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CICERO ORTHO-MED CENTER, INC. a/a/o Caridad Quintana, Plaintiff, vs. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant.

13 Fla. L. Weekly Supp. 365a

Insurance — Personal injury protection — Standing — Assignment — Where unambiguous language of purported assignment indicates that only benefit that has been assigned to provider is right to collect payment directly from insurer, document is merely direction to pay and does not assign to provider rights necessary to proceed in litigation against insurer

CICERO ORTHO-MED CENTER, INC. a/a/o Caridad Quintana, Plaintiff, vs. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant. County Court, 11th Judicial Circuit in and for Miami-Dade County, Civil Division. Case No. 05-2797-CC-25 (02). January 27, 2006. Lawrence D. King, Judge. Counsel: Liam P. Kelly, Wood Bronstein, Miami. Sadie Naveo.

ORDER GRANTING DEFENDANT’S SECOND MOTION FOR SUMMARY FINAL JUDGMENT

THIS CAUSE, having come on to be heard before this Court on Tuesday, January 17, 2006 upon Defendant’s Second Motion for Summary Final Judgment, and this Court having heard argument of counsel, having reviewed the court file and being otherwise duly advised in the premises, it is hereupon,

ORDERED AND ADJUDGED as follows:

1. This is an action for the alleged breach of an automobile insurance contract brought by the Plaintiff, CICERO ORTHO-MED CENTER, INC., as an alleged assignee of the Personal Injury Protection benefits held by Caridad Quintana, in a policy of insurance issued by the Defendant, PROGRESSIVE EXPRESS INSURANCE COMPANY.

2. The Plaintiff alleges in paragraph 8 of Plaintiff’s First Amended Complaint, that on June 5, 2001, Caridad Quintana “assigned his benefits to the Plaintiff.”

3. The Plaintiff produced the alleged assignment of benefits in response to the Defendant’s First Request for Production, and the Defendant has filed it with the Court together with Defendant’s Second Motion for Summary Final Judgment.

4. The language of the alleged assignment of benefits is clear and unambiguous.

5. The alleged assignment of benefits reads in substantive part:

Please be advised that this office is treating the above referenced patient for injuries sustained in a motor vehicle accident on the above referenced date. As you know pursuant to Florida Statute 627.736(5) “the insurer may pay for such charges directly to such person or institution lawfully rendering such treatment.” Please be advised that EFFECTIVE IMMEDIATELY THIS OFFICE IS ACCEPTING ASSIGNMENT OF BENEFITS FROM THE ABOVE REFERENCED PATIENT.

Pursuant to Nationwide Mut. Fire Ins. Co. v. Pinnacle Medical Center, Inc., No. SC94539 (Fla. February 3, 2000), we are not subjecting any dispute regarding the payment of this claim to arbitration and maintain our rights to pursue an action in a court of law as assignee of the subject policy against the named insured to enforce the payment of P.I.P. benefits.

Therefore, it is at this time that I, the undersigned, do hereby request the P.I.P. insurance carrier that is responsible for payment of my medical bills, to pay Cicero Ortho-Med Center, Inc for their services rendered to me, as a result of the subject motor vehicle accident on the above referenced date. You may make the drafts payable to Cicero Ortho-Med Center, Inc and mail them to 4950 S.W. 8th St., suite 305, Coral Gables, Fl. 33134.

Please be advised that a P.I.P. Complaint will be filed if payment or written notification of denial of payment is not received within the statutory thirty (30) day time period. Thank you in advance for your time an consideration in this matter.

6. When an alleged assignment of benefits is unambiguous, the construction of the terms of that assignment is a question of law for the court. See Peacock Construction Co. Inc. v. Modern Air Conditioning, Inc., 353 So. 2d 840 (Fla. 1977).

7. If a party is to give up a right or benefit it should be unambiguously stated within the four corners of the document. South Brevard Chiropractic & Wellness vs. Progressive Southeastern Insurance Company, 12 Fla. L. Weekly Supp. 260a (2004).

8. Merely using the words “Assignment of Benefits” in the title and the body of the document, without more, is not sufficient to transfer rights in a policy of insurance to a third party. Nile R. Lestrange, MD vs. Progressive Express Insurance Company, 11 Fla. L. Weekly Supp. 155a (2003).

9. In order for a non-contracting third party to have standing to sue on a policy of insurance, the agreement assigning the rights of the insured to the third party must contain sufficient language indicating that the assignor is assigning his or her right to bring direct action against the insurer, or in the alternative, language assigning all of the insured’s benefits or rights under the contract.

10. The unambiguous language of the document relied upon by the Plaintiff for standing in the instant case indicates that the only benefit which has been assigned to the Plaintiff is the right to collect payment directly from the insurer.

11. The Court finds that the document relied upon by the Plaintiff for standing titled “Assignment of P.I.P. Benefits” is by its plain language merely a direction to the insurer to pay benefits directly to CICERO ORTHO-MED CENTER, INC., and does not assign to the Plaintiff the necessary rights to proceed in litigation directly against the insurer for breach of contract.

12. Accordingly, this Court enters Summary Final Judgment in favor of the Defendant and against the Plaintiff. The Plaintiff shall take nothing by this action and the Defendant shall go hence without day.

13. This court retains jurisdiction for the purpose of entertaining any appropriate motions for costs and attorneys fees.

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