12 Fla. L. Weekly Supp. 174b
Insurance — Discovery — Defendant’s objection to interrogatory requesting names of providers whose charges were compared with plaintiff provider’s charges in order to determine that the amounts charged by plaintiff were not usual, reasonable and/or customary — Inability to provide response due to manner in which database is compiled
ST. GERMAIN CHIROPRACTIC, P.A., as assignee of LUIS SAGARNAGA, Plaintiff, vs. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant. County Court, 18th Judicial Circuit in and for Seminole County. Case No. 02-SC-4107-19-Z. October 29, 2004. Carmine M. Bravo, Judge. Counsel: David B. Blessing, The Coury Law Firm, P.A., Lake Mary. George Milev.
ORDER ON DEFENDANT’S OBJECTION TO PLAINTIFF’S INTERROGATORY NO. 7
This case was before the Court on September 22, 2004, on the defendant’s objection contained in Defendant’s Unverified Response to Plaintiff’s First Set of Interrogatories (served May 20, 2004) and in Defendant’s Verified Responses to Plaintiff’s First Set of Interrogatories (served September 10, 2004) to interrogatory 7 contained in Plaintiff’s Interrogatories to Defendant (served January 10, 2003). The Court, having heard argument and representations of counsel, having reviewed the pleadings and file materials, and being otherwise fully advised in the premises, hereby
FINDS, ORDERS and ADJUDGES as follows:
1. Interrogatory 7 states as follows: “Please list the names of the providers whose charges were compared with the Plaintiff’s charges in order to determine that the amounts charged by the Plaintiff were not usual, reasonable and/or customary.
2. The defendant objected as follows:
Objection, vague and ambiguous, not relevant nor reasonably calculated to lead to the discovery of admissible evidence. Without waiving said objection, the requested information is not in defendant’s possession, custody or control Defendant utilized a third party to assist Defendant in determining the usual and customary charges for the particular geographic region:
Mitchell Medical
Mitchell International, Inc.
9889 Willow Creek Road
San Diego, CA 32131
3. The defendant’s explanation of benefits for a date of service at issue states, regarding explanation code 41, that “[t]he amount allowed is based on provider charges within the provider’s geographic region.” The explanation of benefits further states that “[t]he above explanation is what Progressive has determined to be the appropriate reimbursement amount based on generally accepted billing and coding rules and practices.”
4. The defendant stated at the hearing that neither the defendant, Mitchell Medical, nor Ingenix can provide the requested information due to the manner in which the data base is compiled. As a result, the defendant agreed to serve an amended and verified response to interrogatory 7 stating that the requested information cannot be provided by the defendant, Mitchell Medical, or Ingenix due to the manner in which the data base is compiled.
5. The defendant shall serve said amended and verified response on or before twenty (20) days from the date of this order.
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