11 Fla. L. Weekly Supp. 337a
Insurance — Personal injury protection — Coverage — Medical bills — Where insurer requested that provider/assignee provide definitive description of supply charge on bill within ten days of receipt of bill, and provider failed to provide requested information until after filing suit, action was filed prematurely before satisfying all conditions precedent — Summary judgment granted in favor of insurer
HESS SPINAL & MEDICAL CENTERS, INC., on behalf of Jon Cash, Plaintiff, vs. DIRECT GENERAL INSURANCE COMPANY, Defendant. County Court, 6th Judicial Circuit for Pinellas County, Civil Division. Case No. 03-740-SC-SPC. February 4, 2004. Karl B. Grube, Judge. Counsel: Paul Puzzanghera, St. Petersburg. John T. Golding, Allen, Kopet & Associates, PLLC, Tampa.
ORDER GRANTING DEFENDANT’S MOTION FOR SUMMARY JUDGMENT
THIS MATTER came before the Court on the Defendant’s Motion for Summary Judgment. The Court considered the argument of counsel, as well as the uncontroverted facts set forth in the pleadings, affidavits, depositions, answers to Interrogatories and admissions on file, and then found and ruled as follows:
1. In granting Defendant’s Motion for Summary Judgment, this Court has considered the factual allegations contained in the Motion insofar as those allegations are supported by uncontroverted facts set forth in the pleadings, affidavits, depositions, answers to Interrogatories and admissions on file. Firestone v. Time, Inc., 231 So.2d 862 (4th Dist. 1970).
2. In paragraphs 2-4 of Defendant’s Motion for Summary Judgment, it is alleged that:
When the Defendant received the noted bill, there was insufficient information included therein by the Plaintiff to ascertain the basis of the charge; The Defendant then requested from Plaintiff a definitive description of the supply charge, which the Defendant never received prior to the Plaintiff filing this lawsuit to recover payment of the bill. Thus, Plaintiff failed to complete a necessary condition precedent to filing this lawsuit.
This allegation is supported by the uncontroverted sworn testimony of PIP (Personal Injury Protection) Supervisor for Direct Adjusting Company, Eric Nodland, as set forth in his affidavit filed in this cause on November 3, 2003 and deposition filed in this cause on December 5, 2003. It is also corroborated by the sworn testimony of Plaintiff’s attorney, Angela Stone, as contained in her affidavit filed in this cause on November 5, 2003.
3. In Eric Nodland’s affidavit, he stated that Defendant requested from Plaintiff a definitive description of the supply charge. Pursuant to Fla. Stat. §627.736(6)(b) (2003), that request tolled the thirty days in which to investigate and pay a timely submitted bill until ten days after receipt of such documentation. In Eric Nodland’s deposition, Page 29, he stated that it wasn’t until October 29, 2003 when the Defendant received sufficient information from the Plaintiff describing the supply charge on the bill.
4. In Angela Stone’s affidavit, she stated that on April 2, 2003, she attended the pre-trial conference and mediation in this case. During the mediation, she stated that she telephoned her legal assistant, Connie Griesheimer, to fax the description of the charge to the Judge’s office. Thereafter, she stated that she received and reviewed the description, and personally provided a copy to Eric Nodland. The affidavits of Connie Griesheimer and Lydia Rodriguez, filed in this cause on November 5, 2003 and November 6, 2003 respectively, corroborate Ms. Stone’s testimony that a description of the supply charge was requested and faxed on that date.
5. The true and uncontroverted facts in this case show that the Plaintiff filed this cause of action on February 5, 2003. The Defendant’s request for the description of the supply charge was made, but not honored until, at the earliest, April 2, 2003. This Court finds that there are no issues of material fact regarding whether Plaintiff satisfied all conditions precedent to the filing of this action. The uncontroverted material facts establish that the Plaintiff failed to provide the Defendant with the required information until after filing suit. According to Fla. Stat. §627.736(6)(b) (2003), “if an insurer makes a written request for documentation or information under this paragraph within 30 days after having received notice of the amount of a covered loss under paragraph (4)(a), the amount or the partial amount which is the subject of the insurer’s inquiry shall become overdue if the insurer does not pay in accordance with paragraph (4)(b) or within 10 days after the insurer’s receipt of the requested documentation or information, whichever occurs later.” Therefore, this Court finds that this cause of action was filed prematurely and contrary to the legal requirements of Florida law. Plaintiff was not entitled, pursuant to Florida law, to bring this action to collect on claim that was not overdue.
WHEREFORE, it is
ORDERED AND ADJUDGED that Defendant’s Motion for Summary Judgment be and the same is herewith granted. Judgment is to be entered for the Defendant. The Court will reserve jurisdiction to consider the taxation of costs and fees.
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