11 Fla. L. Weekly Supp. 645b
Insurance — Personal injury protection — Demand letter — Sufficiency — Court cannot grant summary judgment for plaintiff on claim for statutory 10% interest following insurer’s payment of overdue bills after receipt of demand letter or for insurer on claim that interest is not due because demand letter failed to satisfy statutory requirements where disputed issues of material fact exist concerning whether confusing letter could be understood by someone in insurance and billing industry as giving information required by statute
GLENICE COATES, Plaintiff, vs. PROGRESSIVE EXPRESS INSURANCE CO., Defendant. County Court, 4th Judicial Circuit in and for Duval County. Case No. 03-SC-10003, Division B. May 12, 2004. Roberto A. Arias, Judge. Counsel: D. Scott Craig, Farah, Farah, & Abbott, P.A., Jacksonville, for Plaintiff. Ellen C. Pappas, McFarlain & Cassedy, P.A., Tallahassee, for Defendant.
ORDER DENYING PLAINTIFF’S AND DEFENDANT’S MOTIONS FOR FINAL SUMMARY DISPOSITION OR JUDGMENT
THIS CAUSE came on to be heard upon the Plaintiff’s Motion for Summary Judgment and Defendant’s Cross Motion for Final Summary Disposition. Present before the Court appeared D. Scott Craig, Esquire, attorney for Plaintiff and Ellen C. Pappas, Esquire, attorney for Defendant. After having reviewed the file, exhibits and Motions for Summary Dispositions or Summary Judgment, and having considered the argument and memoranda of law provided by counsel for both parties, the Court finds:
A. This law suit concerns allegations of Defendant’s failure to pay in full, billing for medical treatment rendered to Plaintiff by a medical provider, Northeast Florida Neurology Clinics.
B. Pursuant to Section 627.736(11), Florida Statutes Annotated, the Plaintiff submitted to Defendant’s designee, a “demand letter” which contained an itemized statement from the medical provider.
C. Subsequent to the demand letter being received by Defendant’s designee, the Defendant paid overdue medical bills which were included in the Plaintiff’s “demand letter”. However, while paying the six (6%) percent as statutory interest on those overdue bills, the Defendant did not pay the ten (10%) percent statutory penalty, pursuant to the Section 627.736(11)(b), Florida Statute Annotated.
D. The Plaintiff claims that it is entitled to a summary judgment because the Defendant paid the overdue bills, after the “demand letter” was sent.
E. The Defendant, however, claims the Court should grant their Motion for Summary Disposition because the Plaintiff’s “demand letter” did not comply with the requirements of Section 627.736(11), Florida Statutes and was therefore defective. Because the Plaintiff’s “demand letter” was defective, the Defendant argues, the Plaintiff failed to perform the statutorily required condition precedent to file in an action for benefits under the section.
F. The Court finds that Sections 627.736, Florida Statutes, requires that a “demand letter” be sent to Defendant, as a condition procedent, which must be met before an action for benefits may be filed. However, the Court finds that the Legislature’s intent in enacting Section 627.736 requirement of a demand letter was to place the insurance companies on notice as to what debts or bills remain unpaid. Therefore, based upon the “demand letter” and its attachments, this Court cannot hold that a matter of law that the letter gave, or failed to give, notification required by the statute. While the letter and its attachments at first glance may seem to be confusing to someone who is not involved in the medical billing and insurance industry, the “demand letter” could very well have been understood by the Defendant’s designee as giving the information required by the statute. Therefore, the Court finds that there is a disputed material issue of fact which prevents it from ruling for either Defendant or Plaintiff.
For the above stated reasons, it is hereby
ORDERED:
The Defendant’s and Plaintiff’s Motions for Summary Judgment or disposition is DENIED.
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