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Defense Digest

COVID-19 and Florida’s Health Care Provider Liability Protection

Defense Digest, Vol. 27, No. 3, June 2021

June 1, 2021

by Megan J. Nelson

Key Points:

  • Florida Statute 768.38 and Florida Statute 768.381 offer liability protection for health care providers against claims related to COVID-19.
  • In order for the immunity to apply to a health care provider, the complaint must state the damages, injuries or death were related to COVID-19.
  • An affirmative defense that may apply to COVID-19-related claims against a health care provider is substantial compliance with government-issued health standards specifically related to COVID-19 when the injury occurred.

The coronavirus was first detected in Florida on March 1, 2020, and from its start, health care providers and facilities have been overrun with sick patients and limited supplies. At the beginning of the pandemic, multiple health care organizations provided guidance on how to properly manage patients during the crisis. Hospitals, nursing homes, assisted living facilities, and doctor’s offices were running low on supplies, and many patients were dying from COVID-19. More than a year has passed since the pandemic began, and Florida is being overrun with lawsuits against health care providers and facilities for claims associated to damages, injuries and deaths related to COVID-19. On March 29, 2021, Florida Governor, Ron DeSantis, signed CS/SB into law, creating Florida Statute 768.38 and Florida Statute 768.381, which offer liability protection for health care providers against claims related to COVID-19.

Florida Statute 768.381 provides liability protection for health care providers, including hospitals, nursing homes and assisted living facilities, against claims brought by a patient (or legal representative) related to damages, injuries or death due to COVID-19.

The liability protection for COVID-19-related claims against a health care provider mainly relates to claims arising from the diagnosis or treatment of a person for COVID-19, the provision of a novel or experimental COVID-19 treatment, the transmission of COVID-19, and the delay or cancellation of a surgery or medical procedure.

The new law will apply retroactively. A plaintiff will have one year from the time the injury related to COVID-19 occurred to bring a lawsuit. However, if a lawsuit for a cause of action related to COVID-19 were filed before March 29, 2021, the liability protection would not apply.

A plaintiff will still be required to participate in Chapter 766 pre-suit investigation. The liability protection will not be addressed until a complaint has been filed. For the liability protection to apply to a health care provider, the complaint must be pled with particularity. Meaning, the complaint must state that the damage, injury or death was related to COVID-19 and was caused by the health care provider’s acts or omissions.

There has been a recent surge in COVID-19 lawsuits, and plaintiffs have become creative in the language contained in their complaints. The language may claim an injury or death caused by a health care provider’s negligence related to COVID-19 without using the term COVID-19. For example, instead of the complaint stating the plaintiff died due to contracting COVID-19, the complaint will state the plaintiff died due to contracting a respiratory illness that eventually led to multi-organ failure.

Currently throughout the United States, cases related to COVID-19 injuries and death have been moved to federal court. This is due to the federal government allowing the COVID-19 pandemic to fall under the PREP Act. The PREP Act grants liability immunity to entities and individuals involved in developing, manufacturing, testing, distribution, administration and use of medical countermeasures. As the COVID-19 pandemic continued, seven amendments have been made to the PREP Act related to the medical countermeasures and who qualifies for immunity as a covered person. Health care providers and facilities have been identified as a covered person. With each amendment, the definition and qualification of a covered person have become more defined.

Once these cases are moved from state court to federal court, the judges must determine if the complaint was pled with particularity to include a cause of action related to COVID-19. The majority of federal courts have determined that the complaints do not include the specific language regarding COVID-19-related claims. Since the complaints do not specifically state a claim related to COVID-19, the health care provider does not qualify for immunity under the PREP Act. Therefore, the cases are sent back to the corresponding state court to be tried under that state’s medical negligence standard.

Florida has joined ranks with other states to combat these lawsuits and provide liability immunity to health care providers. Although Florida has passed a new law that gives liability immunity to health care providers and facilities, it is not an instant immunity. A complaint must still be filed, and the plaintiff must prove that the health care provider was negligent. However, if the health care provider can prove that they followed the guidance and standards from health care organizations, federal agencies or Florida agencies at the time of the incident, then immunity will apply.

The burden of proof that the plaintiff must prove is by the greater weight of the evidence. The plaintiff must prove more than just medical negligence. They must prove that the health care provider was grossly negligent or engaged in intentional misconduct. This means that the health care provider’s conduct must have been deliberate or committed with reckless disregard for the patient’s safety.

Even with this new law, in order for the immunity to apply to a health care provider, the complaint must state the damages, injuries or death was related to COVID-19. If the complaint states the medical negligence was related to anything other than COVID-19, the liability protection may not apply.

