12 Fla. L. Weekly Supp. 1190a
Insurance — Personal injury protection — Claims — Disclosure and acknowledgment form — Where it is undisputed that insured did not execute standard disclosure and acknowledgment form which is part of claims process until after last treatment for which medical provider seeks payment, insurer’s motion for summary judgment is granted
POLINA NOSEL, M.D., P.A., (a/a/o Renal Jean-Louis), Plaintiff, vs. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 17th Judicial Circuit in and for Broward County. Case No. 04-15701 COCE 53. October 17, 2005. Robert W. Lee, Judge. Counsel: Justin G. Morgan, Weston, for Plaintiff. Leandro E. Lissa, Coral Gables, for Defendant.
ORDER GRANTING DEFENDANT’S MOTION FOR SUMMARY FINAL JUDGMENT, and FINAL SUMMARY JUDGMENT IN FAVOR OF DEFENDANT
THIS CAUSE came before the Court on October 10, 2005 for hearing on Defendant’s Motion for Summary Final Judgment, and the Court’s having reviewed the Motion and entire Court file; heard argument; reviewed the relevant legal authorities; and been sufficiently advised in the premises, finds as follows:
Background: On September 24, 2004, the Plaintiff filed its Complaint seeking payment of PIP benefits. On December 21, 2004, the Defendant filed its Answer and Affirmative Defenses. The Defendant raised three affirmative defenses, only one of which is at issue in this motion: defective acknowledgment and disclosure form.
On August 22, 2005, the Defendant filed its Motion for Summary Final Judgment. It argued that it is not required to pay Plaintiff’s claim because the Plaintiff failed to obtain the required disclosure and acknowledgment form at the initial treatment or service provided, as required by Fla. Stat. §627.736(5)(e)(1). The Court set the matter for hearing for October 10, 2005.
Conclusions of Law. The Plaintiff has submitted claims for medical treatment beginning on June 4, 2004 and continuing through July 13, 2004. The undisputed evidence established that the insured did not execute the Standard Disclosure and Acknowledgment Form until July 20, 2004.
Florida Statute §627.736(5)(e)(1) provides that the insured person is required “to execute a disclosure and acknowledgment form” with minimum requirements set forth in the statute. Subsection (5)(e)(5) further provides that “[t]he original completed disclosure and acknowledgment shall be furnished to the insurer pursuant to paragraph (4)(b)” (emphasis added). Subsection (4)(b) provides in pertinent part that “[p]ersonal injury protection insurance benefits [. . .] shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same [. . .].” Therefore, the Court concludes that the Legislature has made the disclosure and acknowledgment form part of the claims process.
The Plaintiff argues that the disclosure form is not a “statement or bill,” and therefore is not part of the “written notice of the fact of a covered loss” under subsection (4)(b). To support its position, the Plaintiff cites subsection (5)(d), which provides in pertinent part, “[f]or purposes of paragraph (4)(b), an insurer shall not be considered to have been furnished with notice of the amount of covered loss or medical bills due unless the statements or bills comply with this paragraph, and unless the statements or bills are properly completed in their entirety as to all material provisions, with all relevant information being provided therein.” The Court, however, does not read subsection (5)(d) as setting forth the exclusive components of “written notice of a covered loss.” Rather, the Court reads the subsection as setting forth that statements or bills are part of the (4)(b) requirement, and then further setting forth what must be in those bills. Otherwise, in the Court’s view, the reference to (4)(b) in subsection (5)(e) would be meaningless. See Forsythe v. Longboat Key Beach Erosion Control District, 604 So.2d 452, 455 (Fla. 1992) (court must “construe related statutory provisions in harmony with one another”).
The Plaintiff further argues that the Defendant’s argument fails because the insurer failed to provide the insured the itemized specification required by Fla. Stat. §627.736(4)(b). The Court rejects the Plaintiff’s position for two reasons. First, the Plaintiff did not raise this issue as an avoidance to the Defendant’s properly pled affirmative defense. Second, the Plaintiff provided no timely competent record evidence to raise a disputed issue of material fact on the issue of the itemized specification.
Finally, as there is no record evidence to establish that the Plaintiff is seeking payment for any treatment after the execution of the disclosure and acknowledgment form, there is no disputed issue of material fact in this case. Accordingly, it is hereby
ORDERED AND ADJUDGED that Plaintiff’s Motion for Summary Final Judgment is GRANTED. The Plaintiff shall take nothing in this action, and the Defendant shall go hence without day. The Court reserves jurisdiction on the issue of costs and attorney’s fees.
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