13 Fla. L. Weekly Supp. 903a
Insurance — Personal injury protection — Coverage — Medical expenses — Overdue bills — Request for documentation/information — Failure to respond — Medical provider was not entitled to bring action to collect on claim for nerve conduction testing where provider had not responded to insurer’s request for documentation or information regarding medical necessity of testing and, therefore, claim was not yet overdue
RHODES & ANDERSON, D.C., P.A. d/b/a VENICE CHIROPRACTIC CENTER (a/a/o IRENA DYNDUL), Plaintiff, v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 12th Judicial Circuit in and for Sarasota County, Small Claims Civil Division. Case No 2005-SC-001960-SC. June 13, 2006. David L. Denkin, Judge. Counsel: Virlyn B. Moore, III, Venice, for Plaintiff. Philip A. Friedman, Ramey & Kampf, P.A., Tampa, for Defendant.
ORDER ON PLAINTIFF’S AND DEFENDANT’S MOTIONS FOR SUMMARY JUDGMENT
THIS MATTER has come before this court pursuant to Plaintiff’s Amended Motion for Summary Judgment and several of Defendant’s Motions for Summary Judgment.1
The Plaintiff has filed suit to recover payment for treatment rendered to State Farm’s insured. At issue are two (2) sets of Nerve Conduction Velocity’ (NCV) tests performed on April 28, 2004. Upon receipt of the billing on May 24, 2004, State Farm sent out a request for information pursuant to §627.736(b), (2003) on May 28, 2004. Specifically, State Farm requested “documentation or information concerning . . . . . Medical necessity for nerve conduction testing in absence of needle EMG.” It is undisputed that Dennis Rhodes never responded to this request.
Fla. Stat. §627.736(6)(b), Fla. Stat. (2003), provides in pertinent part that:
“if an insurer makes a written request for documentation or information under this paragraph within 30 days after having received notice of the amount of a covered loss under paragraph (4)(a), the amount or the partial amount which is the subject of the insurer’s inquiry shall become overdue if the insurer does not pay in accordance with paragraph (4)(b) or within 10 days after the insurer’s receipt of the requested documentation or information, whichever occurs later.”
Therefore, this Court finds that this cause of action was filed prematurely and contrary to the legal requirements of Florida law. Plaintiff was not entitled to bring this action to collect on claim that was not yet overdue. Hess Spinal & Medical Centers, Inc. o/b/o Cash v. Direct General Ins. Co., 11 Fla. L. Weekly Supp. 337a (Pinellas Cty., 2004); Drew Medical, Inc. v. Progressive Express Insurance Company, 12 Fla. L. Weekly Supp. 403b (Seminole Cty., 2005).
Plaintiff’s Motion for Summary Judgment is DENIED. Defendant’s Motion for Summary Judgment for failing to satisfy a condition precedent under §627.736(6)(b), Fla. Stat. (2003) is GRANTED. Defendant’s remaining motions for summary judgment are DENIED. The Court reserves jurisdiction to consider the taxation of costs and fees.
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1Each Motion alleges a specific ground for summary judgment relief. One alleges Plaintiff’s lack of standing, one alleges failure to satisfy a condition precedent (i.e. notice of covered loss under 6(b)), and one alleges failure to comply with billing requirement (i.e. billing for an unlawful amount).
