13 Fla. L. Weekly Supp. 1112a
Insurance — Personal injury protection — Standing — Assignment — Consent to treatment and authorizations and guarantee agreement given to hospital which references “my physicians” is assignment of benefits to emergency room doctors — Even if emergency room doctors were not included in written assignment, equitable assignment exists where insured intended to give and doctors intended to receive assignment, and insurer would be justified in paying doctors who rendered treatment to insured — Insurer had notice of medical bill where insurer’s corporate representative testified that nothing further was needed for insurer to consider bill, and insurer paid 80% of approved amount
FLORIDA EMERGENCY PHYSICIANS KANG & ASSOCIATES, MD, PA, as assignee of Ronald Cefarelli, Plaintiff, vs. DAIRYLAND INSURANCE COMPANY, Defendant. County Court, 18th Judicial Circuit in and for Seminole County. Case No. 06-SC-000155. August 7, 2006. John R. Sloop, Judge. Counsel: Mark A. Cederberg, Rutledge Bradford, Orlando. Aaron E. Leviten, Winter Park.
ORDER DENYING DEFENDANT’S MOTION FOR FINAL SUMMARY JUDGMENT
THIS MATTER having come before this Court on Defendant’s Motion for Final Summary Judgment and this Court having heard arguments of counsel and being otherwise fully advised in the premises, finds as follows:
1. This is a claim for breach of contract arising out of a motor vehicle collision that occurred on or about 9/1/05.
2. The Plaintiff in this matter is FLORIDA EMERGENCY PHYSICIANS, as assignee of Ronald Cefarelli.
3. On or about 9/1/05, Ronald Cefarelli was involved in a motor vehicle collision which required emergency treatment at Florida Hospital East. The emergency treatment was rendered to Ronald Cefarelli by the Plaintiff, FLORIDA EMERGENCY PHYSICIANS.
4. On or about 9/30/05, the Defendant received the bill that the Plaintiff submitted to the Defendant for payment. The bill was not paid in full.
5. Thereafter, the Plaintiff sent a Notice of Intent to Initiate Litigation, on December 20, 2005, as well as a demand for a declarations page, copy of the policy and a PIP log, pursuant to Florida Statutes 627.4137 and 627.736(6)(d) that was received by the Defendant on December 23, 2005.
6. In response to the December 20, 2005 demand, the Defendant responded that the bill at issue had been paid at a reduced amount “based on the 90th percentile of the Ingenix fee schedule for usual and customary charges in your geographical area. Payment for 80% of the approved amount has been paid timely, thus we respectfully deny your demand for this date of service at this time.”
7. Along with the Notice of Intent to Initiate Litigation, the Plaintiff also sent a document entitled “Consent to Treatment and Authorizations and Guarantee Agreement,” upon which it relied as an assignment of benefits.
It is therefore ORDERED AND ADJUDGED as follows:
1. The Defendant’s Motion for Final Summary Judgment is hereby denied.
2. The Court finds, as a matter of law, that the document entitled “Consent to Treatment and Authorizations and Guarantee Agreement,” is an assignment of benefits.
3. The Court finds that the Plaintiff is included in the Assignment of Benefits given to Florida Hospital East and is clearly referenced by the words “and my physicians.”
4. Further, even if the assignment were not sufficient or the Plaintiff was not included, the Plaintiff has provided un-controverted evidence of its intent to receive an assignment.
5. Under Florida law, no particular words of art are necessary to create an assignment and the same can be made in writing; orally or partially of each.
6. An assignment can be expressed or implied under the circumstances. Assignments can be equitable, where no words or form of instrument is necessary to effect an equitable assignment, and any language, however informal, which shows an intention on one side to assign a right or chose in action and an intention on the other to receive, will operate as an effective equitable assignment.
7. As set forth by the Florida Supreme Court, the true test of an assignment is whether the debtor would, however be justified in paying the debt to the person claiming to be the assignee. Here, clearly that is the case. The Defendant would be quite justified in paying the emergency room doctors who rendered treatment to their insured at Florida Hospital East.
8. The Court further finds that the Defendant was put on proper notice of the Plaintiff’s bill as the Defendant’s Corporate Representative testified that nothing further was needed from the Plaintiff to consider the bill for payment and, indeed, the Defendant paid 80% of the “approved amount” pursuant to the Ingenix fee schedule.
9. The Court reserves jurisdiction as to the issue of attorney’s fees and costs.
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