10 Fla. L. Weekly Supp. 1021b
Insurance — Personal injury protection — Declaratory judgment action filed by provider/assignee seeking declaration that it is entitled to receive PIP log under section 627.736(6)(d) and a “Dec” sheet under section 627.4137 — Plaintiff does not have right to requested information under these statutes
DYNAMIC IMAGING MRI CENTER, INC., TAHNEE D. DOYLE, Plaintiff, v. NATIONWIDE ASSURANCE COMPANY, Defendant. County Court, 9th Judicial Circuit in and for Orange County. Case Nos. CCO-02-15116, CCO-02-16112. September 3, 2003. C. Jeffery Arnold, Judge. Counsel: Michael Tierney, Winter Park, for Plaintiff. John L. Morrow, Conroy, Simberg, Ganon, Krevans & Abel, P.A., Orlando, for Defendant.
ORDER ON PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND DEFENDANT’S MOTION TO DISMISS
THIS CAUSE having been heard on June 24, 2003 on Plaintiff’s Motion for Summary Judgment and Defendant’s Motion to Dismiss and the Court having reviewed the pleadings, relevant statutes and cases as well as argument of counsel rules as follows:
1. Plaintiff’s Motion for Summary Judgment is DENIED.
2. Defendant’s Motion to Dismiss is GRANTED.
The facts of the case are as follows:
1. On October 7, 2002 Plaintiff sent a letter to “Nationwide Insurance Co.” (note Defendant is Nationwide Assurance Company) stating as follows:
“Pursuant to Florida Statute 627.4137 and 627.736(6)(d), please provide us with a copy of the insured’s PIP payout sheet, the Declaratory Sheet of the insurance policy covering this patient, and any Explanation of Benefits (EOBs) issued to us showing payments for bills we submitted for reimbursement under the patient/insured’s PIP benefits”.
2. Plaintiff did not receive the requested PIP log and Plaintiff did not receive the requested DEC sheet.
3. Plaintiff then filed suit in Case No.: CCO 02-16112 in a Declaratory Judgment action under Fla. Stat. Chapter 86, essentially to recover the Dec Sheet under Fla. Stat. 627.4137.
4. Around the same time the above suit was filed Plaintiff filed suit under Case No. CCO-02-15116. In Count I, Plaintiff attempts to allege a cause of action for declaratory judgment under Fla. Stat. Chapter 86 seeking entitlement to a “PIP Log”. In Count II, Plaintiff sued for Breach of Contract seeking damages for payment on a bill a portion of the bill remained unpaid for DOS 5/31/01. Defendant paid the balance on the bill and interest on 3/27/03.
5. To prosecute Plaintiff’s Breach of Contract case Plaintiff propounded a Request for Production with typical requests including a request for coverage information including the policy and DEC Sheet and a PIP log. Nationwide responded and provided the DEC Sheet and a listing of all checks issued on the policy. (Note Nationwide does not create a “PIP Log”).
6. Plaintiff then filed Summary Judgment contending that Defendants response to discovery constituted a confession of judgment.
7. Defendant moved to dismiss for failure to state a cause of action and lack of subject matter jurisdiction.
8. As Plaintiff made no requests under the policy. The Court must construe the requests as made by Plaintiff. Here Plaintiff made requests under 2 statutes.
9. Plaintiff made a request for a “PIP Log” under Fla. Stat. §627.736(6)(d) which states:
“The injured person shall be furnished, upon request, a copy of all information obtained by the insurer under the provisions of this section, and shall pay a reasonable charge, if required by the insurer”.
10. This statute is narrowly tailored to include information received by the insurer under 6(a) & 6(b). The Court rules that there is no obligation to provide a provider/insured with a “PIP log” under this statute.
11. Plaintiff made a request for a “DEC Sheet” under §627.4137 which states:
627.4137 Disclosure of certain information required. —
(1) Each insurer which does or may provide liability insurance coverage to pay all or a portion of any claim which might be made shall provide, within 30 days of the written request of the claimant, a statement, under oath, of a corporate officer or the insurer’s claims manager or superintendent setting forth the following information with regard to each known policy of insurance, including excess or umbrella insurance:
(a) The name of the insurer.
(b) The name of each insured.
(c) The limits of the liability coverage.
(d) A statement of any policy or coverage defense which such insurer reasonably believes is available to such insurer at the time of filing such statement.
(e) A copy of the policy.
In addition, the insured, or her or his insurance agent, upon written request of the claimant or the claimant’s attorney, shall disclose the name and coverage of each known insurer to the claimant and shall forward such request for information as required by this subsection to all affected insurers. The insurer shall then supply the information required in this subsection to the claimant within 30 days of receipt of such request.
12. As the statute is clear on its face the Court rules that Fla. Stat. §627.4137 is clearly designed to relate to situations where a third party claimant seeks to recover insurance information from an alleged tortfeasor’s insurer.
13. The Court notes there are other statutes governing disclosure of policy information to their insureds in Fla. Stat. 627.4143 and 627.7401, which are not at issue in this case.
14. Plaintiff has asked the Court to declare its right to a “PIP Log” under Fla. Stat. 627.736(6)(d) and “DEC sheet” under 627.4137 Fla. Stat. The Court declares that Plaintiff does not have a right to the requested information under the statutes, under which the information was requested.
15. Plaintiff did not make a request under the policy of insurance, nor sue for breach of contract, so the Court does not extend its opinion to cases of that nature.
16. As there is no current case or controversy in Case No.: CCO-02-16112 and Count I of Case No.: CCO-02-15116 and Plaintiff has no right under the referenced statutes applicable to the facts of this case, Plaintiff’s claims are dismissed without prejudice as to entitlement to relief sought under the two statutes. This is because at this point Plaintiff cannot replead a cognizable claim.
17. Plaintiff’s Motion to Amend its Complaint is DENIED. For the reasons set forth above, Plaintiff cannot plead entitlement to the requested documentation under either of the two statutes.
18. The Court reserves jurisdiction to consider a request to award Court Costs and reasonable attorneys fees incurred in defending this action.
* * *
