14 Fla. L. Weekly Supp. 394a
Insurance — Personal injury protection — Notice of claim — Disclosure and acknowledgment form — Failure to submit — Where medical provider failed to submit original standard disclosure and acknowledgment form to insurer prior to insured filing suit, insurer was never placed on notice of claim, and claim was never overdue and is legal nullity — No merit to argument that failure to provide form impacts only initial date of service, not entire claim — No prejudice to insured from dismissal of suit because, where medical provider fails to comply with legal requirement to submit bill, neither insurer nor insured is responsible for payment
JASON MARTIN, Plaintiff, v. PROGRESSIVE AUTO PRO INSURANCE COMPANY, Defendant. Small Claims Court, 4th Judicial Circuit in and for Duval County. Case No. 16-2005-SC-008073, Division K. February 2, 2007. Sharon H. Tanner, Judge. Counsel: James J. Woodruff, II, The Woodruff Law Firm, P.L., for Plaintiff. Glenn S. Banner, James C. Rinaman, III & Associates, P.A., Jacksonville, for Defendant.
AMENDED ORDER GRANTING DEFENDANT’S MOTION FOR SUMMARY DISPOSITION
THIS CAUSE, came before the Court on January 16, 2007, present for Plaintiff was James J. Woodruff, II, Esquire, and for Defendant appeared Glenn S. Banner, Esquire, for the hearing on Defendant’s Motion for Summary Disposition, and the Court having heard arguments of counsel, reviewed the pleadings motions and evidence before the Court and being otherwise advised in the premises, it is,
ORDERED and ADJUDGED as follows:
1. Defendant’s Motion for Summary Disposition is granted.
2. On or about October 21, 2005, the Plaintiff, Jason Martin, filed suit alleging non-payment of No-Fault/Personal Injury Protection (“PIP”) benefits for medical services rendered by the Nirvana Clinic related to a motor vehicle accident that occurred on May 22, 2004.
3. It is undisputed that an original disclosure and acknowledgment form was never submitted to Defendant prior to the filing of this suit, by the Nirvana Clinic.
4. On February 28, 2006, a copy of a disclosure and acknowledgment form was received by Defendant from the Nirvana Clinic. The disclosure and acknowledgment form furnished by the Nirvana Clinic did not list or describe the treatment rendered as required by the statute and the standardized form adopted by the Financial Services Commission.
5. FLA. STAT. § 627.736(4)(b) states, in pertinent part: “Personal injury protection insurance benefits paid pursuant to this section shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss.”
7. FLA. STAT. § 627.736(5)(e)(1) requires,
“At the initial treatment or service provided, each physician . . . providing medical services upon which a claim for personal injury protection benefits is based shall require an insured person . . . to execute a disclosure and acknowledgment form . . .”
FLA. STAT. § 627.736(5)(e)(5) states,
“The original completed disclosure and acknowledgment form shall be furnished to the insurer pursuant to paragraph (4)(b) . . .”
8. FLA. STAT. § 627.736(4)(b), states in pertinent part that an insurer can assert that a claim is in violation of FLA. STAT. § 627.736(5), at any time. The Defendant asserted its statutory right to assert that the claim was in violation of FLA. STAT. 627.736(5).
9. The Plaintiff cites the Court to FLA. STAT. § 627.736(5)(e)(9), in an attempt to argue that the failure to provide the original disclosure and acknowledgment form would only impact the initial date of service not the entire claim. The Court is not persuaded. FLA. STAT. § 627.736(5)(e)(9) merely provides that the requirements of completing the form only apply to the initial treatment. The intent of the section is further demonstrated by the next sentence which requires the patient to sign a patient log on subsequent visits. The section does not address any penalty for failing to comply with the statutory requirements.
10. The controlling provision is FLA. STAT. § 627.736(5)(e)(5) which mandates that the original completed disclosure and acknowledgment form be furnished to the insurer pursuant to paragraph (4)(b). The unambiguous language of the statute clearly provides that providing the insurer with the original disclosure and acknowledgment form is mandatory to place the insurer on notice of the claim pursuant to FLA. STAT. § 627.736(4)(b), as a matter of law.
11. The Plaintiff’s interpretation of the statute would allow medical providers to avoid the requirements of providing the insurer with the original disclosure and acknowledgment form, which would render the provision useless. Courts must assume that statutory provisions are intended to have some useful purpose. Courts are not to presume that a given statute employs “useless language.” Johnson v. Feder, 485 So. 2d 409 (Fla. 1986).
12. The Court acknowledges that it may seem unfair to the Plaintiff that its claim be denied because the medical provider failed to comply with the legislative requirements to make a claim for PIP benefits. However, the procedures and requirements set forth in the PIP statute is a matter of policy exclusively within the province of the Legislature who, as opposed to Courts, are not only equipped to deal with and weigh the relevant policy issues, but also to whom the legislative authority is accorded.
13. The Court finds that there is no prejudice to the Plaintiff, because where the medical provider has not complied with the legal requirements to submit the bill, neither the insurer, nor the insured are responsible for payment. FLA. STAT. § 627.736(5)(b)(1)(b).
14. The original standard disclosure and acknowledgment form was not submitted to Defendant prior to the filing of this suit in violation of FLA. STAT. § 627.736(5)(e)(5). The Defendant was never placed on notice of the claim as a matter of law. FLA. STAT. § 627.736(4)(b). The disclosure and acknowledgment form requirements are mandatory and an integral part of the claim process. The statutory procedures for placing the Defendant on legal notice of the claim were not satisfied, and the claim was not lawfully presented to Defendant. The claim was never overdue, and is a legal nullity. Defendant’s Motion for Summary Disposition is granted as a matter of law.
IT IS HEREBY ADJUDGED that Plaintiff, Jason Martin, take nothing with regards to the claims in this action, and the Court retains jurisdiction for the purpose of determining any motion by Defendant to tax attorney’s fees and costs.
