16 Fla. L. Weekly Supp. 1088b
Online Reference: FLWSUPP 1611LYNN
Insurance — Personal injury protection — Coverage — Version of PIP statute in effect at time PIP policy was executed, which provided for payment of 80% of reasonable charges, rather than version in effect at time of treatment after expiration of policy, which provides for payment of 80% of 200% of Medicare Part B fee schedule, is applicable
OMI OF ORANGE PARK, INC., a Florida Corporation (assignee of Lynn, Catherine), Plaintiff, v. GEICO GENERAL INSURANCE COMPANY, Defendant. County Court, 17th Judicial Circuit in and for Broward County. Case No. 08-11345 Coce (56). August 19, 2009. Linda R. Pratt, Judge. Counsel: Jonathon J. Warrick, P.A, for Plaintiff. Dale Parker, for Defendant.
[Editor’s note: Final Judgment published at 17 Fla. L. Weekly Supp. 222b.]
ORDER GRANTING PLAINTIFF’S MOTION
FOR SUMMARY JUDGMENTTHIS CAUSE came before the Court for hearing on Plaintiff’s Motion for Summary Judgment on the issue of whether Defendant improperly and retroactively applied the 2008 P.I.P. fee schedule to a claim made under a 2007 policy. Upon consideration of the record and arguments presented, the Court finds as follows:
Background:This is a P.I.P. case. Catherine Lynn obtained an MRI from Plaintiff on March 27, 2008. The date of the accident was August 11, 2007. The applicable policy was in effect from July 10, 2007 to January 10, 2008. Defendant reduced the allowable amount for the MRI service to 200% of the 2008 participating physician’s fee schedule under Medicare Part B pursuant to F.S. 627.736 (“2008 fee schedule”). Defendant maintains that the 2008 fee schedule applies. Plaintiff responds that the 2007 fee schedule applies because the insurance contract was entered into in 2007, prior to the effective date of the 2008 P.I.P. statute. As such, the insurer must apply the P.I.P. law in place at the time the contract was executed, asto do otherwise would affect the provider’s substantive rights to payment (namely, the contracted payment amount).
Legal Conclusions: This Court agrees with the Plaintiff, for the reasons set forth in Explorer Insurance Company v. Physicians Group, LLC, case no. CA-010710 (13th Judicial Circuit Court, January, 21, 2009) [16 Fla. L. Weekly Supp. 317a] and Physicians Group, LLC v. GEICO Indemnity Company, 15 Fla. L. Weekly Supp. 1207c (Orange County, October 22, 2008).
