13 Fla. L. Weekly Supp. 718b
Insurance — Personal injury protection — Coverage — Exhaustion of policy limits — Subsequent claim for unpaid portion of bills — Where PIP benefits were exhausted prior to medical provider filing suit for unpaid portion of reduced bills, and provider does not allege bad faith or inappropriate bill processing, provider is not entitled to recover benefits or statutory penalties
LAWRENCE H. FINK, M.D., FACS, P.L., As assignee of KIM COPELAND, Plaintiff, vs. PROGRESSIVE AMERICAN INSURANCE COMPANY, Defendant. County Court, 12th Judicial Circuit in and for Sarasota County. Case No. 2005 SC 4184 NC. April 12, 2006. Judy Goldman, Judge. Counsel: Adam R. Filthaut, Adams & Diaco, P.A., Tampa. Kenneth P. Gerber.
ORDER
THIS CAUSE, having come on to be heard upon Defendant’s Motion for Summary Judgment on April 7, 2006, and the Court, having heard argument of counsel and being otherwise duly advised in the premises, IT IS ORDERED AND ADJUDGED:
1. Defendant’s Motion For Summary Judgment is GRANTED.
2. It is undisputed that the Defendant insured the claimant, Kim Copeland, and that said policy of insurance provided ten thousand dollars ($10,000.00) in personal injury protection benefits, with no deductible and no medical payments coverage.
3. It is also undisputed that the claimant, Kim Copeland, assigned the benefits under her policy of insurance to the Plaintiff.
4. The bills submitted by the Plaintiff were reduced by the Defendant to reflect an amount that it determined was “reasonable” for the services provided in the providers geographic region. Other than contesting the amount that Defendant reimbursed, the Plaintiff does not allege bad faith nor does the Plaintiff allege that Defendant otherwise processed the bills inappropriately.
5. Subsequent to reimbursing Plaintiff and receiving the Plaintiff’s statutorily required pre-suit demand, the Defendant continued to pay other providers bills. By continuing to pay the other providers bills, Defendant exhausted benefits on July 19, 2005.
6. The Court does find it significant that all available benefits had been exhausted prior to suit being filed by the Plaintiff on August 3, 2005.
7. The Court finds Physical Medicine Center (a/a/o Timothy Baitinger, Donald Jackson, Michelle Davison, Thomas Dickson and Mary Sommery), 12 Fla. L. Weekly Supp. 210c, (Fla. 13th Jud. Cir. November 19, 2004) (Appellate) and Space Coast Chiropractic Health Services & Dr. Bradley Clow Chiropractic v. Nationwide Mutual Insurance Company, 13 Fla. L. Weekly Supp. 393a (Brevard County, 2006) persuasive in this matter before the Court.
8. Additionally, the Court finds that Simon a/a/o Eric Hon v. Progressive Express Insurance Company, 904 So.2d 449 (Fla. 4th DCA, 2005) is controlling in this matter and the Court is bound by its precedence.
9. Pursuant to Simon, the Court finds that the Defendant is statutorily obligated to continue to pay bills submitted on behalf of an insured, even if that results in the exhaustion of benefits.
10. It is Black Letter law in the State of Florida that upon receiving an assignment, the assignee steps into the shoes of the assignor. As such, the assignee cannot obtain any greater rights than that of which the assignor originally had under the contract.
11. It is the opinion of this Court that pursuant to the cases cited above, the Defendant has met its contractual and statutory obligations by paying the full ten thousand dollars ($10,000) and Plaintiff is not entitled to recover more than that of which the insured is entitled to recover under the policy of insurance; nor is Plaintiff entitled to seek recovery of statutory penalties.
