16 Fla. L. Weekly Supp. 959b
Online Reference: FLWSUPP 1610YOLA
Insurance — Personal injury protection — Standing — Assignment — Insurer’s motion for summary judgment based on lack of standing is denied where factual issue exists as to whether document that indicates in three places that it is assignment of benefits was intended as assignment — Further, insurer lacks standing to challenge assignment — Equitable assignment may be formed where medical provider finished treatment and filed suit based on assignment, and insured signed assignment and never challenged its validity
ADVANCE HEALTH CENTER, INC., A Florida Corporation (assignee of Joseph, Yolande) v. UNITED AUTOMOBILE INSURANCE COMPANY. County Court, 11th Judicial Circuit in and for Miami-Dade County. Case No. 08-19045 CC 23 (01). August 11, 2009. Myriam Lehr, Judge. Counsel: Russel Lazega, Law Offices of Russel Lazega, P.A., North Miami, for Plaintiff. Karen Trefzger, for Defendant.
ORDER DENYING DEFENDANT’S MOTION FOR SUMMARY JUDGMENT (STANDING TO SUE)
THIS CAUSE, came before the court for hearing on July 17, 2009 on Defendant’s Motion for Summary Judgment as to Defendant’s affirmative defense asserting that the Plaintiff lacks standing to sue. The operative facts are as follows:
Factual Background: This is a P.I.P. insurance case. Defendant seeks final summary judgment asserting that the Plaintiff, Advanced Health Center, lacks standing to sue based upon an assignment of benefits which Defendant contends is really just a direction to pay without assignment of benefits. Defendant seeks to have this court determine that even construing all reasonable inferences in the light most favorable to the non-moving party, that the document relied upon by Plaintiff as its assignment of benefits could not have been intended to be an assignment of benefits. The document reads in total as follows:
ADVANCE HEALTH CENTER
11900 WEST DIXIE HIGHWAY
N. MIAMI FL 33161
ASSIGNMENT OF BENEFITS
THE UNDERSIGNED PATIENT HEREBY ASSIGNS THE BENEFITS OF INSURANCE WITH: UNITED AUTO INSURANCE INSURANCE [SIC] COMPANY TO ADVANCE HEALTH CENTER, FOR SERVICES RENDERED TO THE UNDERSIGNED PATIENT AND COVERED BY PERSONAL INJURY PROTECTION (PIP) UNDER YOLANDE B. JOSEPH POLICY WITH UNITED AUTO INS.
AND IN ACCORDANCE WITH FLORIDA STATUTE S. 627.786(5)
THE UNDERSIGNED FURTHER AGREES TO PAY ANY APPLICABLE DEDUCTIBLE OR CO-PAYMENT NOT COVERED BY PIP INSURANCE COVERAGE.
THE UNDERSIGNED HEREBY ACCEPTS ASSIGNMENT OF INSURANCE BENEFITS FOR SERVICES RENDERED TO YOLANDE B. JOSEPH AND TO BE PAID DIRECTLY TO ME UNDER YOLANDE B. JOSEPH PERSONAL INJURY PROTECTION (PIP) COVERAGE WITH UNITED AUTO INSURANCE COMPANY AND IN ACCORDANCE WITH FLORIDA STATUTE S. 627.786(5)
[SIGNED BY PATIENT] 9-4-07
[SIGNED BY PROVIDER] 9-4-07
Legal Conclusions: Intent is the operative factor in determining whether a valid assignment of benefits exists. Wellness Associates of Florida v. Progressive Express Insurance Company, 10 Fla. L. Weekly Supp. 941b (County Court 17th Jud. Cir. 2003) (“No particular words or form of instrument is necessary to effect an assignment and any language, however informal, which shows the intention on one side to assign a right or chose in an action, and an intention on other side to receive it, if there has been valuable consideration, will operate as an effective equitable assignment. ”); Allstate Ins. Co. v. BMW Enters., Inc., 9 Fla. L. Weekly Supp. 95 (17th Jud. Cir. Appellate 2001); Digital Medical Diagnostics v. Allstate Ins. Co., 15 Fla. L. Weekly Supp. 1147b (11th Jud. Cir. Appellate 2008).
Upon review of the assignment in question, the court determines that, at a minimum, a fact question exists as to whether the above document (which indicates in three separate places that it is an assignment of benefits) could, in fact, have been intended to be an assignment of benefits.
The court recognizes its prior ruling finding this same assignment of benefits to not be a valid assignment of benefits. See Advance Health Center (a/a/o Jacqueline Aroche) v. United Auto Ins. Co., 16 Fla. L. Weekly Supp. 339 (Dade Cty. Ct. 2009). However, in the Jacqueline Aroche case no record evidence of intent was filed by the Plaintiff (whereas, in the instant case the Plaintiff has filed the affidavit of Dr. Jorge Iribar (indicating that the parties intended an assignment and that the Defendant accepted Plaintiff’s assignment without raising any pre-suit objection) and Plaintiff has moved to amend the complaint to add a count for reformation of the assignment of benefits). Additionally, this court did not have the benefit of the binding circuit court appellate authority in Digital Medical, which plainly holds that the insurer does not have standing to challenge the assignment of benefits and that an equitable assignment may be formed where the medical provider finished medical treatment and filed lawsuit based upon the assignment of benefits and the patient signed the agreement and never challenged its validity even after suit was filed.
ACCORDINGLY it is hereby ORDERED & ADJUDGED based on the foregoing analysis of fact and law that Defendant’s Motion for Summary Judgment based upon Defendant’s affirmative defense of lack of standing is DENIED.
