11 Fla. L. Weekly Supp. 1072a
Insurance — Personal injury protection — Coverage — Exhaustion of policy limits — Subsequent claim for unpaid portion of bills — Summary judgment is granted in favor of insurer where policy limits have been exhausted — Medical provider/assignee carries no right greater than that available to assignor, who has used full amount of contracted benefits
SIEGFRIED K. HOLZ, M.D., P.A., a/a/o HESLYN CUNNINGHAM, Plaintiff, vs. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant. County Court, 10th Judicial Circuit in and for Polk County, Small Claims Division. Case No. 53-2003SC-003689-0000-00. August 11, 2004. Karla Foreman Wright, Judge. Counsel: Jason F. Lamoureux, Holland & Lamoureux, P.A., Brandon, for Plaintiff. Scott W. Dutton, Haas, Dutton, Blackburn, Lewis & Longley, Tampa, for Defendant.
ORDER ON DEFENDANT’S MOTION FOR SUMMARY JUDGMENT
This matter came on for hearing upon Defendant’s Motion for Summary Judgment. Defendant moved the court for summary judgment arguing Defendant’s liability for medical benefits were paid out on the assignor’s behalf were exhausted. Therefore, as a matter of law, Defendant’s obligation under contract with assignor was fully discharged. The court, having considered the arguments of counsel, the affidavits on file, and the case law presented by counsel, finds and rules as follows:
1. Heslyn Cunningham (assignor) had an insurance policy with Progressive Auto Pro Company (Defendant). The policy provided for personal injury protection (PIP) benefits of ten thousand ($10,000.00) dollars.
2. On or about December 12, 1998, assignor was involved in a motor vehicle accident in which she sustained bodily injury in the course of operating her motor vehicle.
3. Assignor received benefits from the policy as required by law. F.S. §627.7330-§627.7450.
4. Siegfried Holz, M.D., P.A., d/b/a Lakeland Open MRI (Plaintiff) treated assignor for the injuries she sustained from the accident. Plaintiff accepted an assignment of benefits from assignor. Pursuant to the assignment of benefits, Plaintiff billed the Defendant for medical services rendered to the assignor.
5. On or about August 11, 2000, Plaintiff presented Defendant with a bill in the amount of $2,950.00 for services rendered. The Defendant paid $1,056.42. This amount was less than 80% of Plaintiff’s bill. At the time the Plaintiff’s claim was submitted, the policy had sufficient benefits to pay the full 80% of the billed amount.
6. Thereafter, assignor made other claims for benefits under her policy resulting in an exhaustion of PIP benefits prior to Plaintiff’s suit in this matter.
7. Defendant now argues that Defendant, irrespective of the merits of Plaintiff’s claim, has satisfied its legal obligation to pay benefits pursuant to the its contract with the assignor.
8. Neuro-Imaging Associates, P.A. v. Nationwide Insurance Company, 10 Fla. L. Weekly Supp. 738A (Florida 15th Judicial Circuit 2002), in a factually analogous situation, holds for the defendant PIP carrier. In Neuro-Imaging, and the instant case, the defendants argue that plaintiff, as assignee, cannot have any rights greater than those once held by the assignor/insured. The assignor has used the full amount of the contracted benefits.
9. The rationale in Neuro-Imaging also applies to the case sub judice and this court adopts its reasoning in finding for Defendant. The assignee carries no right greater than that available to the assignor. It is therefore,
ORDERED and ADJUDGED that Defendant’s motion for summary judgment is GRANTED and judgment shall be entered for the Defendant who shall go henceforth without day. The court reserves jurisdiction as to entitlement to and amount of fees and costs, if any.
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