A decision by a federal appeals court last week shows what limited options insurance carriers have when they discover major misrepresentation by the insured long after claims have been paid.
The U.S. 11th Circuit Court of Appeals last week found that MONY, also known as Mutual of New York, could not sue a well-known Tampa ophthalmologist for unjust enrichment after the insurer discovered that the doctor had misrepresented the extent of his disability and loss of income.
The July 23 ruling threw out a verdict that had awarded more than $388,000 to MONY in 2023. A federal court jury found that the eye doctor, Bernard Perez, had no lasting effects from a bout of skin cancer in 2011, despite his claims. After the trial judge added interest, the award came to almost $449,000.
But the doctor appealed, and the 11th Circuit found that Florida law does not allow unjust enrichment tort claims if the matter is covered by a contrac…