14 Fla. L. Weekly Supp. 1157b
Insurance — Personal injury protection — Declaratory judgment — Insurer is obligated to provide copy of explanation of benefits, policy and declarations page on presuit request from medical provider even if documents have been given to insured — Motion to dismiss denied
DADE INJURY REHABILITATION CENTER, a Florida Corporation (assignee of Taylor, Annetta), Plaintiff, v. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 17th Judicial Circuit in and for Broward County. Case No. 07-02954 COSO 62. September 17, 2007. Terri-Ann Miller, Judge. Counsel: Russel Lazega, for Defendant.
AGREED ORDER DENYING DEFENDANT’S MOTION TO DISMISSCOUNT I (RE: BREACH OF CONTRACT FOR FAILURE TO PROVIDE AN EXPLANATION OF BENEFITS) AND COUNT II (RE: BREACH OF CONTRACT FORFAILURE TO PROVIDE COPY OF THE INSURANCE POLICY AND DECLARATIONS PAGE)
THIS CAUSE came before the Court on hearing on Defendant’s Motion to Dismiss and the Court’s having reviewed the Motion and entire Court file; reviewed the relevant legal authorities; heard argument, and been sufficiently advised in the premises the Court finds as follows:
Factual Background: Thisis 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 a policy declarations page and for a copy of the insurance policy. Defendant has moved to dismiss Count I (explanation of benefits) and Count II (declarations page and insurance policy) 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 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).
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. Defendant shall respond to the Amended Complaint within 20 days.
