17 Fla. L. Weekly Supp. 1030a
Online Reference: FLWSUPP 1710RAM2
Insurance — Personal injury protection — Summary judgment is granted as to reasonableness, relatedness and necessity of medical services provided prior to independent medical examination where physician who conducted IME concluded that no further care would be medically necessary as of date of IME — Summary judgment is denied as to necessity of post-IME care
ALL CARE HEALTH AND WELLNESS CENTERS, P.A., a Florida Corporation (assignee of Ramirez, Monique), Plaintiff, v. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 11th Judicial Circuit in and for Miami-Dade County. Case No. 09-19651CC23, Division 05. July 6, 2010. Lisa Walsh, Judge. Counsel: Russel Lazega, Law Office of Russel Lazega, P.A., North Miami. Alina O’Connor.
ORDER GRANTING IN PART PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT
This cause came before this Court on Plaintiff’s Motion for Summary Judgment. Based upon a review of the Plaintiff’s motion, the affidavit of Dr. Brad Kern, treating physician and the attached billing records, health forms, and medical records, the affidavit of Dr. Michael Mansdorf, independent medical examiner, and the attached report of independent medical examination, the complaint, answer and affirmative defenses, and a hearing on the motion, this Court grants in part the Plaintiff’s motion on the following grounds:
1. This is an action for breach of contract for failure to pay benefits under Florida’s motor vehicle bodily injury insurance or “PIP” statutes.
2. In support of its motion for summary judgment, the Plaintiff filed an affidavit of the treating physician, Dr. Kern, and supporting medical records, billing records and health forms relied upon by Dr. Kern.
3. The Defendant filed an affidavit and report of an independent medical examination of Dr. Michael Mansdorf. Dr. Mansdorf opines that as of the date of the examination, December 23, 2008, no further medical care would be reasonable, related or medically necessary.1
4. Accordingly, this Court grants summary judgment, in part, on the following grounds, as the Plaintiff has presented undisputed evidence of the following:
(A) patient Monique Ramirez was involved in an accident of 11/12/2008.
(B) Ms. Ramirez assigned the benefits of her PIP policy with the Defendant to the Plaintiff, ALL CARE HEALTH AND WELLNESS (“ALL CARE”).
(C) The Plaintiff rendered medical care to Ms. Ramirez.
(D) the pricing for the medical services was reasonable.
(E) the medical treatment rendered to Ms. Ramirez was for injuries sustained which were related to the automobile accident.
(F) Any treatment that occurred prior to the date of an independent medical examination was medically necessary.
5. Summary judgment is denied on the issue of medical necessity of further care after 12/23/08.
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1While Dr. Mansdorf states in conclusion that no further care would be “reasonable, necessary or related to the motor vehicle accident in question,” it is clear from his report that his opinion is restricted to the medical necessity of further care. He gives no opinion in his affidavit or attached report that challenges the reasonableness of the pricing of medical services or that the injuries sustained were the result of anything other than the accident at issue.
