15 Fla. L. Weekly Supp. 922c
Insurance — Personal injury protection — Assignee/medical provider may state causes of action for breach of contract for failure to provide explanation of benefits and for breach of contract and/or declaratory relief to determine and enforce right to copy of policy and declarations information
DADE INJURY REHABILITATION CENTER, a Florida Corporation (assignee of Jean-Pierre, Marie 2), Plaintiff, v. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 11th Judicial Circuit in and for Miami-Dade County. Case No. 07-16373 CC 23 (01). June 20, 2008. Myriam Lehr, Judge. Counsel: Aura Brooks, Law Office of Russel Lazega, P.A., North Miami, for Plaintiff. Jennifer Hogue, Pinkert Law Firm, Miami, for Defendant.
ORDER DENYING DEFENDANT’S MOTION TO DISMISS COUNTS I, II & III.
THIS CAUSE, came before the court and the court, having reviewed the Motion, the court file, legal authorities and having heard argument of counsel, finds as follows:
Factual Background: This is a multi-count P.I.P. case. Count I claims breach of contract for failure to provide an Explanation of Benefits (commonly known as an “EOB”) pursuant to F.S. 627.736(4)(b); Counts II and III seek declaratory relief and breach of contract for failure to provide a copy of the policy of insurance and the policy declarations page pursuant to F.S. 627.736 and/or 627.4137.
Conclusions of Law:
Claims for Explanations of Benefits
This court follows its prior rulings and finds that a Plaintiff may state a cause of action for breach of contract for failure to provide an Explanation of Benefits. As such Defendant’s motion is denied as to Count I.
Claims for Policy and Declarations Page
The court denies the Defendant’s Motion to Dismiss as to Counts II and III, and follows its prior rulings finding that an assignee medical provider may maintain a cause of action for breach of contract and/or declaratory relief to determine and enforce its right to a copy of the insurance policy and policy declarations information pursuant to F.S. s. 627.4137.
Accordingly, it is hereby:
ORDERED AND ADJUDGED that Defendant’s Motion to Dismiss is DENIED as to Counts I, II, and III. Defendant shall respond to the remaining counts of the complaint within 20 days of the date of this order.
