15 Fla. L. Weekly Supp. 1016a
Insurance — Personal injury protection — Coverage — Medical expenses — Where insurer failed to request additional documentation within 30 days of receipt of bill for functional capacity test and supplies, request was untimely — Partial summary judgment is entered in favor of medical provider as to test and supplies
FIDEL S. GOLDSON, D.C., P.A., a Florida Corporation (assignee of Turner, Carlton), Plaintiff, v. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant. County Court, 17th Judicial Circuit in and for Broward County. Case No. 08-06085 COCE (50). July 16, 2008. Peter B. Skolnik, Judge. Counsel: Jonathan J. Warrick, Law Office of Russel Lazega, P.A., North Miami, for Plaintiff. Christopher L. Kirwan, for Defendant.
ORDER GRANTING PLAINTIFF’S MOTION FOR PARTIAL SUMMARY JUDGMENT
(re: Functional Capacity Test and Supplies)
THIS CAUSE came before the Court on hearing on Plaintiff’s Motion for Partial Summary Judgment (re: Functional Capacity Test and Supplies), and the Court’s having reviewed the Motion and entire Court file; reviewed the relevant legal authorities; heard argument, and been sufficiently advised in the premises the Court finds as follows:
Background:This is a multi-count P.I.P. case. Plaintiff submitted bills for payment of functional capacity testing and supplies. Defendant denied payment asserting that supporting documentation is required prior to making a reimbursement decision. Plaintiff submitted proper record evidence that it furnished a report, test data and invoices with its bills to Defendant, and further that Defendant’s request for additional documentation was untimely. Defendant has presented no proper record evidence showing that Plaintiff failed to submit the required documentation or that its request was timely made.
Conclusions of Law:The Plaintiff is correct that an insurer’s request for additional information must be made within 30 days of receipt of the bill or the request is untimely. See F.S. s. 627.736(4)(b); see also Martinez v. Fortune Ins. Co., 684 So. 2d 201 (Fla. Dist. Ct. App. 4th Dist. 1996); United Auto. Ins. Co. v. Rodriguez, 808 So. 2d 82, 85 (Fla. 2001). Uncontroverted evidences establishes that Defendant failed to request the additional information within 30 days of receipt of the bill.
Accordingly, it is hereby:
ORDERED AND ADJUDGED the Plaintiff’s Motion for Partial Summary Judgment is GRANTED as to the bills for the functional capacity test and supplies. Summary judgment is entered in favor of Plaintiff as to liability and at a minimum nominal damages relative to the functional capacity testing and supplies. Plaintiff is the prevailing party as to these issues and pursuant to Florida Statute 627.428, Plaintiff has obtained a “judgment or decree” entitling Plaintiff to recover from Defendant the payment of bills submitted for functional capacity testing and supplies attorney’s fees and costs in an amount to be determined at a later hearing. The court reserves jurisdiction to determine the amount of fees and costs.
