Opinion ID: 76301
Heading Depth: 2
Heading Rank: 3

Heading: Other Issues to be Resolved on Remand

Text: 28 Torres argues that the district court erred in excluding from the record to be considered Torres' supplemental submission, in particular the Aetna letters of June 1999 and February 2001 declaring that Torres was unable to work at any reasonable occupation. The Insurers respond that exclusion was appropriate because Torres submitted this evidence after the instant suit was filed on February 22, 2001. Because the Insurers do not explain why the filing of the suit should cut off consideration of this supplemental evidence, but not cut off consideration of the Insurers' own decision letter of March 15, 2001, because the district court's discussion of this issue was inadequate, because the briefs on appeal with respect to this issue are inadequate, and because resolution of this issue may be affected by the other issues remanded for the district court's initial resolution, we vacate the district court's decision with respect to this issue and remand for the district court to address anew on remand. We express no opinion with respect to resolution of the issue. 29 We also note that the Insurers placed primary reliance in their brief on appeal, and also at oral argument, on what they characterize as evidence of fraud by Torres — discrepancies between Torres' description of circumstances of the accident and the police report of the incident; the timing of Torres' claim (filed the day Brinks announced that the Jacksonville office was being closed); alleged exaggerations in Torres' accounts to his doctors of the severity of the accident and its causal link to his injuries; and Torres' criminal record and disciplinary record with the Florida Department of Insurance. Because the district court did not in its decision rely at all on fraud, because it is not at all clear that the Insurers' decision denying Torres' claim was based in part on fraud, and because it is not clear that the Insurers' March 15, 2001 denial letter afforded notice to Torres that his claim was denied in part on the basis of fraud and an opportunity to respond thereto, we decline to address the significance of the Insurers' assertions of fraud. We prefer for the issue to be addressed in the first instance by the district court, and we express no opinion thereon.