13 Fla. L. Weekly Supp. 973a
Insurance — Personal injury protection — Declaratory judgment — Insurer’s obligation to provide PIP log on presuit request from assignee/medical provider — Although section 627.736 does not require insurer to provide PIP log to assignee/medical provider, provider is entitled to log and other documents necessary to determine status as claimant — No merit to argument that trial court usurped legislature’s responsibility by modifying PIP statutes to require disclosure of documents and information where statutes do not specifically prohibit disclosure, and court is not adding to or modifying laws but merely ensuring that providers can fairly assess status as claimants
AMERICAN VEHICLE INSURANCE COMPANY, Appellant, vs. FLORIDA EMERGENCY PHYSICIANS KANG & ASSOCIATES, P.A., a/a/o William Eve, Appellee. Circuit Court, 18th Judicial Circuit (Appellate) in and for Seminole County. Case No. 05-60-AP. April 21, 2006. Appeal from the County Court for Seminole County, Honorable Joseph Davis, Senior Judge. Counsel: Sean M. McDonough, for Appellant. Kevin B. Weiss, for Appellee.
[Count court order published at 12 Fla. L. Weekly supp. 593a.]
(NELSON, D., J.) Florida Emergency Physicians, Kang & Associates (“FEP”), sued American Vehicle Insurance Company (“AVIC”) after a bill for their services in the amount of $474.00 became overdue. When the bill became overdue, FEP sent a demand letter requesting documents including a copy of the policy, the declarations page, and the PIP “payout sheet.” AVIC only provided a copy of the declarations page, and FEP filed suit seeking the remaining documents. On March 15, 2005, final summary judgment was entered for FEP, and AVIC appeals from this Order.
The standard of review for a final order granting a motion for summary judgment is de novo. Volusia County v. Aberdeen at Ormond Beach, L.P., 760 So.2d 126 (Fla. 2000).
AVIC contends that section 627.736, Florida Statutes, does not require disclosure of the information sought by FEP. This argument is correct: “No provision of §627.736 dictates that an insurer must provide a PIP log to an insured, or his/her assignee.” New Hampshire Indemnity Insurance Co. v. Rural Metro Ambulance, a/a/o William Zaniboni, [13 Fla. L. Weekly Supp. 573a] Appeal No. 04-72-AP (Cir. Ct. 18th Jud. Cir., Nov. 18, 2005) on rehearing. However, this Court held that although section 627.736 does not require disclosure, that does not mean that the medical care provider is not entitled to the information it requested.
Nevertheless, this finding does not mean that [RMA] is not entitled to the information that would otherwise be compiled in a PIP log. This Court agrees with [RMA] that it has a right to determine, pre-suit, what claims have been made and when; if any claims have been paid or denied; whether the deductible has been met; and, if not, how much remains; and whether benefits have truly been exhausted. Whether such information is compiled in a PIP log or some other data compilation format is immaterial. For these same reasons, RMA has a right to a copy of the insurance policy and the declarations page. Although a requirement to provide such information may not be expressly stated in section 627.736, Florida Statutes, this Court finds that the provision of such information is essential to [RMA’s] ability to determine its status as a claimant and makes eminently good common sense.
New Hampshire Indemnity Insurance, supra at 4.
This argument applies to both sections 627.4137 and 627.736. The trial court was correct in finding that AVIC must provide this information to FEP upon request.
AVIC also contends that the trial court “usurped the Legislature’s responsibility to enact statutes that meet policy concerns by adding to or modifying existing laws.” New Hampshire Indemnity Insurance acknowledged that the wording of the statutes did not specifically compel an insurer to provide this documentation. This Court found that the provision of this information enabled the medical care provider to determine their status asa claimant, and makes eminently good common sense. There is no indication that this Court was attempting to add to or modify the wording of the PIP statutes.
It should also be noted that the wording of sections 627.736 and 627.4137 do not specifically prohibit the release of this documentation and/or information, either through a court compelling the release, or the insurer voluntarily providing the information. As the statute does not specifically prohibit the court from requiring this information to be provided to the medical care provider, it cannot be concluded that the court is acting outside the scope of its authority in ordering its disclosure. The court is not “adding to” or “modifying” existing laws, but merely ensuring that the medical care providers can fairly assess their status as claimants.
AFFIRMED.
* * *
