16 Fla. L. Weekly Supp. 179a
Online Reference: FLWSUPP 162RIVER
Insurance — Personal injury protection — Coverage — Medical expenses — Exhaustion of policy limits — Where PIP benefits were exhausted, and there is no allegation that insurer acted in bad faith, insurer has no liability for further benefits — Insurer was not required to escrow funds pending resolution of contested claim
TALLAHASSEE ORTHOPEDIC CLINIC, III, PL, (as assignee of RONALD RIVERS), Plaintiff, v. PROGRESSIVE SELECT INSURANCE COMPANY, A Florida Insurance Company, Defendant. County Court, 4th Judicial Circuit in and for Duval County. Case No. 16-2008-SC-3897, Division CC-J. December 3, 2008. Eleni Elia Derke, Judge. Counsel: Erin Moorman Pooley, Camerlengo & Brockwell, Jacksonville. James C. Rinaman, III, James C. Rinaman, III & Associates, P.A., Jacksonville.
ORDER GRANTING DEFENDANT’S MOTION FOR SUMMARY JUDGMENT ON EXHAUSTED BENEFITS
THIS CAUSE, having came before the Court on September 22, 2008, on Defendant’s Motion for Summary Judgment on Exhausted Benefits. Present before the Court appeared counsel for Defendant and counsel for Plaintiff.
Having considered the arguments of counsel, the record in this case, all relevant authority, and being otherwise fully advised, the Court makes the following findings of fact and conclusions of law:
1. The Defendant, Progressive, insured Ronald Rivers, under a policy of insurance that provided the insured with $10,000.00 in No-Fault/Personal Injury Protection (“PIP”) benefits which was in effect for the subject loss.
2. On or about October 2, 2007, Ronald Rivers began to receive treatment from the Plaintiff, Tallahassee Orthopedic Clinic, III. (TOC). Ronald Rivers assigned his rights and benefits under his Progressive policy of insurance to TOC in exchange for treatment.
3. TOC submitted bills to Defendant for services rendered to Ronald Rivers.
4. Progressive made timely payments to the Plaintiff, based on a reasonable fee determined by a statistically valid database that is designed to reflect charges for the same or comparable services or supplies in the same or similar geographic region.
5. All PIP benefits under the policy of insurance were exhausted by payments to the Plaintiff medical services provider, prior to suit being filed in this case.
6. The Defendant has satisfied its contractual obligations to its insured Ronald Rivers, by exhausting all available PIP benefits payable under the subject policy of insurance prior to being served with this suit. By fulfilling its contractual obligation to pay $10,000.00 in PIP benefits, the Defendant has no further obligation to pay PIP benefits pursuant to the contract of insurance with assignor, Ronald Rivers.
7. In making its ruling, the Court follows the controlling authority of the Fifth District Court of Appeals, in Progressive American Insurance Company v. Stand-Up MRI of Orlando, a/a/o Eusebio Isaac, 990 So.2d 3 (Fla. 5th DCA 2008). As in that case, this Court finds that in this case, since PIP policy benefits are exhausted, and there have been no allegations that Defendant has acted in bad faith, there is no basis to impose liability on Defendant, as it has met its contractual duties in full, and the insurer has no duty to escrow funds pending resolution of a contested claim.
IT IS THEREFORE ORDERED AND ADJUDGED that Defendant’s Motion for Summary Judgment on Exhausted Benefits is hereby Granted, with final judgment for the Defendant. The Court retains jurisdiction to rule on Defendant’s Motion for fees and costs.
