15 Fla. L. Weekly Supp. 825b
Insurance — Personal injury protection — Explanation of benefits — Assignee medical provider may state claim for breach of contract for failure to furnish EOB — Declaratory judgment — Assignee medical provider may maintain action for copy of policy and declarations page
PERSONAL CHIROPRACTIC CARE CENTER, Florida Corporation (assignee of Joachim, Jesula), Plaintiff, v. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 11th Judicial Circuit in and for Dade County. Case No. 07-16378 CC 23 (01). May 30, 2008. Myriam Lehr, Judge. Counsel: Jonathan J. Warrick, Law Office of Russel Lazega, P.A., North Miami, for Plaintiff. Illon Kantro, for Defendant.
ORDER DENYING DEFENDANT’S MOTION TO DISMISS COUNTS I, II AND III
THIS CAUSE, came before the court for hearing on May 30, 2008, and the Court, having reviewed the motion, the court file, legal authorities, 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. Defendant alleges in its Motion to Dismiss that Plaintiff cannot maintain inconsistent causes of action to support its position (i.e., both declaratory relief and breach of contract counts) and further that any breach is immaterial.
Conclusions of Law:The Court finds that a claimant may state a claim for breach of contract for failure to furnish an explanation of benefits pursuant to Florida Statute s. 627.736(4)(b) and that Plaintiff’s claim for damages is adequately stated. United Auto. Ins. Co. v. R.J. Trapana, M.D., P.A. (Decision of the Honorable Richard Eade) Circuit Court, Broward County (Appellate) 12 Fla. L. Weekly Supp. 452a (2005) Review Denied by 4th District Court of Appeal; United Auto. Ins. Co. v. Stat Technologies, Inc., 12 Fla. L. Weekly Supp. 840d (Decision of Judge John Luzzo (Appellate), Circuit Court, Broward County 2005).
This court agrees with the reasoning of the majority of county and circuit courts that have considered the issue and finds that an assignee medical provider may maintain an action for a copy of the insurance policy and policy declarations page. See, e.g., Integra Diagnostics v. Reliance Nat’l Ind., 8 Fla. L. Weekly Supp. 349c (County Court, Broward 2001); Florida Orthopedic Center, P.A. v. United Auto. Ins. Co., 13 Fla. L. Weekly Supp. 1234 (County Court, Broward 2006); Scott M. Jablon, D.C. v. United Auto. Ins. Co., 13 Fla L. Weekly Supp. 643c (County Court, Broward 2006); American Vehicle Ins. Co. v. Florida Emergency Physicians Kang & Assoc., P.A., 13 Fla. L. Weekly Supp. 973 (18th Circuit Appellate 2006); ROM Diagnostics v. Security Nat’l Ins. Co., 9 Fla. L. Weekly Supp. 323b (County Court, Orange 2002); Rural Metro Ambulance v. Liberty Mut. Ins. Co., 11 Fla. L. Weekly Supp. 583a (County Court, Broward 2003); Palm Beach Regional MRI v. Southern Group Ind. Co., 11 Fla. L. Weekly Supp. 742a (County Court, Palm Beach 2004); Florida Emergency Physicians Kang & Assoc. v. United Auto. Ins. Co., 12 Fla. L. Weekly Supp. 805b (County Court, Seminole 2005); Florida Emergency Physicians Kang & Assoc. v. American Vehicle Ins. Co., 12 Fla. L. Weekly Supp. 774c (County Court, Orange 2005); Florida Emergency Physicians Kang & Assoc. v. American Vehicle Ins. Co., 12 Fla. L. Weekly Supp. 478b (County Court, Orange 2005).
Accordingly, it is hereby:
ORDERED AND ADJUDGED that Defendant’s Motion to Dismiss is DENIED.