However, if the damage, injury or death is related to COVID-19 (e.g., medical diagnosis of COVID-19, positive COVID-19 respiratory swab, death certificate states cause of death was COVID-19), the health care provider should state the liability protection in the affirmative defenses. The new law provides additional affirmative defenses a health care provider should use.

The affirmative defenses that may apply to COVID-19-related claims against a health care provider include substantial compliance with government-issued health standards specifically related to COVID-19 when the injury occurred. This includes the early standards related to preserving or prioritizing supplies, materials or equipment due to widespread shortages of those necessary items.

Since the pandemic began, federal and state health care agencies have performed unannounced facility investigations to verify proper compliance with recommended health standards. Those certificates of compliance will be essential in proving that the facilities were making a good faith effort and substantially complied with the appropriate health standards at that time.

It will be essential to talk with your attorney regarding your facility’s compliance with the health care standards as soon as the pre-suit investigation begins. Although the court will not have a pre-suit hearing on health care liability protection related to COVID-19, it will help determine the strategy for the defense of your case.

*Megan is an associate in our Orlando, Florida office. She can be reached at 407.420.4381 or mjnelson@mdwcg.com.

Defense Digest, Vol. 27, No. 3, June 2021 is prepared by Marshall Dennehey Warner Coleman & Goggin 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. © 2021 Marshall Dennehey Warner Coleman & Goggin. 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

Commonwealth Court Reaffirms the Constitutionality of Act 111's IRE Provisions

In this case, the claimant sustained a work injury of January 6, 1994, which was acknowledged by Notice of Compensation Payable (NCP). After the claimant’s receipt of 104 weeks of temporary total disability benefits, the employer filed a Request for an Impairment Rating Examination (IRE). The IRE was performed in May 2023 and the IRE physician found that the claimant had a 5% whole person impairment, under the AMA Guides. The employer filed a Petition based on the IRE results, and the Petition was granted by the WCJ. During litigation, the claimant argued that the IRE provisions of Act 111 (Section 306(a.3) of the Act) were not applicable to her injury, since it predated June 24, 1996, the date Act 57 went into effect, and that the IRE provisions were unconstitutional. The Workers’ Compensation Judge (WCJ)) granted the Petition and the Board affirmed. On appeal to the Commonwealth Court, the claimant argued that Act 111 violated the nondelegation doctrine and that its retroactive application to the claimant’s injury was unconstitutional. The court rejected the arguments on the basis that they had already found the same arguments without merit in multiple, prior cases. The court also addressed an argument made by the claimant that Act 111 was procedurally defective under the Pennsylvania Constitution because it was only considered on two days in each House after having undergone amendments and reassignments. The court noted that the Pennsylvania Constitution requires every bill to be considered on three different days in each House. The claimant maintained that, according to the legislative history, the bill did not receive three separate days of consideration from each House when it was assigned a new bill number. The court pointed out, however, that the bill number, H.B. 1840 remained constant and was considered on three occasions by the House. Further, the court concluded that minor amendments to the bill were germane to its original subject, which was to modify the Act’s IRE process, in accordance with Protz II.

Thought Leadership

Florida Supreme Court Rules Florida Statute §627.70152 Does not Apply Retroactively

