12 Fla. L. Weekly Supp. 670c
Insurance — Personal injury protection — Coverage — Exhaustion of policy limits — Insurer did not err in exhausting policy limits by paying hospital claim rather than medical provider’s claim that was submitted prior to hospital’s claim where insurer received hospital claim of lien within 30 days from date insurer received provider’s claim, and insurer properly held benefits pending receipt of hospital invoice and then exhausted benefits by paying invoice
THE ORTHOPEDIC CENTER OF NORTH CENTRAL FLORIDA, P.A. a/a/o Charlotte Shafer, Plaintiff, vs. NATIONWIDE MUTUAL FIRE INSURANCE COMPANY, Defendant. County Court, 9th Judicial Circuit in and for Orange County. Case No. 48-2003-CC-6871-O. April 15, 2005 Antoinette Plogstedt, Judge. Counsel: Robert Nichols, Ft. Lauderdale, for Plaintiff. Scott Simmons, Law Offices of Capito & Polk, Lake Mary.
ORDER GRANTING DEFENDANT’S MOTION FOR SUMMARY JUDGMENT
THIS CAUSE having come to be considered upon the Defendant’s Motion for Summary Judgment and the Court having heard reviewed evidence, heard argument of counsel, and being otherwise fully advised in the premises, it is
HEREBY ORDERED AND ADJUDGED, as follows:
The Defendant’s Motion for Summary Judgment is hereby granted. There are no genuine issue of material facts and the Defendant is entitled to a Judgment as a matter of law. The Court further finds the following undisputed facts:
1. The insured was involved in an automobile accident and presented a claim for personal injury protection benefits with the Defendant.
2. On August 30, 1999, Plaintiff submitted its claim to Defendant.
3. On September 3, 1999, the Defendant received Shands Hospital’s Claim of Lien.
4. On October 8, 1999, Defendant received Shands’ Hospital bill.
5. On October 18, 1999, Defendant exhausted benefits by paying Shands Hospital invoice to satisfy the lien.
Plaintiff contends that Defendant erred in paying the Shands Hospital claim prior to paying Plaintiff’s claim, as Plaintiff’s claim was properly submitted first. Defendant contends that it properly satisfied the Shands Hospital Lien, as the lien was received within 30 days from the date Defendant received Plaintiff’s Claim. Plaintiff argues that Shands Hospital failed to properly file its claim with Defendant under Chapter 627, Florida Statutes. Plaintiff further contends that since Shands Hospital submitted a Hospital Lien to Defendant, and not a Chapter 627 Claim for PIP benefits, within the 30 day period from Plaintiff’s Claim, Defendant should have paid Plaintiff’s Claim before paying the Shands’ Hospital invoice.
This Court finds that upon receipt of Shands Hospital Lien, Defendant properly held the PIP benefits pending receipt of the Shands Hospital invoice. Defendant promptly exhausted benefits by paying the Shands Hospital invoice on October 18, 1999. Plaintiff stipulates that Defendant is entitled to a Judgment as to dates of treatment rendered on October 11, 1999; November 24, 1999; March 6, 2000; and June 12, 2000. Defendant is entitled to a Judgment as a matter of law as to all dates of treatment by Plaintiff.
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