15 Fla. L. Weekly Supp. 188b
Insurance — Personal injury protection — Standing — Assignment — Validity — No merit to claims that assignment does not identify policy being assigned or that there is no evidence that assignment attached to demand letter and to complaint was executed before suit was filed — Affidavit clarifies any ambiguity in assignment — There is no requirement that assignment be signed by medical provider or witnesses — Even if assignment were invalid, assignment combined with affidavit demonstrates existence of equitable assignment — Motion for summary judgment denied
ARTIBONITE INJURY CARE CENTER, (a/a/o Rigobert Leger), Plaintiff, v. NEW HAMPSHIRE INDEMNITY COMPANY, INC., Defendant. County Court, 17th Judicial Circuit in and for Broward County. Case No. 05-07126 COSO 62. November 27, 2007. Terri-Ann Miller, Judge. Counsel: Joshua Meadow, Law Office of Russel Lazega, P.A., North Miami, for Plaintiff. Luis N. Perez, for Defendant.
ORDER DENYING DEFENDANT’S MOTION FOR SUMMARY JUDGMENT
This action came before the Court on Defendant’s Motion for Summary Judgment (as to the validity of the Assignment), and the Court having considered the record, having heard argument of counsel, and being otherwise advised in the premises, it is hereupon ordered and adjudged as follows:
Facts and Procedural History
1. On March 30, 2005, Rigobert Leger was injured in a motor vehicle accident.
2. Mr. Leger subsequently sought treatment with the Plaintiff for his injuries.
3. As a pre-condition to treating Mr. Leger, the Plaintiff presented Mr. Leger with a blank “Assignment of Benefits” form for him to complete, which the Plaintiff in turn accepted.
4. The Plaintiff submitted bills for the services provided to Mr. Leger to the Defendant under Mr. Fanel Leger’s policy of insurance, claim number 0500187581.
5. After receiving no payments from the Defendant, the Plaintiff submitted two (2) separate demand letters to the Defendant as required by Florida Statute 627.736(11) before filing suit.
6. The first Demand Letter was sent on or about August 4, 2005.
7. More than fifteen (15) days after submission of the Demand Letter, having received no payments from the Defendant, the Plaintiff filed suit on September 2, 2005.
8. The second Demand Letter was sent on or about December 19, 2005.
9. An Amended Complaint was filed on August 4, 2006 seeking benefits demanded in both Demand Letters.
10. Defendant filed its answer on January 25, 2007, raising as affirmative defenses the failure of the patient to appear for an independent medical examination, and that the medical services were not reasonable, related or medically necessary.
11. On or about August 6, 2007, approximately 6½ months after the answer was filed, the Defendant filed its Motions for Summary Judgment, alleging the Defendant had an invalid assignment of benefits.
Conclusions of Law
Defendant, in its Motion, raises several red herrings, which must be addressed. The Defendant claims that the assignment is invalid because: (a) it was not witnessed; (b) the AOB does not identify which medical provider is receiving the assignment; (c) there is no signature of the entity accepting the assignment; (d) the assignment does not identify the insurance policy; (e) there is no evidence that the assignment was executed before suit was filed; (f) the document was unsigned by the Plaintiff and there was no proof it was accepted by the Plaintiff before suit was filed; and (g) there was no witness signature for the patient.
Unfortunately for the Defendant, as stated in Giles vs. Sun Bank, N.A., 450 So.2d 258 (Fla. 5th DCA 1984),
No particular words or form of instrument is necessary to effect an equitable assignment, and any language, however informal, which shows an intention on one side to assign a right or chose in action and an intention on the other to receive, if there is valuable consideration, will operate as an effective equitable assignment. Asphalt Paving, Inc. v. Ulery, 149 So.2d 370 (Fla. 1st DCA, 1963). See also McClure v. Century Estates, 96 Fla. 568, 120 So. 4 (1928).
This principle has been followed in this Judicial Circuit notably by Judge Peter Skolnik and Judge Lisa Trachman (Martinez Chiropractic Center, Inc. (Brandon Kos, Patient) vs. United Automobile Insurance Company, 14 Fla. L. Weekly Supp. 187b, December 4, 2006; and Mitchell R. Pollack, M.D., P.A. (Bryan Goldstone, Patient) vs. Progressive Express Insurance Company, 12 Fla. L. Weekly Supp. 166b, November 5, 2004).