In a decision that resolves years of appellate uncertainty and confirms that insurers and insureds alike can rely on the legal framework in place when a policy is issued, the Supreme Court of Florida last week found that Florida Statute §627.70152, which involves an insured’s requirement to provide an insurer with pre-suit notice before filing a suit, cannot be applied retroactively. In Universal Property & Casualty Insurance Company v. Hughes, the Court was presented with the issue of whether the statutory pre-suit notice requirement applied retroactively and whether it would apply to a breach of contract of an insurance policy that was issued before the statute went into effect. Before the Court was an appeal from a homeowner, Ms. Hughes, who sued her insurance carrier, Universal Property & Casualty Insurance Company (Universal) for breach of contract under an insurance policy that was in effect from April 24, 2019 through April 24, 2020. During the policy period, Ms. Hughes suffered a loss and, on May 29, 2019, made a claim for water damage. The carrier investigated the loss and issued payment; Ms. Hughes disputed the payment, finding the amount insufficient for repairs. On July 1, 2021, Florida Statute §627.70152 went into effect, which required insureds to provide notice of intent to initiate litigation against the carrier prior to filing a lawsuit; if an insured filed the lawsuit without complying with §627.70152, a court must dismiss the case without prejudice. On August 4, 2021, Ms. Hughes filed her lawsuit against Universal for breach of contract. Universal moved to dismiss based on her failure to comply with §627.70152. Ms. Hughes contended the notice requirement could not be applied retroactively. The trial court disagreed and dismissed the lawsuit without prejudice, and Ms. Hughes appealed. During the appeal, the Fourth District Court of Appeal, in Cole v. Universal Property & Casualty, 363 So. 3d 1089 (Fla. 4th DCA 2023), ruled that Florida Statute §627.70152 did apply retroactively to policies issued before the effective date of §627.70152. However, the Sixth District Court agreed with Ms. Hughes and overturned the trial court’s ruling, finding the statute could not retroactively apply to policies issued prior to the statute effective date. Thereafter, the other district courts weighed in, with the Third District Court agreeing with the Fourth District Court, and the First, Second and Fifth District Courts agreeing with the Sixth District Court. In resolving the conflict amongst the district courts, the Supreme Court advised “as a general rule, ‘the statute in effect at the time an insurance contract is executed governs substantive issues arising in connection with that contract.’ Hassen v. State Farm Mut. Auto. Ins. Co., 674 So. 2d 106, 108 (Fla. 1996). The Court applied the two-step test when deciding whether a statute has retroactive application: “First, the Court must ascertain whether the Legislature intended for the statute to apply retroactively. Second, if such an intent is clearly expressed, the Court must determine whether retroactive application would violate any constitutional principles.” Menendez v. Progressive Exp. Ins. Co., 35 So. 3d 873, 877 (Fla. 2010). In analyzing the Legislature’s intent, the Court must determine whether the Legislature has manifested a clear command for retroactivity in the statutory text.  In review of the statutory text, the Court found nothing in the language of the statute to indicate that the phrase “all suits” was serving another purpose of expanding its reach to suits based on policies that both predate and postdate the enactment of the statute. Buis v. Universal Prop. & Cas. Ins. Co., 394 So. 3d 738, 741 (Fla. 2d DCA 2024). Further, the Court noted the statute has an effective date, which has long been considered to be evidence against retroactive application of a statute. The Court concluded that, on its face, no provision of §627.70152 speaks to application of the statute to insurance policies issued before the statute’s effective date and therefore, the Legislature did not clearly command retroactivity of the statute to include insurance policies issued prior to the enactment of the statute. The Court briefly reviewed Universal’s argument that the presuit notice requirement was procedural, not substantive, and therefore should be applied retroactively; however, the Court agreed with the Sixth District Court’s finding that, in its entirety, §627.70152 transformed an insured’s ability to sue an insurance company under a property insurance policy and an insurer’s obligations to respond to and pay insurance claims, thus making the requirement a substantive change. The Court thereby upheld the decision of the Sixth District and disapproved the decision of the Fourth District in Cole.

Thought Leadership

The Tolling Trap: Filing Alone Will Not Toll the Statute Without Good-Faith Service

The Eastern District of Pennsylvania recently reinforced a critical limitation on bad faith claims, holding that a timely filing alone will not preserve a cause of action absent a good-faith effort to serve the original process. The plaintiff had presented a claim for underinsured motorist benefits to his auto insurer. The insurer evaluated the claim and determined that the plaintiff’s accident-related damages did not exceed the bodily injury liability insurance limits of the at-fault driver and denied his claim. Among other claims, the plaintiff sought to present a claim for insurance bad faith under 42 Pa. C.S.A. § 8371, to which a two year statute of limitation applies. He first filed a praecipe for writ of summons before the expiration of the statute of limitation. However, the plaintiff did not attempt to serve the praecipe or writ until after the statute of limitations had expired. Additionally, the service failed as the plaintiff had mailed the original process to an incorrect address. Despite receipt of the Postal Service’s failure to deliver the original process, the plaintiff did not attempt to re-serve the writ. Two months later, the plaintiff filed a complaint and then successfully served that complaint. The insurer sought to dismiss the plaintiff’s bad faith claim as time-barred by the statute of limitations. The district court agreed. Though the plaintiff had filed a praecipe for a writ of summons prior to the expiration of the statute of limitations, the statute is only tolled if there is a good faith effort to serve that original process. In this case, the court determined that the plaintiff had failed to perform a “good faith effort to serve the original process”. Additionally, though the filing and service of a complaint can serve as alternative original process when the lawsuit is commenced by the filing of a praecipe for a writ of summons, the plaintiff filed his complaint after the statute of limitations had expired. The plaintiff’s bad faith claim was therefore determined to be barred by the statute of limitations and dismissed by the court, with prejudice. A key takeaway for the defense is not to assume that the statute of limitations has been successfully tolled by a plaintiff merely because a praecipe for a writ of summons or complaint has been filed prior to the expiration of the statute. A filed complaint or writ is only part of the equation. The defense should carefully review the docket and filings to confirm that the plaintiff also performed the requisite good faith effort to serve that original process. A thorough review of the docket may reveal that the plaintiff failed to make the good-faith service efforts necessary to toll the statute of limitations.