16 Fla. L. Weekly Supp. 777a
Online Reference: FLWSUPP 168MAJOR
Insurance — Personal injury protection — Coverage — Medical expenses — Determination of applicable PIP statute is based on date of treatment and accident, not when policy was issued
FLORIDA SUPERIOR IMAGING, INC., a/a/o JEAN MAJOR, Plaintiff, vs. DIRECT GENERAL INSURANCE COMPANY, Defendant. County Court, 11th Judicial Circuit in and for Miami-Dade County. Case No. 08-14790 SP 25. April 9, 2009. Lawrence D. King, Judge. Counsel: Neil M. Gonzalez, for Plaintiff. Cary C. Woods, for Defendant.
ORDER GRANTING DEFENDANT’S MOTION FOR SUMMARY JUDGMENT AND DENYING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT
THIS CAUSE having come on for hearing on the Defendant’s Motion for Summary Judgment, and the Court having heard argument of counsel on, and otherwise being fully advised in the premises, it is, hereby,
ORDERED AND ADJUDGED:
1. Defendant’s Motion for Summary Judgment is hereby GRANTED regarding application of Florida Statute §627.736(5)(a)(2)(f) (2008).
2. Plaintiff’s Motion for Summary Judgment as to application of Florida Statute §627.736 (2007) is DENIED.
3. After review of Defendant and Plaintiff’s uncontested facts, the Court determined that the policy at issue had effective dates of July 16, 2007 through July 16, 2008. The subject accident occurred on January 8, 2008 and as a result of the subject accident, the claimant sought treatment from the Plaintiff on January 21, 2008 for PIP No-Fault benefits. Based on the foregoing facts, the Court has ruled that Lumbermen’s Mutual Casualty Co. v. Ceballos, 440 So.2d 612 (Fla. 3d DCA 1983) is not binding upon the facts of the subject case. The Court has based this opinion upon Progressive v. Menendez, 979 So.2d 324 (Fla. 3d DCA 2008). Counsel for Defendant has cited Physicians Group LLC a/a/o Paul Androski v. Geico, 15 Fla. L. Weekly Supp. 1207c (Fla. 12th Cir. Ct. Oct. 22, 2008) in support of its contention that the subject policy was binding and incorporated the amendments to the 2008 PIP statute. In the finding the language “as amended” to be unambiguous, the Court highlights the importance of the accident and treatment occurring after the effective date of the statutory amendment and during the policy period.
4. The Court has also ruled that it should be anticipated by the provider that based on the dates of treatment, policy issued to the claimant/insured, and aforementioned case law, payment was correctly made pursuant to Fla. Stat. §627.736(5)(a)(2)(f) (2008).
