17 Fla. L. Weekly Supp. 1115c

Online Reference: FLWSUPP 1711SILV

Insurance — Personal injury protection — Coverage — Medical expenses — Exhaustion of policy limits — Where PIP benefits were exhausted by payment of medical bills, including untimely bill of medical equipment provider, and there is no allegation that insurer acted in bad faith, insurer is not liable for payment of additional charges

SILVERMAN CHIROPRACTIC & REHABILITATION CENTER, A/A/O WILBER ORELLANA, Plaintiff, vs. MERCURY INSURANCE COMPANY OF FLORIDA, Defendant. County Court, 11th Judicial Circuit in and for Miami-Dade County, Civil Division. Case No. 09-10896 SP 05. July 13, 2010. Shelley J. Kravitz, Judge.

ORDER GRANTING DEFENDANT’S MOTION FOR FINAL SUMMARY JUDGMENT AND DENYING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT

THIS CAUSE came before this Court for hearing on April 29, 2010 on Defendant’s Motion for Final Summary Judgment and Plaintiff’s Motion for Summary Judgment regarding the issue of exhaustion of benefits. The Court, having reviewed the motions; having heard argument; and having been sufficiently advised in the premises, finds as follows:

Facts

1. This is a Personal Injury Protection (PIP) case arising out of an accident that occurred on July 25, 2008.

2. Plaintiff, SILVERMAN CHIROPRACTIC & REHABILITATION CENTER, INC., submitted medical bills to Defendant, MERCURY INSURANCE COMPANY OF FLORIDA, based on a policy of insurance that the insured, Wilber Orellana, had with the Defendant.

3. Pursuant to the policy of insurance, Defendant paid a total of $8,128.81 to Plaintiff.

4. Defendant also paid $1,508.69 to an MRI facility.

5. Defendant lastly paid $362.50, the remainder of the PIP benefits, to a medical equipment provider that supplied the insured with a custom-fitted brace, which was prescribed by the Plaintiff. Said bill was paid by Defendant despite it being untimely.

6. There was no allegation nor any proof of bad faith by the insurer.

Legal Analysis

An insured cannot gain more from the insurance company than the contractual benefit amount in the absence of showing bad faith on the part of the insurer. See Progressive v. Stand-Up MRI (a/a/o Eusebio Isaac), 990 So. 2d 3 (Fla. 5th DCA 2008); and GEICO v. Robinson, 581 So. 2d 230 (Fla. 3rd DCA 1991); See also Allstate v. Shilling, 374 So. 2d 611 (Fla. 4th DCA 1979); Atkins v. Bellefonte Insurance Co., 342 So.2d 837 (Fla. 3d DCA 1977); Dixie Insurance Co. v. Lewis, 484 So. 2d 89 (Fla. 2nd DCA 1986).

In this case, since PIP policy benefits were exhausted, and there were 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. Progressive American Insurance Company v. Stand-Up MRI of Orlando a/a/o Eusebio Isaac, 990 So. 2d 3 (Fla. 5th DCA 2008).

Thus, it is this Court’s ruling that absent bad faith, an insurer is not liable for benefits once benefits are exhausted. See Progressive American Insurance Company v. Stand-Up MRI of Orlando a/a/o Eusebio Isaac, 990 So. 2d 3 (Fla. 5th DCA 2008).

WHEREFORE, it is ordered and adjudged:

That Mercury’s Motion for Final Summary Judgment is hereby GRANTED, and that Plaintiff’s Motion for Summary Judgment is DENIED.