14 Fla. L. Weekly Supp. 480c
Insurance — Personal injury protection — Claims — Where bills submitted to insurer by medical provider do not contain professional license number of provider, insurer was not provided with written notice of covered loss, and bills are not payable
NEW LIFE POLYCLINICS, INC. (a/a/o Camelia Amich), Plaintiff, vs. U.S. SECURITY INSURANCE COMPANY, Defendant. County Court, 11th Judcial Circuit in and for Miami-Dade County. Case No. 06-2969 SP 21. Bar No. 0721182. February 16, 2007. Ana Maria Pando, Judge. Counsel: Alina Palacios-Hart, Hamilton House Counsel, Miami. Stuart Yanofsky.
ORDER GRANTING DEFENDANT’S MOTION FOR FINAL SUMMARY JUDGMENT
THIS CAUSE having come before the Court, the Court having reviewed the Court’s file and considered the matter, and the Court being otherwise fully advised in the premises, it is hereby:FINDINGS OF FACT
1. On or about November 24, 2004, Camelia Amich (“claimant”) was allegedly involved in an automobile accident, and made a claim for PIP benefits with U.S. SECURITY INSURANCE COMPANY (“U.S. SECURITY”) thereafter.
2. NEW LIFE POLYCLINICS, INC. (“NEW LIFE”) has brought suit against U.S. SECURITY, for personal injury protection benefits.
3. U.S. SECURITY received bills from NEW LIFE for dates of services December 3, 2004 through and including February 24, 2005, totaling $11,980.00 in amount.
4. NEW LIFE’s bills did not contain the professional license number of the provider in the line or space provided for “Signature of Physician or Supplier, Including Degree or Credentials,” in direct violation of the express provisions of Florida Statute 627.736(5)(d).
5. Defendant notified Plaintiff that said bills for dates of service December 3, 2004 through and including February 24, 2005 did not contain the professional license number of the treating physician as required by Florida Statute §627.736(5)(d) and therefore the Defendant had not received notice of a covered loss pursuant to §627.746(4)(b).
6. Despite same, Plaintiff did not submit any of its bills for dates of service December 3, 2004 through and including February 24, 2005 with the professional license number of the provider in the line or space provided for “Signature of Physician or Supplier, Including Degree or Credentials,” as required by Florida Statute §627.736(5)(d) and (4)(b).
CONCLUSIONS OF LAW
Florida Statute 627.736(5)(d) expressly states, “[a]ll providers other than hospitals shall include on the applicable claim form the professional license number of the provider in the line or space provided for “Signature of Physician or Supplier, Including Degrees or Credentials.” Said section further expressly states, “[f]or purposes of paragraph (4)(b), an insurer shall not be considered to have been furnished with notice of the amount of covered loss or medical bills due unless the statements or bills comply with this paragraph, and unless the statements or bills are properly completed in their entirety as to all material provisions, with all relevant information being provided therein.”
Therefore based on the undisputed facts and above-cited law, U.S. SECURITY was never provided with written notice of a covered loss as to the Plaintiff’s bills, and said bills are accordingly not payable. Therefore U.S. SECURITY is entitled to the entry of final summary judgment against the Plaintiff herein.
ORDERED and ADJUDGED that:
1. Defendant’s Motion for Final Summary Judgment is GRANTED. Defendant shall go hence without day.
