13 Fla. L. Weekly Supp. 1229a
Insurance — Personal injury protection — Declaratory judgment — Insurer’s obligation to provide explanation of benefits — Count of medical provider’s complaint seeking declaration of right to EOB states cause of action for declaratory relief
COASTAL MEDICAL ORTHOPEDIC SERVICE, a Florida Corporation (assignee of Alcime, Saint Vitel), Plaintiff, v. UNITED AUTOMOBILE INSURANCE CO., Defendant. County Court, 17th Judicial Circuit in and for Broward County. Case No. 06-779 COSO 62. August 7, 2006. Julio E. Gonzalez, Jr., Judge. Counsel: Russel M. Lazega, Law Office of Russel Lazega, North Miami, for Plaintiff. Adam Shapiro, for Defendant.
ORDER DENYING DEFENDANT’S MOTION TO DISMISS COUNT II OF COMPLAINT DECLARATORY RELIEF REGARDING RIGHT TO EXPLANATION OF BENEFITS
This action was heard on Defendant’s Motion to Dismiss Count II of Plaintiff’s Complaint and the court, having heard arguments, read the respective motions and being otherwise advised in the matter finds as follows:
Factual Background:
This is a P.I.P. case. Plaintiff’s complaint contains three counts. Count I claims Defendant breached the insurance contract by failing to furnish a proper Explanation of Benefits (EOB) pursuant to F.S. s. 627.736(4)(b); Count II, in the alternative, seeks declaratory relief, asserting that Defendant has refused to furnish Plaintiff with an EOB (thereby establishing a dispute between the parties as to the legal right to this information requiring resolution by this court), and that Plaintiff needs this information in order to properly determine its rights with regard to claim for P.I.P. benefits; Count III, in the alternative, seeks payment of any P.I.P. benefits that would be properly payable once it is determined why benefits were not paid. Conclusions of Law:
Defendant’s assertion is essentially that Count II does not state a cause of action. This court has considered this issue previously in Demitrio Baldovinos v. United Auto. Ins. Co., Case # 05-9907 COSO 62 and Broward Spine Associates (a/a/o Idole Anilus) v. United Auto. Ins. Co., Case # 06-1400 COSO 62, and finds no reason to depart from its previous rulings finding that a cause of action for declaratory relief is stated.
ACCORDINGLY, IT IS ADJUDGED that
1. Defendant’s Motion to Dismiss is Denied.
2. Defendant shall answer Count II within 20 days of this order.
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