13 Fla. L. Weekly Supp. 737a
Insurance — Personal injury protection — Declaratory judgment — Insurer’s obligation to provide policy, declarations page and/or PIP log on presuit request from assignee/medical provider — Where insurer which maintains and has ability to provide PIP register provided medical provider only with blank PIP register, provider is entitled to summary judgment
FLORIDA EMERGENCY PHYSICIANS KANG & ASSOCIATES, MD, PA as assignee of Camille Davila, Plaintiff, vs. GEICO CASUALTY COMPANY, Defendant. County Court, 18th Judicial Circuit in and for Seminole County. Case No. 04-SC-3159. April 25, 2006. John Sloop, Judge. Counsel: Christopher S. Reed, Rutledge Bradford, Orlando. Karissa Owens, Orlando.
AFFIRMED. 14 Fla. L. Weekly Supp. 238a. (Rehearing denied, 14 Fla. L. Weekly Supp. 239a.)
ORDER GRANTING PLAINTIFF’S MOTION FOR FINAL SUMMARY JUDGMENT ON COUNT II AND DENYING DEFENDANT’S MOTION FOR FINAL SUMMARY JUDGMENT
THIS MATTER having come before this Court on March 20, 2006 pursuant to the Plaintiff’s Motion for Final Summary Judgment on Count II and the Defendant’s Motion for Final Summary Judgment and this Court having heard arguments of counsel and being otherwise fully advised in the premises, the Court makes the following findings:
FACTS
1. This is a claim for declaratory relief arising out of a motor vehicle collision that occurred on or about 01/02/2003.
2. The Plaintiff in this matter is FLORIDA EMERGENCY PHYSICIANS KANG & ASSOCIATES, MD, PA as assignee of Camille Davila.
3. On or about 01/27/03, the Plaintiff submitted its bill for care and treatment of the insured to the Defendant and the bill went unpaid.
4. Thereafter, on 6/25/04, a Notice of Intent to Initiate Litigation was sent to the Defendant’s designated “designee” pursuant to Florida law and was signed for by the Defendant on 6/30/04. Included in the Notice package was a request for a copy of the policy, declarations page and PIP log, as provided for in Florida statutes.
5. On 7/7/04, the Defendant responded to the Plaintiff’s demand advising that the Plaintiff’s bill was applied to the deductible, acknowledging the Plaintiff’s request for a PIP payout sheet, and advising that “statute 627.4137 allows an insurer 30 days (not 15) to provide a declarations page or affidavit of coverage.”
6. On 7/13/04, the Plaintiff received a blank “PIP/MED REGISTER-PAYMENT RECORD” that contained no information regarding the receipt of the Plaintiff’s bill, any other bills that may have been received by the Plaintiff, any application of the Plaintiff’s bill to any deductible, or anyone objective information to verify the Defendant’s assertion that the Plaintiff’s bill was properly applied to the deductible on the policy.
7. On 8/3/04, the Plaintiff received a faxed copy of an affidavit of coverage from the Defendant.
8. Upon receiving the Defendant’s 8/3/04 affidavit of coverage, the Plaintiff sent facsimile correspondence to the Defendant advising the Defendant that the Plaintiff was still in need of a PIP payout log, to verify the amounts that were applied to the deductible.
9. The Defendant failed to respond in any fashion to the follow up request for the PIP log.
10. The Defendant maintains, in the normal course of business and has the ability to provide a “workable PIP register” that shows the dates bills are received, the dates that the bills were applied to the deductible, and the amounts that were applied to the deductible, but it is the Defendant’s policy not to provide said document.
11. The Plaintiff waited several additional weeks before filing suit, but was left in doubt as to whether it had a claim for breach of contract, as the Defendant refused to provide the information that would otherwise be complied in a PIP log.
12. The Defendant failed to furnish the Plaintiff with a copy of the information that would otherwise be compiled in a “pip log,” as the document that the Defendant chose to produce does not contain any information regarding the identity of the bills received by the Defendant, the dates the bills were received by the Defendant, the amount of the bills received by the Defendant, the date the bills were applied to the deductible, the total amount of bills applied to the deductible, and does not even reference the receipt and application of Plaintiff’s bill.
13. The Defendant failed to furnish the Plaintiff with the information that would allow the Plaintiff to determine, “if any claims have been paid or denied, whether the deductible has been met, and if not, how much remains.”
14. The pleadings, depositions, answers to interrogatories, and admissions on file together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the Plaintiff is entitled to final summary judgment as a matter of law.
It is therefore, ORDERED AND ADJUDGED that:
1. The Defendant’s Motion for Final Summary Judgment is DENIED.
2. The Plaintiff’s Motion for Final Summary Judgment on Count II is hereby GRANTED. See New Hampshire Indemnity vs. Rural Metro Ambulance as assignee of William Zaniboni, 04-72-AP, 18th Judicial Circuit, Judge Alley, Simmons, and Perry, November 18, 2005.
3. This appellate opinion is directly on point. The Defendant makes multiple assertions as to why it is not obligated to comply with a pre-suit request for information regarding a policy, declarations page and PIP Log. However, these arguments were rejected by the Appellate Court in the matter of New Hampshire Indemnity v. Rural Metro Ambulance as assignee of William Zaniboni, 04-72-AP, 18th Judicial Circuit, Judge Alley, Simmons, and Perry, November 18, 2005.
4. The Defendant further contends, that the Plaintiff has no standing pursuant to the assignment of benefits upon which it relies. This argument is also rejected.
5. The document has been ruled to be a valid assignment of benefits. See Florida Emergency Physicians Kang & Associates a/a/o Marvene Jones v. Progressive Express Insurance Company, 12 Fla. L. Weekly Supp 805b; Florida Emergency Physicians Kang & Associates a/a/o Sharna Adderly v. United Automobile Insurance Company, 12 Fla. L. Weekly Supp 774c; and Florida Emergency Physicians Kang & Associates a/a/o Raymond Goulet v. United Automobile Insurance Company, Case No.: SCO-04-10849, 9th Judicial Circuit, Judge Nancy L. Clark, October 12, 2005 [13 Fla. L. Weekly Supp. 92a].
6. The court reserves jurisdiction for the sole issue of the amount of the Plaintiff’s attorneys’ fees and costs.
* * *
