12 Fla. L. Weekly Supp. 805b
Insurance — Personal injury protection — Declaratory judgment — PIP insurer is required to provide declarations page, policy and PIP log upon pre-suit request by provider — Standing — Assignment — Document entitled “Consent to Treatment and Authorizations and Guarantee” is assignment of benefits — Assignment given to hospital covers emergency room physicians where assignment clearly references “my physicians” — Even if physicians were not included in assignment, equitable assignment is created where affidavits evidence intent of insured and physicians to give and receive assignment, and insurer would be quite justified in paying physicians for treatment rendered to insured at hospital
FLORIDA EMERGENCY PHYSICIANS as assignee of Marvene Jones, Plaintiff, vs. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant. County Court, 18th Judicial Circuit in and for Seminole County. Case No. 04-SC-2218. May 25, 2005. J.R. Sloop, Judge. Counsel: Christopher S. Reed, Rutledge M. Bradford, P.A., Orlando. Don Matthews, Fort Myers.
AMENDED ORDER GRANTING PLAINTIFF’S MOTION FOR FINAL SUMMARY JUDGMENT ON COUNT II OFPLAINTIFF’S COMPLAINT; DENYING DEFENDANT’S MOTION TO DISMISS; AND DENYING DEFENDANT’S MOTION FOR FINAL SUMMARY JUDGMENT
THIS MATTER having come before this Court on Plaintiff’s Motion For Final Summary Judgment on Count II of the Plaintiff’s Complaint, the Defendant’s Motion to Dismiss, and the Defendant’s Motion for Final Summary Judgment and this Court having heard arguments of counsel and being otherwise fully advised in the premises, finds as follows:
FACTS
1. This is a claim for breach of contract and declaratory relief arising out of a motor vehicle collision that occurred on or about 6/19/03. There is a separate Count for breach of contract that is not addressed in this Order.
2. The Plaintiff in this matter is FLORIDA EMERGENCY PHYSICIANS, as assignee of Marvene Jones.
3. On or about 6/19/03, Marvene Jones was involved in a motor vehicle collision which required emergency treatment at Florida Hospital Altamonte. The emergency treatment was rendered to Marvene Jones by the Plaintiff, FLORIDA EMERGENCY PHYSICIANS.
4. On or about 8/8/03, the Defendant received the bill that the Plaintiff submitted to the Defendant for payment. The bill was not paid.
5. Thereafter, the Plaintiff sent a Notice of Intent to Initiate Litigation, on May 12, 2004, as well as a demand for a declarations page, copy of the policy and a PIP log, pursuant to Florida Statutes 627.4137 and 627.736(6)(d) that was received by the Defendant on May 13, 2004.
6. In response to the May 12th, 2004 demand, the Defendant responded that “the claim was denied due to a material misrepresentation by the Insured. The Insured failed to list one of her household members on the policy when it was taken out, this constitutes a misrep.”
7. The Defendant did not provide a copy of the insurance policy, a declarations page for the insurance policy, or a PIP payout log in response to the Plaintiff’s request, which resulted in the filing of this declaratory judgment action on June 16, 2004.
8. The Defendant produced a copy of the declarations page for the policy on August 24, 2004, in its response to Plaintiff’s request for production.
9. Along with the Notice of Intent to Initiate Litigation the Plaintiff also sent a document entitled “Consent to Treatment and Authorizations and Guarantee,” upon which it relied as an assignment of benefits.
It is therefore ORDERED AND ADJUDGED as follows:
1. The Plaintiff’s Motion for Final Summary Judgment on Count II of its complaint is hereby granted.
2. The Court finds that a Defendant, upon proper request, is required to furnish, pre-suit, a copy of the patient’s declarations page, policy, and/or PIP log in accordance with Florida Statutes 627.4137, and 627.736(6)(d). The court specifically finds that Florida Statute § 627.4137, which references “liability carriers” refers to the nature of the claim being presented as opposed to the type of coverage sought, and obligates a PIP carrier to comply.
3. This Court finds as persuasive the line of county court cases, beginning with INTEGRA DIAGNOSTICS (Shawn Umstead) v. RELIANCE NATIONAL INDEMNITY, 8 Fla. L. Weekly Supp. 349c, 17th Judicial Circuit, Judge William Herring (2001), and followed by ROM DIAGNOSTICS v. SECURITY NATIONAL INSURANCE COMPANY (Rafael Cruz), 9 Fla. L. Weekly Supp. 323b, 9th Judicial Circuit, Judge Jeffery Arnold (2002); RURAL METRO AMBULANCE (Aletha Bryant) v. LIBERTY MUTUAL INSURANCE COMPANY, 11 Fla. L. Weekly Supp. 583a, 9th Judicial Circuit, Judge Leon Cheek III (2004); RURAL METRO AMBULANCE (William Zaniboni) v. NEW HAMPSHIRE INDEMNITY INSURANCE COMPANY, 11 Fla. L. Weekly Supp. 755a, 19th Judicial Circuit, Judge Mark Herr (2004); TALLAHASSEE MRI, P.A. (Jacques Amilcar) v. PROGRESSIVE AUTO PRO INSURANCE CO., 11 Fla. L. Weekly Supp. 69a, 17th Judicial Circuit, Judge Steven Deluca (2003); PALM BEACH REGIONAL MRI, INC. (Cynthia Jackman) v. SOUTHERN GROUP INDEMNITY INC., 11 Fla. L. Weekly Supp. 742a, 15th Judicial Circuit, Judge Joseph Marx (2004).
4. The Defendant’s Motion to Dismiss is hereby denied.
5. The Defendant’s Motion for Final Summary Judgment is hereby denied.
6. The court finds, as a matter of law, that the document entitled “Consent to Treatment and Authorizations and Guarantee,” is an assignment of benefits.
7. The Court finds that the Plaintiff is included in the Assignment of Benefits given to Florida Hospital and is clearly referenced by the words “and my physicians”.
8. Further, even if the assignment were not sufficient or the Plaintiff was not included, the Plaintiff has provided uncontroverted evidence of the intent of the parties, by filing affidavits of the Plaintiff and the insured, evidencing their respective intents to receive and give an assignment.
9. Under Florida law, no particular words of art are necessary to create an assignment and the same can be made in writing; orally or partially of each.
10. An assignment can be expressed or implied under the circumstances. Assignments can be equitable, where no words or form of instrument is necessary to effect an equitable assignment, and any language, however informal, which shows an intention on one side to assign a right or chose in action and an intention on the other to receive, will operate as an effective equitable assignment.
11. As set forth by the Florida Supreme Court, the true test of an assignment is whether the debtor would, however be justified in paying the debt to the person claiming to be the assignee. Here, clearly that is the case. The Defendant would be quite justified in paying the emergency room doctors who rendered treatment to their insured at Florida Hospital Altamonte.
12. The Court reserves jurisdiction as to the issue of attorneys’ fees and costs.
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