issue, it still would not support the majority’s decision 
to place the burden of pleading and proving prejudice on the insurance company.  
 
- 33 - 
As the Fourth District recognized in Goldman, “if prejudice were to be considered, 
the burden would fall on the insured to prove no prejudice to the insurer.”  660 So. 
2d at 305 n.8 (citing Macias, 475 So. 2d 1216); see also Laine, 355 F. Supp. 2d at 
1306 (recognizing that “even under the most favorable view of [Florida] law,” 
Macias would place the burden on the insured “to establish lack of prejudice”).  
Accordingly, Macias does not justify the majority’s decision. 
Custer also does not support the majority’s holding making the CME 
requirement a condition subsequent and placing the burden on the insurance 
company to plead and prove prejudice.  In Custer, 62 So. 3d at 1089, an insurance 
company refused to pay PIP benefits when its insured failed to appear for a 
medical examination the company scheduled after the insured completed all 
treatment for which PIP benefits were requested.  The governing statute provided 
that the insurance company is “no longer liable for subsequent personal injury 
protection benefits” if “a person unreasonably refuses to submit to an 
examination.”  Id. at 1090 (quoting § 672.736(7)(b), Fla. Stat. (2001)).  We 
explained that, under the PIP statute, “[a]ttendance at a medical examination may 
be a condition precedent to the payment of subsequent PIP benefits or, perhaps 
more accurately, an ‘unreasonable’ failure to attend a requested medical 
examination may be a condition subsequent that divests the insured’s right to 
receive further subsequent PIP benefits.”  Id. at 1098-99.  Therefore, we noted in 
 
- 34 - 
dicta that to avoid liability for subsequent PIP benefits (which were not at issue in 
Custer because all treatment occurred before the examination was requested), the 
insurance company must prove that the insured unreasonably refused to attend the 
examination.  Id. at 1100.   
Unlike the PIP statute in Custer, neither the UM statute nor Curran’s policy 
requires proof that Curran unreasonably refused to submit to a CME.  Likewise, 
Custer’s dicta concerning the burden of proof in the PIP context does not apply 
where the parties are litigating over uninsured motorist benefits.  Cf. Custer, 62 So. 
3d at 1099 (finding the Third District’s decision in De Ferrari “inapposite” because 
it pertained to “uninsured motorist benefits, and did not address PIP coverage”). 
Accordingly, neither Macias nor Custer provides a basis for this Court to 
condition enforcement of the parties’ contract on the insurance company’s ability 
to prove prejudice.15
                                         
 
15.  Even if I agreed with the majority’s new prejudice rule, I would 
disagree with its conclusion that the facts preclude a finding of prejudice to State 
Farm.  See majority at 17.  The fact that Curran filed suit without submitting to the 
CME deprived State Farm of its right to investigate and evaluate Curran’s injuries 
prior to litigation and unjustifiably exposed State Farm to a bad-faith claim.  This 
is sufficient to prove prejudice.  See Laine, 355 F. Supp. 2d at 1306 n.2 
(“Depriving the insurer of th[e] opportunity [to conduct an examination under 
oath] is sufficient prejudice, even if, indeed, prejudice is required.”).   
  Moreover, by moving beyond the facts of this case to adopt a 
general rule applicable to all UM policies that provides no deference for what those 
policies might actually say, the majority contravenes law requiring courts to 
 
- 35 - 
enforce the plain language of unambiguous contracts.  See Orozco, 360 F. Supp. at 
225 (“[T]he insurance policy is the contract between the parties and . . . the 
provisions of that contract which are clear and unambiguous and which are neither 
illegal by statute nor by reason of their being against public policy, should be 
enforced by the courts.  The courts may not rewrite for the parties insurance 
contracts which are clear and unambiguous.”).  Therefore, I respectfully dissent.   
Because the contract at issue specifies the consequences for Curran’s breach, 
I would rephrase the certified question as follows:  Where an insurance policy 
requires the insured to submit to a CME prior to filing suit against the insurance 
company, does an insured who inexcusably failed to submit to a CME have a right 
of action for UM benefits against the insurance company?  I would answer the 
rephrased question in the negative and quash the Fifth District’s decision in favor 
of the insured.  
CANADY, J., concurs. 
Application for Review of the Decision of the District Court of Appeal - Direct 
Conflict of Decisions  
 
 
Fifth District – Case No. 5D09-1488 
 
(Brevard County) 
  
Elizabeth Koebel Russo of Russo Appellate Firm, P.A., Miami, Florida; and The 
Turner Law Firm, LLC, Sarasota, Florida,  
 
 
for Petitioner 
 
 
- 36 - 
Gary M. Farmer, Sr., of Farmer Jaffe Weissing Edwards Fistos & Lehrman, P.L., 
Fort Lauderdale, Florida; O. John Alpizar, Palm Bay, Florida; and Marjorie 
Gadarian Graham, Palm Beach Gardens, Florida,  
 
 
for Respondent 
 
Bard Daniel Rockenbach of Burlington & Rockenbach, P.A., West Palm Beach, 
Florida, 
 
 
for Amicus Curiae Florida Justice Association