11 Fla. L. Weekly Supp. 585a
Insurance — Personal injury protection — Coverage — Medical bills — Exhaustion of benefits — Where insured never provided insurer with notice requesting that amount at issue be reserved or escrowed, and policy does not require insurer to reserve funds after making partial payment, exhaustion of benefits precludes recovery of remainder due on bills that were reduced or denied
VICKI-ANN BRUNEAU, Plaintiff, vs. NATIONWIDE PROPERTY AND CASUALTY INSURANCE COMPANY, Defendant. County Court, 18th Judicial Circuit in and for Brevard County. Case No. 05-2002-CC-25361. March 19, 2004 nunc pro tunc. Cathleen B. Clarke, Judge. Counsel: Christopher A. Layman. Hanton Walters, Capito & Polk, Longwood.
ORDER ON DEFENDANT’S MOTION FOR SUMMARY JUDGMENT
THIS MATTER having come on for hearing on March 3, 2004 on Defendant’s Motion for Summary Judgment in the above-styled matter, and the Court having examined the entire court file, having heard arguments of counsel, having reviewed the case law tendered to the Court by counsel and being otherwise fully advised, hereby makes the following findings and/or rulings:
1. Vicki-Ann Bruneau was insured under a policy with the Defendant, Nationwide Property and Casualty Insurance Company, for personal injury protection coverage.
2. On August 23, 2001, Vicki-Ann Bruneau was involved in an automobile accident, in which she suffered injuries and sought treatment from various medical providers.
3. Nationwide received bills from various providers which were either paid in full, reduced or denied, as outlined in the PIP log that was made part of the court file.
4. By paying the bills, Nationwide exhausted all of the PIP benefits of the Plaintiff, Vicki-Ann Bruneau’s policy on February 1, 2002 for the motor vehicle accident of August 23, 2001.
5. On May 28, 2002, the Plaintiff filed a lawsuit requesting the remainder due on bills that were either reduced or denied.
6. At no time prior to the filing of this action did the Plaintiff provide Nationwide with any notice requesting the amount at issue be reserved or escrowed.
7. Nowhere in the policy of the Plaintiff, Vicki-Ann Bruneau, does it require Nationwide to reserve any funds after they make payment in part.
8. The Court finds that the Defendant’s exhaustion of benefits via payment to other providers was proper under the terms of Defendant’s insurance policy and in accordance with Florida Statute section 627.736.
9. This Court looked to the reasoning of the County and Circuit Courts and found Neuroimaging Associates, P.A. v. Nationwide Insurance Company of Florida, Inc., 10 Fla. L. Weekly Supp. 738a(Fla. 15th Judicial Circuit 2002)persuasive and in agreement with the Court’s analysis.
IT IS THEREFORE
ORDERED and ADJUDGED that Defendant’s Motion for Summary Judgment is GRANTED, based upon the exhaustion of PIP benefits available under the subject insurance policy with Defendant.
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