16 Fla. L. Weekly Supp. 109a
Insurance — Personal injury protection — Demand letter — Sufficiency — Demand letter that contained claim for services provided by four different medical providers yet included assignment of benefits to only one provider was sufficient where letter sufficiently advised insurer that it could have paid claim by issuing payment to assignee provider for its bills and payment to insured for three remaining providers’ bills — Demand letter is insufficient as to provider whose claim includes sums not yet overdue
BROWARD REHAB. CENTER, INC. (a/a/o Jenella Oliphant) and JANELLA OLIPHANT, Plaintiff, vs. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 17th Judicial Circuit in and for Broward County. Case No. 07-16819 COCE 53. November 10, 2008. Robert W. Lee, Judge. Counsel: Brian Malamud, Fort Lauderdale, for Plaintiff. Frantz Nelson, Matt Hellman, P.A., Plantation, for Defendant.
ORDER GRANTING IN PART DEFENDANT’S MOTION FOR SUMMARY JUDGMENT
THIS CAUSE came before the Court on October 30, 2008 for hearing of the Defendant’s Motion for Summary Judgment, and the Court’s having reviewed the Motion and entire Court file; heard argument; reviewed the relevant legal authorities; and been sufficiently advised in the premises, the Court finds as follows:
Background. In this PIP case, the Defendant claims that the Plaintiff failed to comply with a statutory condition precedent, submission of a compliant presuit demand letter. The Defendant admits that it received what purports to be a presuit demand letter, but claims that it is facially insufficient. The letter identified the names of four separate medical providers, with a total unpaid balance of $16,802.00. The letter further included an assignment of benefits for only one of the providers, but billing ledgers for all four providers. The Defendant claims that the letter does not advise it who to pay. Finally, the letter included sums attributed to North Broward Radiologists which were not yet overdue at the time the demand letter was sent.
Conclusions of Law. Prior to filing a PIP lawsuit, the unpaid party must provide a presuit demand letter under Florida Statute §627.736(11). The letter cannot be provided until the “claim is overdue.” Id. §627.736(11)(a). The letter must include the following:
(1) “the name of the insured [. . .], including a copy of the assignment giving rights to the claimant”; and
(2) “an itemized statement specifying each exact amount [. . .] claimed to be due.” Id. §627.736(11)(b).
The demand letter in this case was sent by legal counsel. A review of the demand letter reveals that the patient has assigned her benefits to only one provider, Broward Rehab Center, Inc. The Defendant could have paid the claim by issuing payment to the patient for the three remaining providers and a separate payment to the provider who obtained an assignment of benefits. In the Court’s view, the demand letter with attachments, taken as a whole, sufficiently advised the insurance company who should be paid.
The only question in the Court’s view is whether the inclusion of a “not-yet-due” amount for one provider vitiates the demand letter as to the remaining providers. The claims for Broward Rehab Center, Broward General Medical Center, and Phoenix Emergency Physicians of Broward include billing statements “specifying the exact amount claimed due,” as required by the statute. The claim of North Broward Radiologists, however, includes sums that were not yet overdue. Therefore, as to this claim, the demand letter is insufficient. See Dr. David S. Muransky, P.A. v. State Farm Mutual Ins. Co., 15 Fla. L. Weekly Supp. 99 (Broward Cty. Ct. 2007). Accordingly, it is hereby
ORDERED AND ADJUDGED that the Defendant’s Motion for Summary Judgment is GRANTED as to the claim of North Broward Radiologists, and DENIED as to the remaining claims.
