10 Fla. L. Weekly Supp. 825a
Insurance — Personal injury protection — Collection agency which is assignee of medical provider which holds assignment of benefits from insurer does not have right to sue insurer for PIP benefits under current PIP statute
RECOVERY SPECIALISTS, INC., (as assignee of Jacksonville Emergency Consultants), Plaintiff, vs. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant. County Court, 4th Judicial Circuit in and for Duval County. Case No. 16-2003-CC-0001932. Division B. May 29, 2003. Richard O. Watson, Senior Judge. Counsel: Kevin J. Loftus, Harrell & Johnson, P.A., Jacksonville, for Plaintiff. James C. Rinaman, III, McConnaughhay, Duffy, Coonrod, Pope & Weaver, P.A., Jacksonville, for Defendant.
ORDER GRANTING DEFENDANT’SMOTION FOR SUMMARY JUDGMENT
This cause came on for hearing on Defendant’s Motion for Summary Judgment.
Neither party filed any affidavits or sworn pleadings nor is there any discovery in the Court file. Neither party objected to the other party arguing facts not supported by any of the above.
The parties seemed to agree that Emergency Medical Services, P.A. (EMS) rendered medical services to Felicia Williams on July 22, 2000, for personal injuries which Williams suffered in a motor vehicle accident.
Defendant, Progressive Express Insurance Company (Progressive) issued a policy of insurance which provided personal injury protection benefits (PIP) coverage as required by law pursuant to Sections 627.730-627.7405, F.S. EMS obtained an assignment of benefits from Williams of the PIP benefits available for payment of the medical charges for the services rendered to EMS. EMS assigned to Recovery Specialists of Jax. Inc. (RSI) all rights to institute legal proceedings for the collection of payment from Progressive. The agreement between EMS and RSI provides that any recovery of medical payments and interest would be paid to EMS and EMS would not be responsible for any cost or attorney fees associated with any PIP litigation.
RSI filed this action alleging that Progressive did not make payment of all of the No Fault benefits due under the policy within 30 days as required by Section 627.736(4)(b), F.S. by failing to pay RSI for medical services rendered at 80% of the usual and customary fee. RSI further alleged the assignment of benefits and that Progressive had recognized the assignment by making direct payment to RSI. RSI also seeks attorney fees.
Progressive filed an answer and affirmative defenses, one of which is that RSI is a bill collection agency, not a “physician, hospital or clinic, or other person or institution lawfully rendering treatment to an injured person for bodily injury.” Section 627.736(5), F.S. (1999). Further that Progressive is not required nor authorized to pay a bill collector that does not render treatment to a third person.
Progressive filed a Motion for Summary Judgment alleging Progressive is only required to pay a “physician, hospital, clinic or other person or institution lawfully rendering treatment to an injured person for bodily injury” and that RSI is a bill collection agency and not a provider of medical services and has no rights under the PIP statute.
As a parting shot Progressive alleged the agreement between EMS and RSI does not evidence an assignment between the insured, Felicia Williams and EMS or the intent for her rights to be reassigned to RSI. Therefore, alleges Progressive, RSI does not have standing to file this claim.
There have been a number of cases in which the Circuit Court acting in its appellate capacity decided this issue. Some held a collection agency can maintain a suit, some held such an agency could not.
The relevant statute, Section 627.736(5), F.S. authorizes the insurer to pay the charges directly to the person or institution lawfully rendering such treatment if the insured receiving the treatment countersigned the invoice, bill or claim form. The statute does not prohibit EMS from assigning its contractual rights to RSI and in that event RSI could pursue a claim for breach of contract. However, Progressive is not required by the statute to pay a collection agency. In this case the action is brought under the statute.
There is no good reason for prohibiting medical providers from engaging a bill collection agency to pursue their statutory rights, but the statute would have to be amended to so provide. Such an amendment could also address the problem of the fees of the medical providers as witnesses. Defense counsel argued that if the medical providers were not parties they would seek expert witness fees when testifying. If parties to the litigation they are not entitled to expert fees. Since allowing an assignment of their rights under the statute to a collection agency would be for the convenience of the medical providers they should be paid the same fees they would receive if they were parties to the litigation. It makes good sense to permit medical providers to engage bill collectors to pursue litigation.
However, under the current statute a collection agency does not have the right to sue the insurer under the statute for PIP benefits.
It is therefore,
ORDERED
1. Defendant’s Motion for Summary Judgment is granted.
2. Plaintiff, Recovery Specialists, Inc. (as assignee of Jacksonville Emergency Consultants), shall take nothing by this action and Progressive Express Insurance Company shall go hence without day.
3. Jurisdiction is retained to tax costs.
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