12 Fla. L. Weekly Supp. 259b
Insurance — Personal injury protection — Discovery — Depositions — Motion to compel deposition of person who, on behalf of insurer, signed contract between insurer and company whose software program was utilized to evaluate and reduce medical provider’s bills is granted
FIRST CARE CHIROPRACTIC CENTER, INC., by Assignment of Benefit from JEAN-ROBERT LESPINASSE, Plaintiff, vs. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant. County Court, 18th Judicial Circuit in and for Seminole County. Case No. 03-SC-3476. December 2, 2004. Donald L. Marblestone, Judge. Counsel: Christopher W. Conomos, Martindale & Associates, P.A., Orlando, for Plaintiff. Brian T. Forman, Kingsford & Rock, P.A., for Defendant.
ORDER ON PLAINTIFF’S MOTION TO COMPEL DEPOSITION OF BRIAN J. PASSELL
THIS CAUSE came before the Court on Plaintiff’s Motion to Compel the Deposition of Brian J. Passell, on October 20, 2004, and the Court having considered Plaintiff’s motion together with argument of counsel, and the Court being otherwise fully advised in the premises, it is
ORDERED and ADJUDGED as follows:
1. This is an action for personal injury protection (PIP) benefits, in which Plaintiff seeks damages for the denial and/or reductions of Plaintiff’s bills related to the chiropractic treatment of the Defendant’s insured.
2. Some of the bills at issue in the instant case were reduced by the Defendant based on the provider’s geographic region as indicated by the Defendant’s explanation of benefits, which are commonly referred to as “usual and customary” reductions (UCR).
3. The Defendant utilized Mitchell Medical software program in evaluating Plaintiff’s bills in this case, and in particular the UCR reductions to Plaintiff’s bills based on Plaintiff’s geographic region.
4. Mitchell Medical obtains their data related to usual and customary amounts from a third party company known as Ingenix.
5. The Defendant entered into a written contract with Mitchell Medical which is dated December 28, 2000, and effective as of February 1, 2001.
6. The written contract between the Defendant and Mitchell Medical was signed by Brian J. Passell on behalf of the Defendant.
7. The contract between the Defendant and Mitchell Medical was provided to Plaintiff by the Defendant pursuant to Plaintiff’s discovery request.
8. Paragraph 9.7 of the contract between the Defendant and Mitchell Medical states in part:
MITCHELL OBTAINS AND GATHERS ITS INFORMATION FROM SOURCES IT CONSIDERS TO BE RELIABLE; HOWEVER, MITCHELL AND ITS THIRD-PARTY INFORMATION PROVIDERS DO NOT GUARANTEE THE ACCURACY OR COMPLETENESS OF THE INFORMATION PROVIDED HEREUNDER. FURTHERMORE, NOTHING CONTAINED IN THIS SECTION 9 SHALL ASSURE UNINTERRUPTED OPERATION OF THE LICENSED PRODUCT. CONSEQUENTLY, EXCEPT AS EXPRESSLY PROVIDED IN THIS AGREEMENT, MITCHELL PROVIDES THIS PRODUCT ON AN “AS IS” BASIS . . . [emphasis added]
9. Considering the fact that Brian J. Passell signed the contract with Mitchell Medical on behalf of the Defendant, and the fact that the Defendant utilized Mitchell Medical software program to evaluate Plaintiff’s bills in the instant case, the Plaintiff’s Motion to Compel the Deposition of Brian J. Passell is hereby GRANTED.
10. The deposition of Brian J. Passell shall be scheduled forthwith and take place without unnecessary delay.
11. The Defendant’s Motion for Protective Order regarding the deposition of Brian J. Passell is hereby DENIED.
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