11 Fla. L. Weekly Supp. 161a
Insurance — Personal injury protection — Coverage — Late-submitted bills — Amendments to statute allowing for bills erroneously submitted to incorrect carrier to be resubmitted to correct carrier do not apply retroactively — Medical provider failed to submit bills for services within 30days of treatment and failed to include with bills evidence demonstrating that provider reasonably relied on erroneous information — Partial summary judgment is granted in favor of insurer as to those bills — Summary judgment is also granted in favor of insurer for those bills that were never denied or reduced by insurer, as medical provider failed to provide insurer with demand letter for the bills
OWEN D. FRASER, M.D., as assignee of Coretha Sessler, Plaintiff, vs. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant. County Court, 18th Judicial Circuit in and for Seminole County. Case No. 02-CC-2613-20C-S. December 9, 2003. John R. Sloop, Judge. Counsel: George Milev, Adams, Blackwell & Diaco, P.A., Tampa.
ORDER ON DEFENDANT’S MOTION FOR PARTIAL SUMMARY JUDGMENT AND MOTION FOR PROTECTIVE ORDER
This Cause having come before the Court on November 5, 2003 on Defendant’s Motion for Partial Summary Judgment and Motion for Protective Order, Plaintiff and Defendant having appeared through counsel, having presented arguments, and this Court having been duly advised in the premises, the Court hereby ORDER, ADJUDGE and FIND AS FOLLOWS:
1. The Plaintiff, Dr. Owen Fraser, as assignee of Coretha Sessler, filed this Personal Injury Protection Lawsuit to recover payment for medical bills submitted to Defendant, Progressive Express Insurance Company.
2. Plaintiff failed to submit bills for dates of service from 1/20/00 through 3/27/00 in accordance with §627.736(5)(c), Fla. Stat. (2000) as those bills were for services performed more than 35 days before the postmark date of the statement of charges.
3. The amendments to §627.736(5)(c), Fla. Stat. (2000) do not apply retroactively based on the facts in the current case.
4. Plaintiff failed to include with said bills documentary evidence demonstrating that the provider reasonably relied upon erroneous information.
5. Defendant’s Motion for Partial Summary Judgment for bills, dates of service from 1/20/00 through 3/27/00, is GRANTED.
6. Defendant shall not be responsible for said bills.
7. Plaintiff failed to comply with §627.736(11)(a), Fla. Stat. (2000) for bills, dates of service from 4/04/00 through 5/02/00, that were never reduced or denied by Defendant as Plaintiff failed to provide Defendant with demand letter for those bills.
8. Defendant’s Motion for Partial Summary Judgment for bills, dates of service from 4/04/00 through 5/02/00, is GRANTED.
9. Defendant shall not be responsible for said bills.
10. Defendant’s Motion for Protective Order is DENIED as the relief sought by Defendant is included within the Court’s ruling on Defendant’s Motion for Partial Summary Judgment.
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