11 Fla. L. Weekly Supp. 341b
NOT FINAL VERSION OF OPINION
Subsequent Changes at 11 Fla. L. Weekly Supp. 452b
Insurance — Personal injury protection — Coverage — Medical bills — Where provider/assignee or its billing company faxed medical bill to insurer more than thirty days after date of service and, despite provider’s claim that bill was mailed to insurer within thirty days of date of service, there is no evidence that earlier bill was ever generated or mailed to insurer, summary judgment is granted in favor of insurer
REGIONAL MRI OF ORLANDO, INC. as assignee of Guylaine Edouard, Plaintiff, vs. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant. County Court, 9th Judicial Circuit in and for Orange County. Case No. SCO-01-10037. February 3, 2004. C. Jeffery Arnold, Judge. Counsel: Mitzie Archer. George Milev, Adams, Blackwell & Diaco, P.A., Tampa.
ORDER GRANTING DEFENDANT’S MOTION FOR FINAL SUMMARY JUDGMENT AND DENYING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT
This Cause having came before the Court on January 5, 2004 on Defendant’s Motion for Final Summary Judgment and Plaintiff’s Motion for Summary Judgment, 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. Plaintiff filed a PIP suit against Defendant for unpaid medical bills for treatment rendered to Guylaine Edouard as a result of injuries sustained in an automobile accident which occurred on November 28, 2000.
2. Plaintiff provided diagnostic services to Guylaine Edouard on February 27, 2001.
3. On July 12, 2001, Plaintiff or their billing company faxed a bill to Progressive, for date of service February 27, 2001, dated July 12, 2001.
4. Plaintiff failed to submit a bill for date of service February 27, 2001 in accordance with §627.736(5)(c), Fla. Stat. (2001) as that bill was for services performed more than 35 days before the postmark date of the statement of charges.
5. Plaintiff or their billing company claimed that a bill for date of service February 27, 2001 was mailed to Defendant on March 1, 2001 or March 2, 2001.
6. Based the record, there is not a single former or current employee of the billing company who recalls preparing a bill for February 27, 2001 date of service, or recalls mailing the bill to Defendant or knows whether the bill was mailed to the patient or to the Defendant or who recalls seeing the bill or filing the same in any office file or recalls anything about the bill. No one from Plaintiff recalls ever seeing the original bill, mailing the bill to anyone or receiving or filing a copy of the bill.
7. There is not, in the records of the Defendant, nor the Plaintiff, nor the billing company, a copy of a bill for date of service February 27, 2001 with a date of printing during February or March 2001.
8. Based on the record, there is no evidence that the February or March bill was ever generated or mailed to Defendant, including anything from the United States Postal Service.
9. Plaintiff cannot benefit, in this particular case, from the presumption that properly addressed and stamped mail, placed in the mail was received by the addressee since the billing company has served up for the Plaintiff a deficient paper trail.
10. There is no dispute as to a material fact that would bare upon the competing motions for summary judgment in this case.
11. The parties are entitled to a judgment as a matter of law.
WHEREFORE, Plaintiff’s Motion for Summary Judgment is hereby DENIED And Defendant’s Motion for Final Summary Judgment is hereby GRANTED.
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