13 Fla. L. Weekly Supp. 729a
Insurance — Personal injury protection — Coverage — Medical expenses — MRI — Charges in excess of statutory fee schedule — Where charges for MRI set forth in demand letter exceeded statutory fee schedule, charges were unreasonable and not payable
ROSE RADIOLOGY CENTERS, INC., a/a/o ANGELO CIANCIATTO, Plaintiff, vs. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 13th Judicial Circuit in and for Hillsborough County, Civil Division. Case No. 04-13647, Division H. March 1, 2006. Cheryl Thomas, Judge. Counsel: Kimberly A. Sandefer, Gale L. Young, P.A., Tampa. Arthur Liebling.
ORDER ON DEFENDANT’S THIRD AMENDED MOTION FOR FINAL SUMMARY JUDGMENT, ORIN THE ALTERNATIVE, MOTION FOR SUMMARY DISPOSITION AND MEMORANDUM OF LAW
THIS CAUSE, having come on before this Court on February 6, 2006, upon the Defendant’s Third Amended Motion For Final Summary Judgment, Or In The Alternative, Motion For Summary Disposition And Memorandum Of Law, and the Court having heard argument of counsel for the respective parties, and being otherwise duly advised in the premises, it is hereby
ORDERED AND ADJUDGED as follows:
1. As to the first argument, the Court agrees with Defendant that if the charges submitted to a PIP insurer for MRI services exceed the amounts set forth in Florida Statutes § 627.736(5)(b)(5), then said charges are unreasonable and the insurer is not required to pay said charges. The Court finds that the charges in this case were unreasonable as they exceeded the amounts set forth in Florida Statutes § 627.736(5)(b)(5). Therefore, Defendant’s Third Amended Motion For Final Summary Judgment is GRANTED as to the first argument.
2. As to the second argument on the satisfaction of the condition precedent of a demand letter, the Court finds that the charges for the MRI services at issue in this matter exceeded the amounts set forth in Florida Statutes § 627.736(5)(b)(5). The Court further finds there is no requirement set forth in § 627.736 Florida Statutes that requires an insurer to make a determination as to what amount and what is to be paid for the services/treatment in order to satisfy Plaintiff’s demand. The Court further finds that in this case, the demand letter demanded payment for charges in excess of § 627.736(5)(b)(5) and that Defendant is not required to make any payment for the services rendered on April 1, 2002. Therefore, Defendant’s second argument of its Third Amended Motion For Final Summary Judgment is GRANTED.
3. The Court reserves jurisdiction to determine Defendant’s entitlement to attorney’s fees and costs, as to the first and second arguments of Defendant’s Third Amended Motion For Final Summary Judgment, Or In The Alternative, Motion For Summary Disposition And Memorandum Of Law.
4. Arguments have not yet been brought before the Court as to the third argument set forth in Defendant’s Third Amended Motion For Final Summary Judgment, Or In The Alternative, Motion For Summary Disposition And Memorandum Of Law. The third argument shall be addressed before the Court at a later hearing date.
