13 Fla. L. Weekly Supp. 823b
Insurance — Personal injury protection — Coverage — Medical expenses — Lawfully rendered treatment — Affirmative defense of failure to comply with provision of Health Care Act concerning medical director is stricken where during all relevant times medical provider held unencumbered license pursuant to Act, and insurer cannot state cause of action for perceived violation of Act absent independent determination of violation by Agency for Health Care Administration
FLORIDA MEDICAL ASSOCIATES AS ASSIGNEE OF MARITZA CASILLAS, Plaintiff, vs. PROGRESSIVE AUTO PRO INSURANCE COMPANY, Defendant. County Court, 7th Judicial Court in and for Volusia County. Case No. 2005-30502 COCI. May 17, 2006. H. Pope Hamrick, Jr., Judge. Counsel: Kimberly P. Simoes, Susan W. Tolbert, P.L., Daytona Beach. Lynn S. Alfano, Maitland.
[Editor’s note: Order granting Motion for Final summary judgment in this case at 13 Fla. L. Weekly D1205b.]
ORDER ON PLAINTIFF’S MOTION TO DISMISS AFFIRMATIVE DEFENSES REGARDING
COMPLIANCE WITH §400.9935THIS CAUSE having come before the Court for consideration, and the Court having heard arguments of counsel and being otherwise fully advised, it is hereby
CONSIDERED, ORDERED AND ADJUDGED:
1. Plaintiff, FLORIDA MEDICAL ASSOCIATES, Motion to Strike Affirmative Defense is hereby GRANTED.
2. Defendant, PROGRESSIVE AUTO PRO INSURANCE COMPANY, has raised as an affirmative defense, inter alia:
Plaintiff has failed to meet the civil and administrative requirements of Florida Statute §400.9935 concerning a medical director and the duties of that medical director so that the bills at issue were not lawful at the time they were rendered and are therefore not payable by Progressive herein.
3. Defendant, PROGRESSIVE AUTO PRO INSURANCE COMPANY, as a basis for its affirmative defense, has raised the allegation that FLORIDA MEDICAL ASSOCIATES has not complied with the provisions of the Health Care Clinic Act, specifically §400.9935.
4. It is uncontested that during all relevant times FLORIDA MEDICAL ASSOCIATES has held an unencumbered license pursuant to Chapter 400 of the Health Care Clinic Act.
5. The Defendant, PROGRESSIVE AUTO PRO INSURANCE COMPANY, cannot state a cause of action against FLORIDA MEDICAL ASSOCIATES for any perceived violation of the Health Care Clinic Act absent an independent determination by the Agency for Health Care Administration.
6. Plaintiffs Motion to Strike Affirmative Defense is GRANTED with prejudice.
