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Defense Digest

A Warning on Wording: Appellate Court Reverses Summary Judgment Ruling for Insurer After Finding Condition Precedent Affirmative Defense Too Narrowly Pled

Defense Digest, Vol. 29, No. 3, September 2023

September 1, 2023

by Sean P. Greenwalt

Key Points:

  • Florida’s Sixth District Court of Appeal recently examined the pleading requirements for condition precedents as they relate to an examination under oath.
  • The court concluded that an affirmative defense that is narrowly worded may not be extended to a broader definition despite overall non-compliance with a condition precedent.
  • Pleading condition precedent failure requires specificity by a defendant, but, in certain situations, a broader description of condition precedent noncompliance may be warranted. 

In a cautionary tale, the Sixth District Court of Appeal, in Advanced Florida Medical Group, Corp. v. Progressive American Ins. Co., 364 So.3d 1131 (Fla. 6th DCA 2023), after finding the underlying affirmative defense insufficient, reversed a final summary judgment in favor of an insurer where a claimant failed to complete an examination under oath. The examination was a mandatory condition precedent to receiving personal injury protection benefits under the insurer’s policy and per § 627.736(6)(g), Fla. Stat. (2023).

In the lower court, the insurer obtained summary judgment by arguing the claimant failed to “submit” to a mandatory examination under oath. However, the insurer’s affirmative defense pled that the claimant “failed to appear for an examination under oath.” The trial court entered judgment for the insurer, finding no distinction. The plaintiff appealed. 

On appeal, the Sixth District analyzed the pleading standard for contractual condition precedents, noting that “the burden on the defendant [is] to identify the specific condition that the plaintiff failed to perform[.]” Colon v. JP Morgan Chase Bank, NA, 162 So. 3d 195, 197 (Fla. 5th DCA 2015). The court then analyzed the dictionary definitions of the words “submit” (“to yield oneself to the authority or will of another: or permit oneself to be subjected to something”) and “appear” (“to come formally before an authoritative body[.]”)

The Sixth District went on to hold that the defendant’s choice of wording failed to plead its actual defense that the plaintiff failed to “submit” to an examination because a defendant:

[H]as the burden of pleading its affirmative defense with enough specificity and particularity to alert [the Plaintiff] of what condition was violated[.]” Therefore, the insurer “was bound by its pleadings in moving for summary judgment.”

Citing Inphynet Contracting Servs. v. Soria, 77 So. 3d 776, 781 (Fla. 4th DCA 2011).

However, the irony of the situation is that given the District Court of Appeal’s dictionary references, a claimant who fails to “submit” or “yield oneself to the authority or will of another” would certainly also have failed to “appear” or “come formally before and authoritative body[.]” Had the insurer pled more broadly in this situation, they actually would have met the specificity requirement that the Sixth District had placed before them. 

This opinion is an important reminder that no defense should be left behind when drafting an answer and that all affirmative defenses should be artfully worded to encompass the specificity requirement of condition precedents. 

*Sean is an associate in our Tampa, Florida, office. He may be reached at 813.989.1814 or spgreenwalt@mdwcg.com.

 

Defense Digest, Vol. 29, No. 3, September 2023, is prepared by Marshall Dennehey to provide information on recent legal developments of interest to our readers. This publication is not intended to provide legal advice for a specific situation or to create an attorney-client relationship. ATTORNEY ADVERTISING pursuant to New York RPC 7.1. © 2023 Marshall Dennehey. All Rights Reserved. This article may not be reprinted without the express written permission of our firm. For reprints, contact tamontemuro@mdwcg.com.

Firm Highlights

Thought Leadership

The Ohio Supreme Court Extends Sham-Affidavit Rule to Contradictory Expert Reports

