12 Fla. L. Weekly Supp. 674b
Insurance — Personal injury protection — Coverage — Exhaustion of policy limits — Subsequent claim for unpaid portion of bills — Motion for summary judgment is denied despite failure of medical provider to put insurer on notice of dispute regarding insurer’s reduction of bill prior to exhaustion of policy limits where issue of whether sufficient benefits were awarded to pay provider properly and in accordance with statute prior to benefits being exhausted is question for trier of fact
CENTER FOR ORTHOPEDIC SURGERY AND SPORTS MEDICINE AAO BETH CADDEN, Plaintiff, v. NATIONWIDE GENERAL INSURANCE COMPANY, Defendant. County Court, 15th Judicial Circuit in and for Palm Beach County, Civil Division ‘RD’. Case No. 502003CC18963SB. March 11, 2005. Debra Moses Stephens, Judge. Counsel: Glenn Siegel, Boca Raton. Susan R. Kent, West Palm Beach.
ORDER ON MOTION FOR SUMMARY JUDGMENT
THIS CAUSE having come before the Court on Defendant’s Motion for Summary Judgment and the court having been fully advised in the premises it is hereby
ORDERED AND ADJUDGED that Defendant’s Motion for Summary Judgment is DENIED. While the Defendant is convincing in its argument that it should be put on notice about disagreements concerning the way it pays out benefits to doctors and treatment centers, it cannot overcome the law in this area. The PIP Statutes, do not appear to address any right of an insured to object to the payment of benefits after they have been reduced. It would be uncommon indeed for a provider who believes they have given valuable services, who is then told these services are not worth that amount of money to be pleased with a reduction in what was demanded. The objection is neither required nor unexpected. Whether there were sufficient benefits awarded to pay the Plaintiff properly, and in accordance with Florida Statute §627.736(4)(b) prior to the benefits being exhausted, is a question for the trier of fact. Celpha Clinic Inc. v. Progressive Express Insurance Co., 11 Fla. L. Weekly Supp. 113a. Boulevard National Bank of Miami v. Air Metal Industries, Inc., 176 So.2d 94. Pinnacle Medical Inc. d/b/a Data Diagnostics v. Allstate Insurance Co., Case No. 97-12340(18), L.T. Case No. 96-6203 (17th Cir. Broward County, April 23,1998.) [5 Fla. L. Weekly Supp. 663a].
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