14 Fla. L. Weekly Supp. 418a
Insurance — Personal injury protection — Declaratory judgment — Insurer’s obligation to provide PIP log upon presuit request by assignee/medical provider — Jurisdiction — County court has subject-matter jurisdiction over claim for declaratory relief concerning PIP log — Standing — Assignment — Where insured assigned PIP benefits to provider, provider obtained all rights and benefits of insured under policy, including right to obtain PIP log — Where without PIP log provider is unable to determine its status as claimant and whether deductible has been met, provider is entitled to PIP log
Quashed at 33 Fla. L. Weekly D565a
STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Appellant(s), vs. FLORIDA EMERGENCY PHYSICIANS, KANG AND ASSOCIATES, MD, PA., as Assignee of Robert Davis, Appellee(s). Circuit Court, 18th Judicial Circuit (Appellate) in and for Seminole County. Case No. 06-51-AP. L.C. Case No. 04-SC-2746. March 13, 2007. Appeal from County Court, Seminole County, Honorable John R. Sloop. Counsel: Kenneth P. Hazouri, deBeaubien, Knight, Simmons, Mantzaris & Neal, L.L.P., Orlando, for Appellant. Kevin B. Weiss, Weiss Legal Group, P.A., Maitland, for Appellee.
(ALAN A. DICKEY, J.) State Farm Mutual Automobile Insurance Company (“State Farm”) appeals an order entering summary judgment in favor of Florida Emergency Physicians (“FEP”). Pursuant to the reasoning provided herein, this Court affirms.
In this case, FEP submitted a bill to State Farm for services rendered to the insured as the result of an automobile accident. State Farm did not pay the bill within thirty (30) days and informed FEP via letter that its medical bill would not be paid because the insured’s PIP benefits were exhausted. Thereafter, FEP sent a demand letter to State Farm advising State Farm that its failure to pay would result in litigation. In addition to the demand letter, FEP requested additional information including:
[A] copy of the insured’s PIP payout sheet and any explanation of benefits generated concerning the bill. This request is specifically in an attempt to avoid the filing of any unnecessary lawsuit if you have applied this bill to the deductible or you have exhausted benefits.
State Farm did not provide FEP with a PIP payout log, and it responded to FEP’s demand letter by stating that “[the insured’s] benefits were exhausted and we were unable to honor your bill.” Thereafter, FEP sent State Farm another demand letter requesting the PIP payout log. State Farm did not provide any further information, and the instant action ensued.
FEP moved for summary judgment in this case concerning its declaratory action regarding entitlement to the PIP payout log. Pursuant to New Hampshire Indemnity Insurance Co. v. Rural Metro Ambulance, a/a/o William Zaniboni, 13 Fla. L. Weekly Supp. 573a (Fla. 18th Jud. Cir., Nov. 18, 2005), on rehearing, the trial court entered summary judgment in favor of FEP, ruling that FEP was entitled to the requested pre-suit information. Additionally, the trial court ruled that FEP’s assignment was valid and enforceable and that State Farm’s prior production of insurance documentation to the assignor’s counsel was irrelevant to FEP’s request as a claimant.
On appeal, State Farm first contends that the county court did not have subject-matter jurisdiction concerning the entitlement to the PIP payout log because such claim was a claim for declaratory relief. However, section 34.01(4), Florida Statutes, specifically provides that county courts may hear all matters in equity involved in any case within the jurisdictional amount of county court. See MRI Services v. State Farm, 807 So. 2d 783 (Fla. 2d DCA 2002) (stating that legislature gave certain equitable powers to county court); see also Spradley v. Doe, 612 So. 2d 722, 724 (Fla. 1st DCA 1993) (holding that clear intent of the legislature was to expand county court jurisdiction over certain specified equitable matters). Furthermore, section 86.011, Florida Statutes, provides that circuit and county courts have jurisdiction within their respective jurisdictional amounts to declare rights, status, and other equitable or legal relations whether or not further relief is or could be claimed. Therefore, the county court had jurisdiction to consider FEP’s declaratory action concerning entitlement to the PIP payout log.
Next, State Farm argues that the assignment only transferred to FEP the right to receive payment and did not transfer the claim for declaratory relief. In New Hampshire Indemnity Insurance Co. v. Rural Metro Ambulance, a/a/o William Zaniboni, 13 Fla. L. Weekly Supp. 573a (Fla. 18th Jud. Cir., Nov. 18, 2005), on rehearing, this Court held:
[t]his Court finds that RMA was entitled to the information and documentation requested pursuant to the assignment of benefits received from Zaniboni, which NHI did not contest below. Surely, Zaniboni had a contractual right to receive a copy of his insurance policy and declarations page any time he saw fit. Likewise, Zaniboni was entitled to know what claims had been made and paid; as well as the benefits remaining, if any, at a given point in time. By executing an assignment of benefits, RMA obtained all of the rights and benefits of Zaniboni under the policy including the right to obtain the requested documentation.
In the instant case, upon admission to the hospital, the insured signed a form titled, “Consent to Treatment and Authorizations Guarantee.” The form included the following language:
Hospital Assignment of Insurance Benefits: I assign payment directly to the Hospital and my physician(s), the insurance benefits otherwise payable to me. I understand that I am financially responsible to the Hospital and my physician(s) of charges not paid by this assignment and that I will assist in the collection of my insurance should there be any delay in payment. If my insurance payment has not been received by the Hospital within 30 days of billing, I understand that the entire balance becomes due, and I agree to actively and vigorously pursue collecting the insurance payment for the Hospital. . . . . THIS ASSIGNMENT OF BENEFITS IS IRREVOCABLE.
Additionally, the insured submitted an affidavit indicating his intent to assign his benefits, and he testified at his deposition that he signed the consent form and that he intended to sign his PIP benefits to FEP. In this case, the insured intended to assign his benefits to FEP. Therefore, FEP obtained all of the rights and benefits of the insured under the policy including the right to obtain the PIP payout log.
Finally, State Farm argues that this Court’s holding in New Hampshire Indemnity Insurance Co. v. Rural Metro Ambulance, a/a/o William Zaniboni, 13 Fla. L. Weekly Supp. 573a (Fla. 18th Jud. Cir., Nov. 18, 2005), on rehearing, is incorrect and that FEP should not be entitled to the PIP payout log. This Court disagrees. Pursuant to the well-established precedent of Zaniboni, FEP is entitled to the PIP log. See Zaniboni (agreeing that assignee has a right to determine, pre-suit, what claims have been made and when; if any claims have been paid or denied; whether the deductible has been met; and if not, how much remains; and whether benefits have truly been exhausted). Without the PIP log, FEP is unable to determine its status as a claimant with respect to whether the deductible had been met.
Accordingly, the Order Granting Plaintiff’s Motion for Final Summary Judgment on Count II and Denying Defendant’s Motion for Summary Judgment on Count II of Plaintiff’s Complaint is AFFIRMED.
