15 Fla. L. Weekly Supp. 1210a
Insurance — Personal injury protection — Claim form — Professional license number — Where box 31 of CMS-1500 claim form lacks professional license number of medical provider, form does not place insurer on notice of covered loss
BAYVIEW MEDICAL & REHAB CENTER, INC., a/a/o VICTOR VACHEZ, Plaintiff, v. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 13th Judicial Circuit in and for Hillsborough County, County Civil. Case No. 07-CC-024674, Division “J”. September 26, 2008. Gaston J. Fernandez, Judge. Counsel: Timothy A. Patrick, for Plaintiff. Michael P. Liebgold, Luks, Santaniello, Perez, Petrillo & Gold, Tampa, for Defendant.
ORDER
THIS CAUSE came before the Court for hearing on September 4, 2008 upon Defendant’s Motion for Summary Judgment, and the Court having been otherwise duly advised in the premises, it is hereupon, ORDERED AND ADJUDGED:
1. The Plaintiff/healthcare provider provided the Defendant PIP insurer with its billing for its services provided to Victor Vachez on CMS-1500 billing forms.
2. However, it is undisputed that those CMS-1500 billing forms failed to include the medical provider’s professional license number in the field for such information, box 31.
3. This Court is bound by The Aries Insurance Company v. First Chiropractic Clinic, Inc. a/a/o Yvette Orneus, 12 Fla. L. Weekly Supp. 637a (Fla. 13th Circ. Appell. 2005), which held that a PIP insurer has not been placed on legal notice of a covered loss under the PIP statute if box 31 of its CMS-1500 billing forms lacks the medical provider’s professional license number.
4. Therefore, as the Defendant PIP insurer has not been placed on legal notice of a covered loss under the PIP statute, the Defendant’s Motion for Summary Judgment is GRANTED as to Count II of the Complaint for failure to pay PIP benefits.
LEGAL STANDARD FOR AN ENTRY OF SUMMARY JUDGMENT
5. Pursuant to Rule 1.510 of the Florida Rules of Civil Procedure, Summary Judgment is proper when there is no genuine issue of material fact and defendant is entitled to judgment as a matter of law. Summary judgment is an appropriate and necessary means of terminating litigation short of a jury trial and it satisfies the constitutional right of access to the courts as a means of resolving civil disputes. Cassel v. Price, 396 So. 2d 258, 262 (Fla. 1st DCA 1981), review denied, 407 So. 2d 1102 (Fla. 1981). “So long as our system of laws recognizes a dividing line between conduct which may properly require a party to be subjected to the burden of trial and the risk on an adverse jury verdict for damages, and conduct which will not, the trial and appellate courts often have a duty, difficult as the task may be, of drawing that line.” Id. at 261.
6. Summary judgment is properly granted where the moving party conclusively demonstrates that no genuine issues of material fact exist between the parties and that the moving party is entitled to a judgment as a matter of law. Holl v. Talcott, 191 So. 2d 40, 43 (Fla. 1966).
7. Here, as detailed above, there is no dispute as to whether the Plaintiff’s own CMS-1500 billing forms contained the required professional license number, and the Defendant is entitled to summary judgment as to Count II of the complaint for PIP benefits as a matter of law.
WHEREFORE, as there is no dispute as to any material fact, the Defendant’s Motion for Summary Judgment is hereby GRANTED as to Count II of the complaint for PIP benefits. This Court reserves jurisdiction to determine the Defendant’s entitlement to its attorneys’ fees and costs and the amount thereof.