Legal Roundup: Ohio In its June 23, 2026, decision in Moore v. Mercy Medical Center, the Ohio Supreme Court upheld a trial court’s decision to strike an expert witness’s affidavit that contradicted the opinions expressed in the expert’s prior report. This case pertains to allegations of medical malpractice after plaintiff Cheri Moore gave birth to an infant in respiratory distress who required intubation. Moore alleged that a delay in ordering an emergency cesarean section resulted in the need for intubation, causing her child’s injuries. Specifically, Moore sued Dr. Meniru, who completed his first shift at 7:00 a.m. on May 28, 2015, and did not resume treating Moore until 7:00 a.m. on May 29, 2015. One of Moore’s expert witnesses authored a report stating that the doctors, including Dr. Meniru, deviated from the standard of care by not advocating for a cesarean section in the evening of May 28, 2015. Based on this report, Dr. Meniru moved for summary judgment, arguing that the alleged breach occurred during a period when he was not on duty. In response to the summary judgment motion, the plaintiff filed an affidavit from the same expert. Although the expert expressly incorporated his previous report into his affidavit, he also offered an additional opinion: that Dr. Meniru breached the standard of care by failing to begin a cesarean section within 30 minutes of receiving reports of fetal distress. Dr. Meniru filed a motion to strike the expert’s affidavit, arguing that it contradicted the opinions set forth in his prior report in violation of the sham-affidavit rule. The sham-affidavit rule applies to “a contradictory affidavit that indicates only that the affiant cannot maintain a consistent story, or is willing to offer a statement solely for the purpose of defeating summary judgment”. Moore, supra, at ¶ 19, citing Pettiford v. Aggarwal, 126 Ohio St.3d 413, 2010-Ohio-3237. The trial court granted both the motion to strike and the motion for summary judgment, and the Fifth District affirmed. The Ohio Supreme Court accepted two questions of law: (1) whether the sham-affidavit rule applies when the sworn testimony contradicts prior unsworn statements; and (2) whether an inconsistency within the affidavit goes to credibility or admissibility, justifying an order striking the affidavit. Previous rulings by the Ohio Supreme Court regarding the sham-affidavit rule have pertained to contradictions between an affidavit and sworn deposition testimony. See, e.g., Byrd v. Smith, 2006- Ohio-3455, 110 Ohio St.3d 24, 850 N.E.2d 47. However, here, the Court was asked to apply the same rule to contradictions between a sworn affidavit and an unsworn expert report. The Court held that, because Moore’s expert incorporated his prior report into his affidavit, he effectively adopted the report as part of his sworn testimony.

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Thought Leadership

Pennsylvania Superior Court Reaffirms Liberal Pleading Standard in Medical Malpractice Actions

Legal Roundup: Pennsylvania The Pennsylvania Superior Court has reinforced a broader fact-pleading approach that may make it more difficult for health care defendants to obtain dismissal at the preliminary objection stage. In DaSilva v. Abington Memorial Hospital, the court held that the plaintiffs’ second amended complaint satisfied Pennsylvania’s fact‑pleading requirements despite the absence of individually named negligent actors. In DaSilva, the plaintiffs filed a second amended complaint alleging that Abington Memorial Hospital was directly and vicariously negligent after the patient, who was experiencing a mental health crisis, was left unattended by hospital staff, exited the emergency department, and was struck by a vehicle, suffering serious injuries. The trial court sustained the hospital’s preliminary objections and dismissed the complaint with prejudice, stating plaintiffs “failed to plead any material factual allegations in support of their claims of negligence [and] set forth vague allegations of negligence and unidentified agency.” Id. at *5. The plaintiffs appealed. On appeal, the Superior Court reversed, holding that the complaint sufficiently pled negligence and vicarious liability claims under Pa.R.C.P. 1019(a). The court concluded that allegations describing the patient’s condition, the hospital’s awareness of that condition, and the alleged failure to monitor or prevent elopement were adequate to satisfy Pennsylvania’s pleading requirements. Significantly, the court rejected the hospital’s argument that the complaint failed because it did not identify the specific employees responsible for the alleged negligence. Instead, the court found that generalized references to “emergency room staff” were sufficient to place the hospital on notice of the claims because “the names of those who performed services for the plaintiff are known to the defendant or can be ascertained during discovery.” Id. at *12 (citing Est. of Denmark ex rel. Hurst v. Williams, 117 A.3d 300, 307 (Pa. Super. 2015)). The effect of DaSilva is that plaintiffs may proceed past the pleading stage with relatively generalized allegations, particularly in cases involving institutional defendants where relevant details are uniquely within the defendant’s control. As a result, health care defendants should anticipate that challenges to claim sufficiency may be resolved in the later stages of litigation, including discovery and summary judgment.