10 Fla. L. Weekly Supp. 436c
Insurance — Personal injury protection — Declaratory judgments — Medical provider properly pled count for declaratory relief where it is alleged that insurer refused provider’s numerous requests for PIP log, and due to insurer’s dilatory tactics provider is unsure whether there is coverage or whether medical bill was applied to deductible
CICERO ORTHO-MED CENTER, INC., assignee of Illiana Munoz, Plaintiff, vs. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 11th Judicial Circuit in and for Miami-Dade County. Case No. 03-128 SP 25 (3). April 28, 2003. Mercedes A. Bach, Judge. Counsel: Kevin W. Whitehead, Downs & Associates, P.A., Coral Gables. Noel Espinosa.
ORDER DENYING DEFENDANT’S MOTION TO DISMISS COUNT III
THIS CAUSE having come to be heard on Defendant’s, UNITED AUTOMOBILE INSURANCE COMPANY’s, Motion to Dismiss Count III of the Complaint which is a count for a declaration of rights, the Court having heard argument of counsel and having been otherwise fully advised in the premises, it is,
ORDERED AND ADJUDGED:
1. DENIED. This Court finds that the Plaintiff has properly plead a count for declaratory relief in this instance where it is alleged that the Plaintiff requested a PIP log on numerous occasions via writing and via telephone prior to suit being filed and the Defendant insurer failed to comply with this request. The Plaintiff has stated a valid cause of action for Declaratory Relief.
2. As cited by the Defendant in its Motion to Dismiss, the purpose of the Declaratory Judgments statute is to obtain judgment on the rights of which have never before been determined, citing Peregood v. Cosmides, 663 So. 2d 665 (Fla. 5th DCA 1995). The purpose of declaratory judgment is to afford the parties relief from insecurity and uncertainty with respect to rights, status, and other equitable or legal relations. Coalition for Adequacy and Fairness v. Chiles, 680 So. 2d 400 (Fla. 1996).
3. In this instance, the Plaintiff is unsure whether there is coverage, or whether the subject medical bill was applied to the deductible. Due to the Defendant’s dilatory tactics, the Plaintiff was left with no other alternative but to file suit for breach of contract and Declaratory Judgment.
4. This Court agrees with The Honorable Judge William W. Herring, that
Requiring PIP insurers to provide assignee health care providers with payout logs before the latter file suit makes eminent common, good sense on public policy grounds. Providers armed with the information provided by the payout sheets can make informed decisions as to where they stand in relation to other providers vis-a-vis satisfaction of the deductible. Frivolous, unnecessary litigation may thus be avoided. To rule otherwise would be to place a provider in the untenable, “Catch-22” position of having to sue when it is in the dark, and then being faced with exposure for the imposition of Section 57.105(1), F.S., attorney’s fees when it learns that the deductible wholly consumed its bills.
5. Further, this Court relies on ROM Diagnostics on behalf of Rafael Cruz v. Security National Ins. Co., Fla. L. Weekly Supp. 323b (9th Judicial Circuit in and for Orange County, March 18, 2002), wherein the Honorable Judge C. Jeffery Arnold denied the Defendant’s Motion to Dismiss Plaintiff’s Complaint for Declaratory Judgment.
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