13 Fla. L. Weekly Supp. 825a
Insurance — Personal injury protection — Notice of claim — Disclosure and acknowledgment form which differed from standard form promulgated by Office of Insurance Regulation only by rewording of acknowledgment phrase substantially complies with promulgated form and cannot be used to preclude payment of claim
ERIC G. FRIEDMAN, D.C., P.A. a/a/o HELEN GREENE, Plaintiff, vs. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 11th Judicial Circuit in and for Miami-Dade County. Case No. 04-12106 SP 25. May 25, 2006. Lawrence D. King, Judge.
ORDER GRANTING PLAINTIFF’S MOTION FOR SUMMARY FINAL JUDGMENT
Plaintiff’s Motion for Summary Final Judgment was heard in chambers on May 11, 2006. The court having heard argument of counsel and having otherwise being fully advised in the premises, it is
ORDERED AND ADJUDGED:
1) Plaintiff’s Motion for Summary Final Judgment is GRANTED. After reviewing the court file, including Plaintiff’s and Defendant’s Motion for Summary Final Judgment and Plaintiff’s Memorandum of Law in Support of Motion for Summary Final Judgment, deposition transcripts, pleadings and filed affidavits, and hearing the argument of counsel, there appears not to exist any genuine issues of material fact, thereby entitling the Plaintiff to a Summary Final Judgment as a matter of law.
2) Plaintiff brought of cause of action against Defendant alleging violation of FS 627.736 and breach of contract seeking to enforce payment of PIP benefits arising out of injuries sustained resulting from an automobile accident that occurred on April 18, 2004.
3) Plaintiff treated Helen Greene for injuries sustained as a result of the above referenced accident between April 26, 2004 and July 26, 2004 and incurred medical bills amounting to $3,895.00.
4) Plaintiff timely submitted its claims for PIP benefits to Defendant.
5) Helen Greene wasinvolved in the accident subject to this case and suffered injuries as a result thereof. The accident in this case occurred during the coverage period of Defendant’s policy. Defendant admitted that there was coverage in this case.
6) Plaintiff’s affidavit of its treating physician established that Plaintiff’s medical bills were within a reasonable degree of chiropractic probability, reasonable, necessary and related to the accident subject to this case. Plaintiff’s affidavit of its treating physician established that Plaintiff’s medical bills were usual normal and customary for like chiropractic treatment in the Miami-Dade County area.
7) Defendant withdrew its fraudulent billing affirmative defense. Defendant’s only affirmative defense in this case contends that the Standard Disclosure and Acknowledgment Form submitted by the Plaintiff in this case did not comply with FS 627.736(5)(e) and therefore all of Plaintiff’s bills incurred as a result of medical treatment to Helen Greene were not payable.
8) Plaintiff’s Standard Disclosure and Acknowledgment Form was exactly the same as the form promulgated by the Office of Insurance Regulation, Bureau of Property and Casually Forms and Rates except that it contained the following language in paragraph one: “I knowledge that I received the treatment listed below.” Below line 1 of Plaintiff’s Standard Disclosure and Acknowledgment Form were an exhaustive list of the treatment received by Helen Greene on the first date of service. Line one of the Office of Insurance Regulation, Bureau of Property and Casually Forms and Rates Standard Disclosure and Acknowledgment Form states the following: “The services set forth below were actually rendered. This means that the services have already been provided.” Defendant contended that the change in wording in line 1 of the Plaintiff’s Standard Disclosure and Acknowledgment Form invalidated the entire form and resulted in Plaintiff’s failure to comply with FS 627.736(5)(e). Defendant contended that Plaintiff’s alleged noncompliance with FS 627.736(5)(e) ultimately precluded Plaintiff from receiving any PIP benefits in this case.
9) Plaintiff’s affidavit of its treating physician stated that he explained to Helen Greene the items that forth in paragraphs 1-5 and A-D of the Standard Disclosure and Acknowledgment Form as well as all of the treatment received on the first date of service.
10) The court finds that Plaintiff’s Standard Disclosure and Acknowledgment Form substantially complies with the form promulgated by the Office of Insurance Regulation, Bureau of Property and Casually Forms and Rates and the strictures of FS 627.736(5)(e). Accordingly, Defendant’s affirmative defense claiming that Plaintiff’s Standard Disclosure and Acknowledgment Form is invalid cannot be used to preclude Defendant from paying PIP benefits to Plaintiff in this case.
11) Defendant filed no opposition to Plaintiff’s Motion for Summary Final Judgment in this case and the remaining allegations set forth in Plaintiff’s Motion for Summary Final Judgment were unchallenged and otherwise undisputed.
12) Accordingly, this court grants Plaintiff’s Motion for Summary Final Judgment as to all of the issues presented therein.
13) As such, Plaintiff is entitled to $3,584.59 in PIP benefits ($3,895.00 less the 80% statutory reduction $1,000 deductible and plus statutory interest and penalties).
