12 Fla. L. Weekly Supp. 505a
Insurance — Personal injury protection — Declaratory action — Insurer is required to provide copy of policy, declarations page and PIP log on pre-suit request from medical provider
FLORIDA EMERGENCY PHYSICIANS KANG & ASSOCIATES, MD. PA., as assignee of Venton Brown, Plaintiff, vs. NATIONWIDE PROPERTY AND CASUALTY INSURANCE COMPANY, Defendant. County Court, 18th Judicial Circuit in and for Seminole County. Case No. 04-SC-2088. March 1, 2005. J.R. Sloop, Judge. Counsel: Richard Oliver Hale, IV, Orlando. Lisa Bernardini, Lake Mary.
ORDER GRANTING PLAINTIFF’S MOTION FOR FINAL SUMMARY JUDGMENT AS TO COUNT II OF ITS COMPLAINT FOR DECLARATORY RELIEF
THIS MATTER having come before this Court on Plaintiff’s Motion for Final Summary Judgment as to Count II of its Complaint for Declaratory Relief and this Court having heard arguments of counsel and being otherwise fully advised in the premises, the Court makes the following:
FINDINGS OF FACT
1. This is a claim for PIP benefits arising out of a motor vehicle collision that occurred on or about 08/01/2003.
2. Venton Brown executed an assignment of benefits in favor of Florida Emergency Physicians Kang & Associates, MD., P.A.
3. Florida Emergency Physicians submitted their billing for payment and the bill went unpaid.
4. Thereafter, on April 27, 2004, the Plaintiff sent a Notice of Intent to Initiate Litigation, as well as a request to the Defendant for a copy of the policy, declarations page, and PIP payout log, pursuant to Florida Statutes 627.736(6)(d), 627.4137 and 627.7401. The Defendant admitted receiving this request.
6. On May 3, 2004, the Nationwide representative responsible for responding to the demand, provided a response indicating that the Plaintiff’s bill had been applied to the patient’s deductible and that a PIP payout sheet had not been generated. However, Nationwide failed to send a copy of the patient’s policy or declarations page.
7. On May 5, 2004, the Plaintiff sent another request for a copy of the policy, declarations page and PIP log in an effort to confirm that the bill was correctly and appropriately applied to the deductible.
8. On May 17, 2004, Nationwide sent a response to the Plaintiff’s inquiry indicating that a declarations page would not be forthcoming as “This request for information is not addressed in the statute pertaining to demand letters”.
9. After failing to secure the requested documents within thirty (30) days, the Plaintiff filed a two count complaint, alleging breach of contract and requesting declaratory relief.
10. The pleadings, depositions, answers to interrogatories, and admissions on file together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the Plaintiff is entitled to judgment as a matter of law.
Based upon the foregoing, IT IS THEREFORE ORDERED AND ADJUDGED:
The Plaintiff’s Motion for Final Summary Judgment is GRANTED on the merits. The Defendant’s argument that none of the statutes cited by Plaintiff obligate the Defendant to provide a policy, declarations page and PIP log is rejected. 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, 677.736(6)(d) and 627.7401. 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.
This Court finds as persuasive the long line of county court cases across the state 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, 11Fla. 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). Each of these cases found the Plaintiff was entitled to the information being sought pre-suit and rejected the same arguments presented here by the Defendant.
This Court also finds as persuasive the Fourth District’s opinion in UNITED AUTOMOBILE INSURANCE COMPANY v. ROUSSEAU, 21 Fla. L. Weekly D2477a, (4th DCA, 1996). Rousseau involved an uninsured motorist claim. It is undisputed that an uninsured motorist claim, like a PIP claim, is a first party claim by nature, lending support to this court’s finding that the liability portion of Florida Statute 627.4137 goes to the nature of the carrier, and not the nature of the claim. The court reserves jurisdiction for the taxation of fees and costs as may be appropriate.
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