12 Fla. L. Weekly Supp. 539c
Insurance — Personal injury protection — Coverage — Medical expenses — MRI — Insurer is not relieved of liability for payment of benefits for an otherwise payable MRI bill because bill submitted reflects amount in excess of amount allowed under statutory scheme — Insurer remains obligated to pay amount allowed under statutory fee scheme based on percentage of coverage afforded under policy
UNITED AUTOMOBILE INSURANCE COMPANY, Appellant, vs. A-1 MOBILE MRI, INC., (Esteban Garcia), Appellee. Circuit Court, 17th Judicial Circuit (Appellate) in and for Broward County. Case No. 04-6125 CACE (03). L.C. Case No. 03-12775 COCE (55). March 9, 2005. Counsel: Roberts J. Bradford, Jr., Ft. Lauderdale. Michael Neimand, Coral Gables.
AMENDED ORDER REVERSING JUDGMENT
(PATTI ENGLANDER HENNING, J.) THIS CAUSE having come on to be heard before the court on an appeal from a directed verdict in favor of Appellee, United Automobile Insurance Company, by the Broward County Court sitting in its Small Claims capacity. The Court having reviewed the briefs and heard the argument of counsel and being otherwise fully advised in the premises, it is hereby
ORDERED AND ADJUDGED that the judgment is reversed for the following reasons:
The Parties agree that there is only one issue on appeal. The true crux of that issue is whether a PIP insurer is relieved from payment of benefits for an otherwise “reasonable, necessary, and related” medical expense for an MRI service for no other reason than the bill submitted to the insurer reflects an amount in excess of that allowed under the statutory scheme imposed by Fla. Stat. §627.736(5)(b)(5). This court holds that it is not and that the insurer remains obligated to pay the amount allowed under the statutory fee scheme based on the percentage of coverage afforded under the policy.
The material facts are not in dispute. The appeal turns solely on a question of statutory construction — a pure question of law. The standard of review governing a trial court’s ruling on a motion for summary judgment posing a pure question of law is de novo. Major League Baseball v. Morsani, 790 So.2d 1071 (Fla. 2001).
The “responsibility of the court when construing a statute is to give the statutory words their plain and ordinary meaning.” U.S. Security Ins. Co. v. Cahuasqui, 760 So.2d 1101, 1104 (Fla. 3d DCA 2000). The plain meaning of the words “may be charged” as chosen by the legislature for use in Subsection (5)(b)(5) governing PIP claims for payment of MRI expenses is “may be collected.” This court will not read into the statute a penalty provision which is clearly not there. Holly v. Auld, 450 So.2d 217 (Fla. 1984). The goal of the No Fault Act is to provide swift and virtually automatic payment of benefits. Negating in toto the insurer’s statutory and contractual obligation to pay when the insurer is capable of paying at the statutorily allowed amount based on the percentage of coverage afforded under the policy can only be considered an interpretation leading to an absurd or ridiculous result. Albert v. Department of Health, 763 So.2d 1130 (Fla. 4th DCA 2000).
An otherwise payable MRI bill should not be made invalid and unpayable simply because the provider’s bill reflected the amount in accordance with the reimbursement amount authorized by the applicable fee schedule.
Accordingly, the Judgment based on the directed verdict in favor of Appellee is reversed and the cause is remanded with instructions to enter judgment in favor of Appellant, A-1 Mobile MRI, Inc.
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