14 Fla. L. Weekly Supp. 1144b
Insurance — Personal injury protection — Declaratory action — Insurer’s obligation to provide policy, declarations page and/or PIP log on presuit request from assignee/medical provider — Provider may maintain action for copy of policy and declarations page, even where documents have been provided to insured
DADE INJURY REHABILITATION CENTER a/a/o IOTHA JOSEPH, Plaintiff, v. UNITED AUTOMOBILE INS. CO. County Court, 11th Judicial Circuit in and for Miami-Dade County. Case No. 07-16372 CC 23 (04). September 19, 2007. Don S. Cohn, Judge. Counsel: Russel Lazega, for Plaintiff. James Pinkert, for Defendant.
ORDER DENYING DEFENDANT’S MOTION TO DISMISS COUNT II (CLAIM FOR INSURANCE POLICY AND DECLARATIONS PAGE)
THIS CAUSE, came before the court for hearing on September 19, 2007, and the court, having reviewed the Motion, the court file, legal authorities and having heard argument of counsel, finds as follows:
Factual Background:This is a multi-count P.I.P. case. Count I claims breach of contract for failure to provide an explanation of benefits (EOB); Count II is a claim for declaratory relief to determine Plaintiff’s right to a copy of the policy and policy declarations page/statement of coverages and Count III is a claim for a breach of contract seeking damages for an alleged violation of F.S. s. 627.4137 and Count IV claims breach of contract damages for failure to pay PIP benefits. Defendant has moved to dismiss Count II (declaratory relief regarding policy/declarations page) arguing that Plaintiff has no right to bring an action for this information and that the patient/assignor was provided this information prior to Plaintiff’s request.
Conclusions of Law:This court has ruled on this issue before in a similar case involving these parties, See Dade Injury Rehabilitation Center v. United Auto. Ins. Co., 14 Fla. L. Weekly Supp. 667 (2007), and maintains its prior ruling. The court agrees with the reasoning of the overwhelming majority of county and circuit courts that have considered this issue and finds that an assignee medical provider may maintain an action for a copy of the insurance policy and policy declarations page. See, e.g., Integra Diagnostics v. Reliance Nat’l Ind., 8 Fla. L. Weekly Supp. 349c (County Court, Broward 2001); Florida Orthopedic Center, P.A. v. United Auto. Ins. Co., 13 Fla. L. Weekly Supp. 1234 (County Court, Broward 2006); Scott M. Jablon, D.C. v. United Auto. Ins. Co., 13 Fla. L. Weekly Supp. 643c (County Court, Broward 2006); American Vehicle Ins. Co. v. Florida Emergency Physicians Kang & Assoc., P.A., 13 Fla. L. Weekly Supp. 973 (18th Circuit Appellate 2006); ROM Diagnostics v. Security Nat’l Ins. Co., 9 Fla. L. Weekly Supp. 323b (County Court, Orange 2002); Rural Metro Ambulance v. Liberty Mut. Ins. Co., 11 Fla. L. Weekly Supp. 69a (County Court, Broward 2003); Palm Beach Regional MRI v. Southern Group Ind. Co., 11 Fla. L. Weekly Supp. 742a (County Court, Palm Beach 2004); Florida Emergency Physicians Kang & Assoc. v. United Auto. Ins. Co., 12 Fla. L. Weekly Supp. 805b (County Court, Seminole 2005); Florida Emergency Physicians Kang & Assoc. v. American Vehicle Ins. Co., 12 Fla. L. Weekly Supp. 774c (County Court, Orange 2005); Florida Emergency Physicians Kang & Assoc. v. American Vehicle Ins. Co., 12 Fla. L. Weekly Supp. 478b (County Court, Orange 2005). The court finds Humanitary Healthcare to be completely distinguishable as Humanitary Heathcare dealt only with a provider’s right to a payout log under F.S. s. 627.736(6)(d) (addressing an insurer’s right to pre-suit discovery). The decision is narrow and did not address the right to relief under any other provision of the PIP statute nor did it even address a right to an insurance policy and statement of coverages.
As to the issue of whether the medical provider may obtain a copy of the policy and declarations page if one was provided to the insured, the Court agrees with the reasoning of R.J. Trapana, M.D., P.A. (a/a/o Paolo D’Onofrio) v. United Auto. Ins. Co., 13 Fla. L. Weekly Supp. 1019a (County Court, Broward 2006) (holding that an insurer must provide an EOB to an assignee medical provider even if one was given to the insured) and finds that it is sound policy to encourage prospective litigants to be informed pre-suit to minimize needless and baseless filings.
Accordingly, it is hereby
ORDERED AND ADJUDGED that Defendant’s Motion to Dismiss is DENIED. The answer filed August 10, 2007 shall be filed as of that date.
