16 Fla. L. Weekly Supp. 1028c
Online Reference: FLWSUPP 1611ROWE
Insurance — Personal injury protection — Coverage — Denial — Failure to maintain patient logs is not valid legal basis for insurer to deny payment of medical bills
UNITED AUTOMOBILE INSURANCE COMPANY, Appellant, vs. DR. CLIFTON OKMAN, D.C., P.A., a/a/o Patrick Rowe, Appellee. Circuit Court, 17th Judicial Circuit (Appellate) in and for Broward County. Case No. 08-23336 CACE 08, 08-46248 (consolidated). L.C. Case No. 06-13042 (50). August 28, 2009. Counsel: Steven N. Ainbinder, Boca Raton. Thomas L. Hunker, Miami.
ORDER AND OPINION
[Editor’s note: Lower court order published at 15 Fla. L. Weekly Supp. 749a]
(RONALD J. ROTHSCHILD, J.) THIS CAUSE comes before the Court upon Appellant, United Automobile Insurance Company’s appeal of the Order Denying Summary Judgment entered on April 2, 2008. Having reviewed the appellate file, applicable law, and being otherwise fully advised in the premises, the Court hereby decides as follows:
Appellee, as assignee of Patrick Rowe, filed suit against Appellant, United Automobile Insurance Company (hereinafter “UAI”) alleging non-payment of personal injury protection insurance benefits, arising from a motor vehicle accident which occurred on November 10, 2003. UAI filed a Motion for Summary Judgment on the grounds that Appellee’s failure to maintain patient logs as required by Section 627.736(5)(e)(9), Florida Statutes was a valid, legal basis for UAI to deny payment of medical bills submitted by the Appellee. The trial court denied the Motion and the case proceeded to trial. At trial, the jury ruled in favor of the Appellee. UAI timely filed the instant appeal.
The applicable standard of review for orders granting summary judgment is de novo. 5th Avenue Real Estate Dev., Inc. v. Aeacus Real Estate Ltd., 876 So.2d 1220 (Fla. 4th DCA 2004). Summary judgment is appropriate only where there are no genuine issues of material fact and the movant is entitled to judgment as a matter of law. Volusia County v. Aberdeen at Ormond Beach, L.P., 760 So.2d 126 (Fla. 2000).
In the instant appeal, UAI argues that Florida Statute § 627.736(5)(e)(9) requires patient logs be submitted to the insurer and that compliance with the statute is mandatory in order to provide the insurer with notice of the amount of a covered loss. UAI contends that it can use a provider’s failure to maintain patient logs as a basis for not paying the insured’s medical bills. However, UAI has failed to point to anything in the PIP statute which requires a service provider to submit a patient log to the insurer, and has failed to provide the Court with any binding case authority to support their arguments. Further, unlike the failure to submit a Disclosure and Acknowledgment form, there is no penalty provision in § 627.736 for the failure to maintain patient logs.
Florida Courts have continuously construed the PIP Statute liberally in favor of the insured. See. Flores v. Allstate Ins. Co., 819 So.2d 740 (Fla. 2002); Derius v. Allstate Indem. Co., 723 So.2d 271 (Fla. 4th DCA 1998). Further, “swift and expeditious payment is at the heart of the no-fault concept and implementing statutes. . .” United Auto Ins. Co. v. Rodriquez, 808 So.2d 82 (Fla. 2001). This Court sees no reason to make a claimant suffer because the service provider mistakenly did not keep patient logs.
Accordingly, it is hereby,
ORDERED AND ADJUDGED that the trial court’s order granting summary judgment in favor of Appellee, Dr. Clifton Okman, D.C., P.A., is AFFIRMED.
It is further ORDERED AND ADJUDGED that the granting of attorney’s fees and costs by the trial court in favor of the Appellee is AFFIRMED.
