10 Fla. L. Weekly Supp. 913b
Insurance — Personal injury protection — Standing — Assignment — Collection agency — Where medical provider received assignment from insured, and in turn, assigned those benefits to collection agency, collection agency has standing to bring PIP action, assuming medical provider received valid assignment from insured
RECOVERY SPECIALISTS, INC. (as assignee of Jacksonville Emergency Consultants) (Nicole Aaron), Plaintiff, vs. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant. County Court, 4th Judicial Circuit in and for Duval County. Case No.16-2003-CC-2674. Division B. August 28, 2003. Eleni Elia Derke, Judge.
ORDER DENYING DEFENDANT’SMOTION FOR SUMMARY JUDGMENT
This matter came before the court on Defendant’s Motion For Summary Judgment. The facts are not at issue. The insured, Nicole Aaron, sought medical treatment from Jacksonville Emergency Consultants, hereafter JEC, on August 22, 1999. The injuries were allegedly related to a motor vehicle accident occurring shortly prior to the emergency room visit. JEC employed the emergency room doctors who rendered medical treatment to Ms. Aaron. At the time of the accident, Defendant, Progressive Express Insurance Company provided PIP benefits to Ms. Aaron, who in turn, assigned those benefits to JEC.
JEC timely billed Progressive $80.00 for the August 22, 1999 medical services. Progressive alleged that the $80.00 charge exceeded the reasonable fee in the area for that procedure, and reduced that amount to $65.00 and subsequently paid $52.00. (80% coverage) JEC, wishing to remain in the hospital and out of the courtroom, assigned Ms. Aaron’s insurance benefits to Recovery Specialist, Incorporated, (RSI), the billing and collection agent for JEC.
RSI initiated litigation against Progressive, claiming the assignment of benefits were transferred from Ms. Aaron to JEC and ultimately to RSI. It is undisputed that RSI is not a provider of medical services and is not a “physician, hospital, clinic or other person or institution lawfully rendering treatment to an injured person. . .” F.S. §627.736.
There has been a split in Duval County Courts regarding the ability of a non-medical provider to maintain standing in PIP litigation. There is no language in F.S. §627.736 which authorizes or prohibits non-medical providers from accepting assignments. The lack of such language has been the lynchpin for judicial opinions supporting each position. As with most PIP litigation, this court has been without controlling precedent on this issue.
Fortunately, the Second District Court of Appeal, Professional Consulting Services, Inc. a/a/o Susan Berlinghoff v. Hartford Life and Accident Insurance Company, 2003 Fla. App. Lexis 10791, (2nd DCA 2003) [28 Fla. L. Weekly D1661a], resolved this issue, pending further opinions from other Florida Appellate Courts. In Professional Consulting, the insured, Ms. Berlinghoff assigned her PIP benefit rights to Professional Consulting Services, PCS, the billing and collection agent for Dr. Gibson, who treated Ms. Berlinghoff for injuries allegedly related to a motor vehicle accident. No doubt, Dr. Gibson preferred to remain in a medical office and out of the courtroom or arbitration.
PCS timely billed Hartford who declined to pay. Hartford “maintained that it was only required to make payment to four entities: a physician, a hospital, a clinic, or another person lawfully rendering treatment.” Id. at P.2. As in the instant case, there was no dispute that the Plaintiff was not one of those four categories.
The Second District Court reiterated that “generally, rights under a contract are assignable.” Id. at P. 3. Thus if the assignment from Ms. Berlinghoff to Professional was valid, then, “Professional stands in her shoes and has the same rights. . . .” Id. at P.4. The Second District held that, “. . .a PIP insured may assign an after-loss claim to a third party who is not a medical provider.” Id. at P. 7.
This court adopts the reasoning and holding of the Second District Court of Appeal in the above matter. In the instant case, Ms. Aaron assigned the benefits to JEC who then assigned the benefits to RSI. Based on the Professional Consulting rationale, the “double assignment” distinction is immaterial. Assuming JEC received a valid assignment from the insured, and in turn, assigned those benefits to RSI, then RSI held all of the rights to benefits that Ms. Aaron was entitled. This court has not been asked to rule on the validity of the assignments. Defendant’s Motion for Summary Judgment is denied, however, Defendant is not precluded from challenging the reasonableness of the medical charges.
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