13 Fla. L. Weekly Supp. 396a
Insurance — Personal injury protection — Declaratory action — Insurer’s obligation to provide PIP log, declarations page and policy on pre-suit request from medical provider — Although there is no statutory requirement that PIP log be created, maintained, or disclosed and no express statutory requirement giving medical provider right to insured’s policy or declarations page, good common sense mandates that insurer provide policy, declarations page and information that would otherwise be compiled in PIP log on pre-suit request from insured or provider
THE STAND-UP MRI OF ORLANDO, P.A., a/a/o FRANCELA HENRY, Plaintiff(s), vs. OMNI INS. CO., Defendant(s). County Court, 18th Judicial Circuit in and for Seminole County. Case No. 04-SC-815. January 23, 2006. John R. Sloop, Judge. Counsel: Michael Tierney, Michael Tierney, P.A., Winter Park. Penny Creech, Orlando.
[Editor’s note: See also 13 Fla. L. Weekly Supp. 745a.]
ORDER REGARDING INSURANCE COMPANY’SPRE-SUIT PRODUCTION OF DOCUMENTS INPERSONAL INJURY PROTECTION CASES
THIS COURT, upon Defendant’s Motion for Summary Judgment regarding its Count II Declaratory Judgment action under Chapter 86, Florida Statutes, after hearing, and being otherwise fully advised in the premises, finds the following:
1. The 18th Judicial Circuit, in its Appellate capacity, has addressed this matter; New Hampshire Indemnity Insurance Co. v. Rural Metro Ambulance, a/a/o William Zaniboni, 4-72-AP [12 Fla. L. Weekly Supp. 941a and 12 Fla. L. Weekly Supp. 1145b]. (Zaniboni)
2. A personal injury protection (PIP) “log”, the content of which is neither defined, mandated, nor subject to disclosure under Section 627.736, Florida Statutes, is not something to which Plaintiff is entitled.
3. However, Zaniboni mandates that “the information that would otherwise be compiled in a PIP log” must be provided, pre-suit, to Plaintiff by Defendant to allow Plaintiff to verify Defendant’s explanation of benefits and clarify its status as a claimant. This information includes;
i) what claims have been made,
ii) when these claims were received,
iii) the payment (amount) or denial of each claim,
iv) the amount of deductible and the claims applied thereto, and
v) “whether benefits have truly been exhausted,” (Zaniboni).
4. Plaintiff is entitled, pre-suit, to a copy of its assignor’s insurance policy and declarations page. Although production of these documents are not “expressly stated in Section 627.736, Florida Statutes”, Zaniboni found its production “makes eminently good sense” and “is consistent with the purpose of the no-fault statutory scheme.”
It is therefore:
ORDERED and ADJUDGED that:
A) Defendant is required pre-suit, to provide its insured or their assignee, a copy of the insurance policy, the declarations page, and the “information that would otherwise be compiled in a PIP log” (Zaniboni).
B) There is no statutory requirement that a “PIP log” be created, maintained, or disclosed.
C) There is no express Section of 627.736, Florida Statutes, giving Plaintiff a right to its assignor’s insurance policy or declarations page.
D) Compilation and disclosure of these documents is mandated by “good common sense” and the “purpose of the no-fault scheme”. (Zaniboni)
E) Jurisdiction is retained regarding the entitlement and amount of reasonable attorney’s fees and costs.
F) Defendant’s Motion for Summary Judgment Count II is denied.
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