13 Fla. L. Weekly Supp. 92a
Insurance — Personal injury protection — Declaratory judgment — Insurer is obligated to provide PIP log, policy and declarations page on pre-suit request from medical provider
FLORIDA EMERGENCY PHYSICIANS KANG & ASSOCIATES, MD, PA as assignee of Raymond Goulet, Plaintiff, vs. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 9th Judicial Circuit in and for Orange County. Case No. SCO-04-10849. October 12, 2005. Nancy L. Clark, Judge. Counsel: Christopher S. Reed, Rutledge M. Bradford, P.A., Orlando. Sean Amorginos, Orlando.
ORDER GRANTING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT ON COUNT II OF PLAINTIFF’S AMENDED COMPLAINT
THIS MATTER having come before this Court on Plaintiff’s Motion for Final Summary Judgment of Count II of Plaintiff’s Amended Complaint and this Court having heard arguments of counsel and being otherwise fully advised in the premises, finds the following:
UNDISPUTED FACTS
1. Count II of the Plaintiff’s Amended Complaint is a claim for declaratory relief arising out of a motor vehicle collision that occurred on or about 12/18/2002.
2. Raymond Goulet executed an assignment of benefits in favor of Florida Emergency Physicians Kang & Associates, M.D., P.A., with said document being entitled “Consent to Treatment and Authorizations and Guarantee.”
3. Florida Emergency Physicians Kang & Associates M.D., P.A., submitted their billing for payment. The bill was not paid and the Defendant did not provide an Explanation of Benefits to the Plaintiff.
4. Thereafter, on June 25, 2004, the Plaintiff sent a Notice of Intent to Initiate Litigation, as well as a request to the Defendant for a copy of the policy, declarations page, and PIP payout log pursuant to Florida Statutes 627.4137, 627.736(6)(d), and 627.7401.
5. The Defendant did not respond to the Plaintiff’s demand or the Plaintiff’s request a copy of the policy, declarations page, and PIP payout log pursuant to Florida Statutes 627.4137, 627.736(6)(d), and 627.7401.
6. The Plaintiff waited several additional weeks, but was left in doubt as to whether it had a claim for breach of contract, as the Defendant refused to provide the information required by Florida Statutes or even respond to the demand at all.
7. Thereafter, the Plaintiff filed a Complaint requesting declaratory relief.
It is therefore ORDERED AND ADJUDGED that:
1. The Plaintiff’s Motion for Summary Judgment on Count II of the Plaintiff’s Amended Complaint is GRANTED.
2. The Plaintiff had standing to bring this claim pursuant to the document entitled “Consent to Treatment and Authorizations and Guarantee,” which constitutes an assignment of benefits issued in favor of the “Hospital and my physicians”. Said document constitutes a valid and enforceable assignment conferring all rights and benefits to the Plaintiff.
3. The Court finds that a Defendant, upon proper request, is required to furnish, pre-suit, a copy of the patient’s declarations page, policy, and/or PIP log in accordance with Florida Statutes 627.4137, 677.736(6)(d) and 627.7401.
4. This Court finds as persuasive the long line of county court cases across the state beginning with INTEGRA DIAGNOSTICS (Shawn Umstead) v. RELIANCE NATIONAL INDEMNITY, 8 Fla. L. Weekly Supp. 349c, 17th Judicial Circuit, Judge William Herring (2001), and followed by ROM DIAGNOSTICS v. SECURITY NATIONAL INSURANCE COMPANY (Rafael Cruz), 9 Fla. L. Weekly Supp 323b, 9th Judicial Circuit, Judge Jeffery Arnold (2002); RURAL METRO AMBULANCE (Aletha Bryant) v. LIBERTY MUTUAL INSURANCE COMPANY, 11 Fla. L. Weekly Supp. 583a, 9th Judicial Circuit, Judge Leon Cheek III (2004); TALLAHASSEE MRI, P.A. (Jacques Amilcar) v. PROGRESSIVE AUTO PRO INSURANCE CO., 11 Fla. L. Weekly Supp. 69a, 17th Judicial Circuit, Judge Steven Deluca (2003); PALM BEACH REGIONAL MRI, INC. (Cynthia Jackman) v. SOUTHERN GROUP INDEMNITY INC., 11 Fla. L. Weekly Supp. 742a, 15th Judicial Circuit, Judge Joseph Marx (2004); FLORIDA EMERGENCY PHYSICIANS (Marvene Jones) v. PROGRESSIVE EXPRESS INSURANCE COMPANY, 12 Fla. L. Weekly Supp. 805b, 18th Judicial Circuit, Judge John Sloop (2005); FLORIDA EMERGENCY PHYSICIANS (Sharna Adderly) v. UNITED AUTOMOBILE INSURANCE COMPANY, 12 Fla. L. Weekly Supp. 774c, 9th Judicial Circuit, Judge Leon B. Cheek, III, (2005); FLORIDA EMERGENCY PHYSICIANS (Stephanie Carrico) v. AMERICAN VEHICLE INSURANCE COMPANY, 12 Fla. L. Weekly Supp. 478b, 9th Judicial Circuit, Judge Jerry L. Brewer (2005).
5. This Court also finds as persuasive the Fourth District’s opinion in UNITED AUTOMOBILE INSURANCE COMPANY v. ROUSSEAU, 21 Fla. L. Weekly D2477a, (4th DCA 1996).
6. The Defedant agrees that the Plaintiff is entitled to the policy information requested, but denies that the Plaintiff is entitled to attorney’s fees and costs.
7. The Court reserves jurisdiction as to the issue of the Plaintiff’s entitlement to attorneys’ fees and costs.
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