12 Fla. L. Weekly Supp. 982a
Insurance — Personal injury protection — Standing — Assignment — Validity — Assignment which provides that insured remains personally liable for total amount due means insured is ultimately responsible to medical provider only for amount not covered by policy or not paid by insurer and is valid assignment
MILLER CHIROPRACTIC & MEDICAL CENTERS, INC., (As Assignee of Martine Beaubrun), Plaintiff, vs. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 13th Judicial Circuit in and for Hillsborough County, Small Claims Division. Case No. 04-11847 CC, Division I. July 14, 2005. Charlotte Anderson, Judge. Counsel: Timothy Patrick, Timothy A. Patrick, P.A., Tampa. Peter Aare.
ORDER DENYING DEFENDANT’S MOTION FOR SUMMARY JUDGMENT
THIS CAUSE having come before the Court on May 2, 2005 on Defendant’s Motion for Summary Judgment, and the Court having heard argument of counsel, having considered the authorities, and being otherwise fully advised in the premises, the Court makes the following findings:
l. Defendant’s Motion for Summary Judgment based on standing is DENIED.
2. Defendant argued that Plaintiff/medical provider lacked standing to sue Defendant/insurer because of provisions included in the “assignment of benefits,” allegedly assigned by the insured to the medical provider, stating, in pertinent part, that the insured remains:
[P]ersonally responsible for the total amount due Assignees . . . I further understand and agree that this Assignment, Lien, and Authorization does not require Assignees to await payments and they may demand payments from me immediately upon rendering services at their options, although the assignees agree to first demand immediate payment from the insurance company as their first means of pursuing payment for services rendered.
(Emphasis added).
3. Defendant argued that the aforementioned language was distinguishable from the findings in Oglesby v. State Farm Mutual Auto. Ins. Co., 781 So.2d 469, 470 (Fla. 2d DCA 2001), wherein the Second District found that an unqualified assignment of medical benefits accepted by a medical provider on the condition that “the [insured] will be ultimately responsible for any medical bills either not covered by the policy or simply not paid by the insurer”was in fact a valid assignment. Id. (emphasis added).
4. Defendant argued that the distinction between the language cited by the Second District and the language used in the assignment currently before the Court, is that in Oglesby, the insured remained personally liable for the unpaid portions of the medical bills and in the instant action the insured remained personally liable for the total amount due.
5. Defendant argued that the “Assignment of Benefits” failed to transfer all rights and benefits to the medical provider because the general language in the General Patient Responsibilities section stating “I understand that I remain personally responsible for the total amount due Assignees for their services. . .” and that “I further understand and agree that this Assignment, Lien, and Authorization does not require Assignees to await payments and they may demand payments from me immediately upon rendering services at their options, although the assignees agree to first demand immediate payment form the insurance company as their first means of pursuing payment for services rendered. . .” conflicts with the earlier provision purporting to assign all benefits and causes of action to the medical provider.
6. Defendant further argued that as a result of the alleged assignment, the medical provider would obtain the right to recover the benefits directly from Defendant/insurer, the right to file suit against Defendant/insurer to collect the benefits, and would also retain the right to seek payment directly from the insured. On the other hand, the insured is faced with the possibility of having to pay the medical provider directly and be left with no right to sue Defendant/insurer for the benefits because that right was “assigned” to the medical provider.
7. Plaintiff argued that the language in Oglesby is the equivalent to that found in the assignment at issue in the instant action in that both constitute a valid unqualified assignment that holds the insured responsible for the amount not covered by the policy or not paid by Defendant/insurer.
8. Plaintiff argued that as a result of the assignment, the medical provider obtains the right to recover the benefits directly from Defendant/insurer, the right to file suit against Defendant/insurer to collect the outstanding benefits, and retains the right to seek payment directly from the insured where the amount incurred by the insured is not covered by Defendant’s/insurer’s policy or for the amount that Defendant/insurer refuses to pay.
9. This Court finds that the language used in Plaintiff’s assignment, “remains personally liable for the total amount due . . .,” should be interpreted as meaning that the insured is ultimately responsible to the medical provider only for the portion of the payments that the Defendant/insurer fails to pay or that portion of the payments not covered under the insured’s policy of automobile insurance.
10. This Court finds that the aforementioned interpretation is read in light most beneficial to the insured, which is a reading consistent with the underlying purpose of Florida’s No-Fault Law.
11. This Court finds that Plaintiff/medical provider possesses a valid assignment of benefits.
12. This Court finds that its decision is consistent with that of the Thirteenth Judicial Circuit Court in Advanced Orthopaedic Institute Inc., (a/a/o Belinda Carter) v. Metropolitan Property and Casualty Ins. Co., 10 Fla. L. Weekly Supp. 160 (Fla. 13th Cir. Ct. Dec. 30, 2002); and distinguished from this Court’s opinion in Clinic Health Services, Inc. (a/a/o Rosa Fitzsimmons) v. State Farm Mutual Automobile Ins. Co., 10 Fla. L. Weekly Supp. 642 (Fla. Hillsborough Cty. Ct. 2002) wherein the language forming the assignment stated, in pertinent part, that the insured remained personally responsible “for all professional bills submitted. . .”
It is hereby ORDERED and ADJUDGED, for the foregoing reasons, Defendant’s Motion for Summary Judgment is DENIED.
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