11 Fla. L. Weekly Supp. 585b
Insurance — Personal injury protection — Standing — Assignment — Validity — Document that includes language of assignment but also states that insured remains personally responsible for total amounts due for services, whether or not any or all of amount was or will be paid by insurer, is not valid assignment — Summary judgment entered against medical provider
NEUROLOGY CONSULTANTS a/a/o Molly Micklaw, Plaintiff, v. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant. County Court, 19th Judicial Circuit in and for St. Lucie County. Case No. 03 SC 3031. April 14, 2004. Thomas Walsh, Judge. Counsel: Alejandro M. Garcia, Ft. Lauderdale, for Plaintiff. Seth W. Pachter, Vernis & Bowling, North Palm Beach, for Defendant.
ORDER GRANTING DEFENDANT’S MOTION FOR SUMMARY JUDGMENT
THIS CAUSE having come before the Court on the Defendant’s Motion for Summary Judgment and the Court having heard argument and being otherwise advised in the premises makes the following findings of fact:
A document that was dated July 16, 2003 was provided to this Court (Defendant’s Exhibit # 1) as the Plaintiff’s alleged assignment of benefits that would allegedly allow standing for Plaintiff (a medical provider) to sue insured’s insurance company in this personal injury protection claim. This document states, in the first line, in paragraph 3: “I understand that I remain personally responsible for the total amounts due the Office for their services.”
The language in the document, cited above, does not refer to any ‘unpaid’ portions of the medical bills at issue. Instead, said language “I remain personally responsible for total amounts due the office”, leaves insured responsible for any amounts charged for services, whether or not, said amount was or will in the future be paid by insurer to Plaintiff.
Without a valid assignment of the right to personal injury protection benefits, a provider lacks standing to bring suit against an automobile insurer pursuant to the insurance contract. Hartford Insurance Company of the Southeast v. St. Mary’s Hospital, Inc., 771 So.2d 1210 (4th DCA 2000). While the document at issue, in the second paragraph, states the language of assignment, the plain language of paragraph three, as cited, is not indicative of this document being an assignment of benefits. It has been held that a provider lacked standing to bring action against insurer based on document which was entitled “Assignment of Benefits”, but which was merely functional equivalent of a direction to pay. Lighthouse Orthopedic Associates, P.A. (a/a/o Kylee Treyz v. Progressive Express Insurance Company, 11 Fla. L. Weekly Supp. 152b (Co. Ct., Broward, November 18, 2003). The fact that a document may have language of assignment in it does not automatically end the determination of whether said document is a valid assignment that confers standing to sue on a Plaintiff.
Plaintiff’s counsel relies on the case, Oglesby v. State Farm Mutual Automobile Insurance Company, 781 So.2d 469 (5th DCA 2001), to argue that the document relied upon is in fact a valid assignment. However, Oglesby, is clearly distinguishable from the present matter. In Oglesby the alleged assignment stated, in part, ‘that insured remained liable for any medical bills not paid by the insurer’ (emphasis added). There is no such language in the document alleged to be an assignment of benefits in the present matter. While in Oglesby the insured remained liable under the document for only medical benefits ‘not paid’ by the insurer, in the present matter the insured remains ‘personally responsible’ for the ‘total amounts due the Office for their services’, whether or not all or any part of the services are paid by insurer.
The Fifth District in Oglesby specifically found that case involved ‘a case, as is most often the case, in which the medical provider agrees to perform services based only on an unqualified assignment of medical benefits on the condition that the patient will be ultimately responsible for any medical bills either not covered by the policy or simply not paid by the insurer’. That is far different than in the present matter where the insured remains liable for the bills under the alleged assignment even if the specific bill has been paid by the insurer to the provider.
The plain language of the document, alleged to be an assignment of benefits, in this matter is unambiguous. The Court finds that the plain language of the document is not indicative of the parties intent to create an assignment. Therefore, further inquiry into the intent of the parties is not necessary. Orthopaedics Of Brevard, P.A. v. Progressive Casualty Insurance Company, 11 Fla. L. Weekly [Supp.] 163a (Co. Ct., Brevard, November 21, 2003).
Accordingly, it is hereby,
ORDERED and ADJUDGED as follows:
That based upon the foregoing it is this Court’s finding that Plaintiff, Neurology Consultants did not possess an assignment of benefits from Defendant, Progressive’s insured. Without an assignment of benefits from Defendant, Progressive’s insured, Plaintiff failed to meet the threshold requirement that would provide standing to maintain this cause of action. The Plaintiff, Neurology Consultants lacks standing to bring the action and the Defendant, Progressive Insurance Company’s Motion for Summary Judgment on the issue of standing is GRANTED.
The Court further enters Final Judgment in favor of the Defendant, Progressive Insurance Company and against Plaintiff, Neurology Consultants, and the Plaintiff shall take nothing by this action and the Defendant, Progressive Insurance Company shall go hence without day.
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