13 Fla. L. Weekly Supp. 391a
Insurance — Personal injury protection — Demand letter — Where demand letter did not specify that exact amount being claimed was for interest, but instead, specified that full amount of charges for date of service was due, medical provider failed to comply with statutory condition precedent to filing PIP suit
FLORIDA EMERGENCY PHYSICIANS KANG & ASSOCIATES, M.D., P.A., as assignee of Scott Rubenfeld, Plaintiff, vs. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant. County Court, 18th Judicial Circuit in and for Seminole County. Case No. 04-SC-3577. December 6, 2005. John Sloop, Judge. Counsel: Christopher S. Reed, Rutledge M. Bradford, P.A., Orlando. Eric Biernacki, Adams & Diaco, P.A., Orlando.
ORDER ON DEFENDANT’S AMENDED MOTION FOR SUMMARY FINAL JUDGMENT AND MOTION FOR PROTECTIVE ORDER
This CAUSE having come before this Court on Defendant’s Amended Motion for Summary Final Judgment and Motion for Protective Order and Affidavit of Litigation Specialist in Support of Defendant’s Amended Motion for Summary Final Judgment, and the Court having heard the argument of counsel, and being otherwise fully advised in the premises, finds as follows:
1. Plaintiff filed a PIP suit, as assignee of Scott Rubenfeld, against Defendant for an unpaid medical bill for treatment rendered to Scott Rubenfeld on date of service February 20, 2004, as a result of injuries he allegedly sustained in an automobile accident which occurred on November 4, 2003.
2. Plaintiff sent a demand letter to PROGRESSIVE, entitled “NOTICE OF INTENT TO INITIATE LITIGATION,” dated September 10, 2004. A HCFA form for date of service February 20, 2004, a document requesting coverage information, a document entitled “Consent to Treatment and Authorizations and Guarantee,” and a bill from Plaintiff indicating that no payment was made for date of service February 20, 2004 were attached to the purported demand letter.
3. Defendant received said demand letter on September 15, 2004.
4. According to Plaintiff’s demand letter and the bill attached to said demand letter, the full amount of the charges for date of service February 20, 2004 were due and owing.
5. Defendant’s response to said demand letter, dated September 23, 2004, stated that the charges for date of service February 20, 2004 were paid on July 20, 2004 pursuant to statutory requirements.
6. Plaintiff filed a Motion for Summary Final Judgment on June 6, 2005 claiming that $6.81 in interest was owed for date of service February 20, 2004.
7. Pursuant to §627.736(11), Florida Statutes (2004), a Pre Suit Demand letter is a statutory condition precedent to filing any action for benefits under the PIP statute and must state with specificity “the name of any medical provider who rendered to an insured the treatment, services, accommodations, or supplies that form the basis of such claim; and an itemized statement specifying each exact amount, the date of treatment, service, or accommodation, and the type of benefit claimed to be due.”(Emphasis added)
8. The demand letter did not specify that the exact amount being claimed was for interest in the amount of $6.81. Instead, Plaintiff’s demand letter specified that the full amount of the charges for date of service February 20, 2004 were due. Defendant was unaware that Plaintiff was claiming interest was due because the demand letter did not specify same.
9. Several courts have held that merely attaching a HCFA form to a demand letter does not provide the insurer with the “exact amount” due. Universal Health Care Center, Inc., a/a/o Leslie Cross v. Progressive Express Insurance Co., 11 Fla. L. Weekly Supp. 1095b, (Broward County, August 11, 2004); Jacob Feignbaum v. Progressive American Insurance Co., 11 Fla. L. Weekly Supp. 737a, (Sarasota County, May 11, 2004); Progressive Express Insurance Co. v. Travis J. Broussard, 12 Fla. L. Weekly Supp. 277b, (Pinellas County Circuit Court, appellate division, December 6, 2004). This case is similar in that the demand letter itself and the documents attached to the demand letter indicated that the full amount of the bill was due. Progressive was not provided with the “exact amount” due and was not put on notice as to what was at issue.
10. When the language of the statute is clear and unambiguous, and conveys a clear and definite meaning, the statute must be given its plain and obvious meaning. State of Florida v. Warren, 796 So. 2d 489 (Fla. 2001). A strict reading of the statute requires Plaintiff to have provided Defendant with the exact amount claimed to be due. By Plaintiff’s failure to do so, it has failed to comply with the §627.736(11) statutory condition precedent and Defendant is entitled to summary final judgment as a matter of law.
Accordingly, it is hereby
ORDERED and ADJUDGED that Defendant’s Amended Motion for Summary Final Judgment is GRANTED; it is further
ORDERED and ADJUDGED that Plaintiff shall take nothing by this action and Defendant shall go hence without day; it is further
ORDERED and ADJUDGED that the Court shall reserve jurisdiction as to Defendant’s attorney’s fees and taxable costs.
