12 Fla. L. Weekly Supp. 180a
Attorney’s fees — Insurance — Personal injury protection — Contingency risk multiplier — Where PIP suit concerned accounting and billing error primarily caused by medical provider’s accounting and billing practices, multiplier is not appropriate — Expert witness fee awarded
DANIEL S. YACHTER, D.C., P.A., as assignee of LORI WOYCEHOSKI, Plaintiff, vs. NATIONWIDE PROPERTY AND CASUALTY INSURANCE COMPANY, a corp. authorized and doing business in the State of FL, Defendant. County Court, 18th Judicial Circuit in and for Seminole County. Case No. 02-CC-413-20-R. October 15, 2004. Ralph E. Eriksson, Judge. Counsel: Michael B. Brehne, Maitland, for Plaintiff. Lisa Bernardini, Longwood, for Defendant.
ORDER ON PLAINTIFF’S MOTION FOR ATTORNEY’S FEES AND COSTS
THIS CAUSE came on for hearing on September 14, 2004 upon the Plaintiff’s Motion for Attorney’s Fees and Costs. The Court received testimony presented by both sides. The testimony showed that the Plaintiff (a health care provider) retained the services of an attorney to collect bills that were not being paid by the Defendant (an insurance company) for services that the Plaintiff provided to the Defendant’s insured and for which the insured had assigned their benefit rights to the health care provider.
The Plaintiff’s attorney testified that when the case was initially presented to him, it was because the health care provider (the Plaintiff) was not certain that all of the bills that they were submitting were being paid. Upon further examination he determined that it was because of billing code problems and an inability to determine which payments were made toward which bills. This was further compounded because the health care provider had outsourced the billing function and the health care provider was not getting clear information from this outside billing company as to what bills were paid.
The insurance company’s expert testified that his review of the file showed that the health care provider’s office did not keep good records and were never able to provide accurate records as to what payments they had received. A review of the complaint filed with this Court seems to support the Defendant’s proposition because the complaint fails to specify what bills were not paid and what dollar amount the Plaintiff’s lawsuit was seeking. The complaint merely states that the Defendant has “refused to pay for certain medical care.”
The essence of the case seems to be reflected in the testimony of the Plaintiff’s attorney which showed he had to get copies of the front and back of the checks that the insurance company had paid with so he could determine what bill the health care provider had applied a particular payment to. The health care provider’s records did not clearly show what amounts of money they had received. Three months after the insurance company completed their review of the case and had found that there were $210.00 in bills outstanding, the Plaintiff completed their audit, agreed and the case was settled. Therefore, the testimony shows that this was really an accounting problem and no difficult, or unique legal issue was involved. The Court further finds that the problem was primarily caused by the health care provider’s billing and accounting practices and not the insurance company’s. The Court does not find that a multiplier is appropriate with this kind of issue, on these facts. Since the Court finds that this is simply an accounting and billing issue an experienced lawyer would not be needed, or if one were employed, a paralegal could have handled most of the work. The Court finds that a $200.00 per hour fee is appropriate and that 15 hours was a reasonable amount of time expended on the case.
Plaintiff’s expert witness on attorney’s fees, Brian Coury, is entitled to be compensated for the time he expended in preparing to testify and testifying in this case. Mr. Coury has expended 4 hours in this case and the only testimony supports an hourly rate for Mr. Coury of $300 per hour.
It is therefore
ORDERED AND ADJUDGED that Plaintiff’s attorney shall have and recover from the Defendant the sum of $4,200 as attorney’s fees for which let execution issue forthwith.
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