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Florida appeals court finds $20 million coverage case filed too late
The policy was a claims-made form that only triggered coverage if the wrongful-death demand was made during the January 2012 to January 2013 window, the court said.
A Florida appeals court reversed a lower court ruling that would have required an insurer to cover a $20 million wrongful-death judgment, finding the estate’s claim did not meet the timing requirements of the policy. Insurance Business reports the decision was issued on August 5, 2026, after a dispute stemming from the death of an 87-year-old resident at an assisted living facility in 2012.
The underlying case began in 2012, when the resident wandered away unsupervised and was later struck by a logging truck while crossing a busy intersection. State agencies opened investigations, and the facility manager called the insurance agent to report the death, after which the estate sued the facility for wrongful death and won a $20 million judgment in 2018.
The estate then pursued coverage by stepping into the facility’s position under a 2012 policy from National Assisted Living Risk Retention Group, which ran from January 13, 2012 to January 13, 2013. The appeals court said the policy was claims-made, meaning coverage applied only if the claim was made during the policy period.
The court concluded that the manager’s phone call was notice of a possible claim, not the claim itself, and that the later wrongful-death suit was not filed until 2014, after the policy expired. It also rejected the idea that agency questions about coverage counted as a covered claim, reversing the prior order that had limited coverage to the policy’s $50,000 amount.