13 Fla. L. Weekly Supp. 511b
Insurance — Personal injury protection — Demand letter — Where demand letter stated that medical provider was claiming full amount of charges for date of service and did not specify that amount being claimed was only interest for late payment of bill, letter did not satisfy statutory requirement to include exact amount due — Final summary judgment entered in favor of insurer
FLORIDA EMERGENCY PHYSICIANS KANG & ASSOCIATES, MD, PA, as assignee of Marilyn Holbrook, Plaintiff, v. PROGRESSIVE CASUALTY INSURANCE COMPANY, Defendant. County Court, 18th Judicial Circuit in and for Seminole County. Case No. 04-SC-3636. January 31, 2006. John R. Sloop, Judge. Counsel: Christopher S. Reed, Rutledge M. Bradford, P.A., Orlando. Eric Biernacki, Adams & Diaco, P.A., Orlando.
ORDER ON DEFENDANT’S MOTION FOR SUMMARY FINAL JUDGMENT AND MOTION FOR PROTECTIVE ORDER
This CAUSE having come before this Court on Defendant’s Motion for Summary Final Judgment and Motion for Protective Order and Affidavit of Litigation Specialist in Support of Defendant’s 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 Marilyn Holbrook, against Defendant for an unpaid medical bill for treatment rendered to Marilyn Holbrook on date of service January 31, 2004, as a result of injuries she allegedly sustained in an automobile accident which occurred on January 30, 2004.
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 January 31, 2004, a document requesting coverage information, and a document entitled “Consent to Treatment and Authorizations and Guarantee,” were attached to the purported demand letter.
3. Defendant received said demand letter on September 13, 2004.
4. According to Plaintiff’s demand letter, the full amount of the charges for date of service January 31, 2004 were due and owing.
5. Defendant received Plaintiff’s charges, in the amount of $234.00 for date of service January 31, 2004, on April 23, 2004 and paid for same in full on May 11, 2004.
6. Plaintiff filed a Motion for Summary Final Judgment on May 12, 2005 claiming that $3.46 in interest was owed for date of service January 31, 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 $3.46. Instead, Plaintiff’s demand letter specified that the full amount of the charges for date of service January 31, 2004 were due.
9. Moreover, Plaintiff never contacted or sent a bill to Progressive alleging that interest was owed for date of service January 31, 2004 or that the charges for said date of service were paid late.
10. 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.
11. 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 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.
