12 Fla. L. Weekly Supp. 769c
Insurance — Personal injury protection — Demand letter — Pre-suit demand letters sent by medical provider prior to reassigning benefits back to insured do not satisfy requirement that insured send demand letter before initiating suit — Where insured did send demand letter in regard to treatment by second medical provider and moved to amend complaint to add benefits owed to that provider, and insurer cannot be said to suffer prejudice from granting motion to amend, motion to amend is granted and partial summary judgment in favor of insurer is granted only as to unpaid benefits relating to original provider
CONNIE L. HART, Plaintiff, v. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant. County Court, 7th Judicial Circuit in and for Volusia County. Case No. 2004-33316 COCI. April 30, 2005. Stasia Warren, Judge. Counsel: Thomas E. Caldwell. Sandra Kotur, Adams, Blackwell & Diaco, P.A.
ORDER GRANTING PARTIAL SUMMARY JUDGMENT
THIS MATTER came on to be heard before the Court upon Defendant’s Motion for Summary Final Judgment and Motion for Protective Order, and the Court having reviewed the motion, the court file, heard argument of counsel, and being otherwise fully advised in the premises, the Court finds as follows:
Findings of Fact
1. Plaintiff filed a PIP suit against Defendant for unpaid and/or reduced medical bills for treatment received from Florida Medical Associates as a result of injuries she allegedly sustained in an automobile accident that occurred on February 16, 2004.
2. Plaintiff was insured under a PIP policy of insurance issued by the Defendant. This policy was in full force and effect on the date of the alleged accident and it had $10,000 in PIP benefits, $5,000 in Medpay benefits, and no deductible.
3. On February 26, 2004, the Plaintiff executed an Assignment of Benefits in favor of Florida Medical Associates. See Defendant’s Motion Exhibit A.
4. Two demand letters on Florida Medical Associates letterhead were sent to the Defendant on May 18, 2004 and June 24, 2004 for treatment rendered to the Plaintiff. The first demand letter was in regard to treatments dated 4/12/04 and 4/13/04; the second demand letter was for treatments dated 4/29/04 and 6/02/04. The letters were signed by an unknown individual for Tonya Brownius the “Representative of Provider.” See Defendant’s Motion Exhibits B and D.
5. On August 5, 2004, Ken Howe, on behalf of Florida Medical Associates, reassigned the Plaintiff’s Insurance Benefits back to her. See Defendant’s Motion Exhibit F.
6. The instant case was filed on August 24, 2004 and was in regard to treatment the Plaintiff received from Florida Medical Associates.
7. The Plaintiff, while stating in her Complaint that all conditions precedent prior to filing suit have been met, has not, even during the hearing on this matter, filed her demand letter to Progressive in regard to treatment received by Florida Medical Associates with the court.
8. On December 12, 2004, the Plaintiff, on counsel’s letterhead sent the Defendant a demand letter in regard to treatments the Plaintiff received from the Ford Group between June 17, 2004 and July 15, 2004.
9. On January 13, 2005, the Plaintiff filed a Motion to Amend Complaint to add the benefits allegedly owed to the Ford Group by Defendant.
10. On February 28, 2005, the Defendant filed the instant motion.
11. On April 12, 2005, the court heard the instant motion and Plaintiff moved to amend her Complaint.
12. As the court is entering this Order, the court is simultaneously entering an Order granting Plaintiff’s Motion to Amend.
Legal Analysis
Florida Statutes section 627.736(11)(a) mandates that “[a]s a condition precedent to filing any action for benefits under this section, the insurer must be provided with written notice of an intent to initiate litigation.” In construing statutory language, the words used in legislation must be given their ordinary and commonly accepted meaning. See Hancock Advertising, Inc. v. Dept. of Transportation, 549 So.2d 1086 (Fla. 3rd DCA, 1989) rev. denied, 558 So.2d 17 (Fla. 1990). Statutes will not be interpreted in a manner that leads to an unreasonable or ridiculous result or a result obviously not intended by the legislature. See Drury v. Harding, 461 So.2d 104 (Fla. 1984).
While it can be argued that the demand letters sent by Florida Medical Associates are sufficient to satisfy the condition of written notice to the insurer, the court finds that a reasonable interpretation of the legislature’s statutory language requires the claimant who is going to file suit, to be the one to send the Presuit demand letter prior to bring the action. In this way the insurer receives adequate written notice as to not only the amount of the claim but the party that it will have to defend itself against should it deny payment. As the Plaintiff failed to serve the Presuit demand letter to the Defendant in regard to treatment she received from Florida Medical Associates, she has failed to comply with the statutory condition precedent pursuant to Florida Statutes section 627.736(11) in regard to that portion of her claim, and her claim must fail.
However, the Plaintiff did serve a Presuit demand letter to the Defendant in regard to treatment she received from the Ford Group, therefore, she has complied with the statutory condition precedent pursuant to Florida Statutes section 627.736(11) in regard to that portion of her claim. The Plaintiff filed her Motion to Amend prior to the Defendant filing the instant motion. Therefore, the Plaintiff’s Motion to Amend was not made in response to the instant motion but was rather made solely for the purpose of including the unpaid Ford Group charges. Therefore, the Defendant cannot be said to suffer prejudice by the court granting the Plaintiff’s Motion to Amend to include the unpaid Ford Group charges.
Accordingly, it is:
ORDERED AND ADJUDGED that:
1. Defendant’s Motion for Summary Judgment is GRANTED as to Plaintiff’s claims of unpaid benefits as to Florida Medical Associates only.
2. Defendant’s Motion for Summary Judgment is DENIED as to Plaintiff’s claims of unpaid benefits as to the Ford Group.
3. Defendant’s Motion for Protective Order is DENIED as Defendant potentially has further liability on this claim, and discovery is ongoing.
* * *
