10 Fla. L. Weekly Supp. 645a
Insurance — Medpay — Coverage — Because there was no personal injury protection coverage for medical bill not timely submitted pursuant to PIP statute, no Medpay benefits were due either — Summary judgment entered in favor of insurer
DAWN LECONTE, Plaintiff, v. UNITED SERVICES AUTOMOBILE ASSOCIATION, Defendants. County Court, 15th Judicial Circuit in and for Palm Beach County, General Jurisdiction Division. Case No. SS-02-012780-RF. May 29, 2003. E. Rodgers, Judge. Counsel: Daniel Norton. Miriam R. Merlo, Gaebe, Mullen, Antonelli, Esco & DiMatteo, Coral Gables.
[Reversed at 11 Fla. L. Weekly Supp. 791d.]
ORDER GRANTING DEFENDANT’S MOTION FOR SUMMARY JUDGMENT AND ENTERING JUDGMENT AGAINST THE PLAINTIFF
This cause was considered on May 29, 2003 on the Motion of Defendant, UNITED SERVICES AUTOMOBILE ASSOCIATION (USAA), for the entry of summary judgment in its favor and against the Plaintiff, and after hearing argument of counsel, and being advised in the premises, it is hereby
ORDERED AND ADJUDGED that Defendant’s Motion is granted based on the following. The Court finds that the Plaintiff failed to timely submit the subject medical bill as required by Fla. Stat. 627.736(5)(c). Because the bills were untimely pursuant to the PIP statute, no payment was due by the insurer or the insured to the medical provider under the PIP portion of the policy. Moreover, because no PIP payments were due for these bills, no payment for MEDPAY Benefits were due either pursuant to Fla. Stat. 627.736(4)(f) (2000) which provides as follows:
Medical payments insurance, if available in a policy of motor vehicle insurance, shall pay the portion of any claim for personal injury protection medical benefits which is otherwise covered but is not payable due to the coinsurance provision of paragraph (1)(a), regardless of whether the full amount of personal injury protection coverage has been exhausted. . .
The words “which is otherwise covered” are decisive in the Court’s interpretation of this issue. Particularly since the specific dates of service sued for are not covered because they were not timely submitted. The Court relies upon the Court’s holding in Bolden v. State Farm Mutual Insurance Co., 689 So.2d 339 (Fla. 4th DCA 1997). In that case, the Fourth District Court of Appeal interpreted section (4)(f) of the PIP statute, and stated that the purpose of the legislation for this statute was not centered on providing additional coverage to persons, but to coordinate coverage. The Court further noted that provision (4)(f) deals with the timing of the medical payments coverage connected with PIP coverage. Id. at 340. Here, there was no PIP coverage for the MRI bill because it was not submitted timely. Thus, there is no medical payments coverage to connect to the PIP coverage. Hence, Medpay is not available and summary judgment is proper in favor of the Defendant.
Final Summary Judgment is hereby entered in favor of Defendant and against the Plaintiff. The Court reserves jurisdiction to enter an award of attorneys’ fees and costs, if any.
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