That said, the problems alleged by the Defendant are either not valid on their face, or any confusion has been cleared up via the affidavit filed by the Plaintiff in this matter.
Defendant asserted that the document does not reflect which insurance policy is being assigned. However, examining the assignment we see it identifies the named insured, the claim number, and the insurer (identified as AIG Insurance Company, which is the parent insurance company of New Hampshire Indemnity, as evidenced by the stationary the reply to the Demand Letter was sent on). It is very clear which policy is being assigned.
Defendant asserted that there is no evidence that the assignment was executed before the suit was filed (September 2, 2005). Common sense tells us this is incorrect. The assignment is dated April 1, 2005 in two (2) separate places and it was presented to the Defendant as an exhibit to the Demand Letter, months before the Complaint was filed, and then again as an exhibit to the Complaint itself. It could not possibly post-date the date of filing suit.
Further, the affidavit filed by Mr. Morilus Dat clarifies any ambiguity the document may have. Mr. Dat states unequivocally that the Plaintiff provided the form to Mr. Leger for his execution so that his facility could accept it and bill and proceed accordingly, which is exactly what the Plaintiff did.
As for signatures of witnesses, or the provider itself, there is no requirement for same, and Defense has not cited any law or case to the contrary.
Even if this Court finds the assignment to be invalid on its face, the assignment, combined with the affidavit of Mr. Dat, more than demonstrates the existence of an equitable assignment, which is what the Plaintiff alleges in its Amended Complaint.
In considering equitable assignments, the 5th District Court of Appeal held that:
“. . . courts of equity can recognize certain kinds of instruments as valid equitable assignments, where it is necessary to effectuate the plain intent of the parties or where to hold otherwise would be unjust. See Morrow v. Commonwealth Life Ins. Co., 118 Fla. 371, 159 So. 525 (1935). No particular words or form of instrument is necessary to effect an equitable assignment, and any language, however informal, which shows an intention on one side to assign a right or chose in action and an intention on the other to receive, if there is valuable consideration, will operate as an effective equitable assignment. Asphalt Paving, Inc. v. Ulery, 149 So.2d 370 (Fla. 1st DCA, 1963). See also McClure v. Century Estates, 96 Fla. 568, 120 So. 4 (1928). As stated in McClure, the true test is whether the debtor would be justified in paying the debt to the person claiming as assignee. 120 So. at 10.
Giles vs. Sun Bank, N.A., 450 So.2d 258 (Fla. 5th DCA 1984).
With the standard established for an equitable assignment, a review of the pleadings and documents reveals that at the very least Mr. Leger equitably assigned his benefits under the policy of insurance with the Defendant. The plain intent of the parties is easy to discern from their actions. Mr. Leger intended to assign his rights and benefits under the policy. That is clearly evidenced by his signature on a document entitled “Assignment of Benefits” with the statement “[t]he undersigned patient hereby assigns the benefits of insurance . . .”. Mr. Leger clearly intended to assign the rights to the Plaintiff, or else he would have given the document to someone else. The Plaintiff intended to accept the assignment (which was confirmed by the affidavit), or why else would it have presented the document to Mr. Leger to sign, why else would it have submitted it to the Defendant with the billing submission, why would it have submitted it with its Demand Letters, and why else would it have attached it to the amended complaint.
The intent of the parties is crystal clear, and there is no evidence to the contrary. As there are no magic words, and the parties are free to use “any language, however informal, which shows an intention on one side to assign a right or chose in action and an intention on the other to receive”, the attached assignment is sufficient to establish the existence of an equitable assignment.
Finally, in considering what the Supreme Court called the “true test”, that is “whether the debtor would be justified in paying the debt to the person claiming as assignee”, (McClure at 10) the answer is a resounding yes. The Plaintiff is the entity that rendered the medical services, and whose bills were wrongfully denied by the Defendant. That is the party that needs to be properly paid. To hold otherwise would result in the inability of the Plaintiff to recover as intended by the parties, which “would be unjust”. Morrow at 526.
Conclusion
Predicated on this Court’s findings of fact as set forth, and in reliance upon the legal precedent, statutes and rules cited herein, Defendant’s Motion for Summary Judgment (as to the validity of the Assignment) is denied.
