10 Fla. L. Weekly Supp. 921b
Insurance — Personal injury protection — Coverage — Summary judgment is granted in favor of insurer where insurer applied medical provider’s bill to deductible which had not been met at time bill was submitted — Filing suit following original submission of bill and subsequent to deductible having been met does not entitle medical provider to recover under benefits portion of policy
SARASOTA SPINE SPECIALISTS, P.A. (LINDA JOHANNING), Plaintiff, vs. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant. County Court, 12th Judicial Circuit in and for Sarasota County. Case No. 2003 SC 001304 NC. September 2, 2003. Judith Goldman, Judge. Counsel: Lisa S. Del Vecchio, Thompson Goodis Thompson Groseclose & Richardson, P.A., St. Petersburg. Brian M. Rodier.
ORDER ON DEFENDANT’S MOTION FOR SUMMARY JUDGMENT
THIS CAUSE having come on before this Court on August 26, 2003 on Defendant’s Motion for Summary Judgment and the Court having heard argument of counsel for the respective parties and being otherwise fully advised in these premises, it is hereby
ORDERED and ADJUDGED that the Defendant’s Motion for Summary Judgment is GRANTED. The Court finds that there are no material issues of fact which would preclude Summary Judgment from being entered in favor of the Defendant. The undisputed facts are as follows:
1. Plaintiff is a health care provider which accepted an assignment of benefits from Progressive’s insured, Linda Johanning.
2. Plaintiff filed a PIP suit against Progressive alleging that Progressive failed to pay Plaintiff in accordance with the PIP statute and the subject policy of automobile insurance.
3. Plaintiff filed said Complaint on or about January 27, 2003.
4. Plaintiff has alleged that the Defendant has refused or otherwise failed to timely pay for PIP benefits incurred by the insured on December 10, 2002.
5. The insured’s policy of insurance provided for ten thousand dollars ($10,000.00) in coverage with a two-thousand dollar ($2,000.00) deductible, for which the insured is responsible.
6. Plaintiff’s bill was applied to the deductible.
7. Defendant reduced the Plaintiff’s bill pursuant to Florida Statute 627.736 and the policy of insurance and applied the reduced amount to the deductible.
Based on the above-referenced facts the Court finds as follows:
Even assuming Progressive had not reduced the bill, the full amount would have been applied to the deductible which had not been met at the time the bill was submitted. Even if the reduction of Plaintiff’s bills were found to be unreasonable by a trier of fact, the English Rule governs the order of payment. Filing a lawsuit following the submission of the original bill, subsequent to the deductible having being met, does not entitle the Plaintiff to recover under the benefits portion of the policy.
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