17 Fla. L. Weekly Supp. 990b
Online Reference: FLWSUPP 1710BELL
Insurance — Personal injury protection — Coverage — Medical expenses — Notice of loss — Errors and omissions — Name and address of facility where services were rendered, if different from that of entity submitting form — Even if failure to complete box 32 on HCFA form can be deemed a material omission, it was cured by amended and properly completed form subsequently submitted by provider, which was received by insurer well before initiation of litigation
UNIVERSAL X-RAYS CORP., a/a/o JOSELYN BELLIARD, Appellant, v. STATE FARM FIRE & CASUALTY COMPANY, Appellee. Circuit Court, 11th Judicial Circuit (Appellate) in and for Miami-Dade County. Case No. 09-033 AP. L.T. Case No. 2007-33974 SP23. June 2, 2010. On appeal from Final Summary Judgment by the County Court of the Eleventh Judicial Circuit of Miami-Dade County, Florida, Lisa Walsh, Judge. Counsel: Marlene S. Reiss, Marlene S. Reiss, P.A., for Appellant. Douglas H. Stein, Seipp & Flick, LLP, for Appellee.
(Before Arthur L. Rothenberg, Kevin M. Emas, and Ivan F. Fernandez, JJ.)
(Per Curiam.) Appellant Universal X-Rays Corporation (“Universal”) appeals the trial court’s decision granting Appellee State Farm Fire & Casualty Corporation’s (“State Farm”) motion for summary judgment upon a determination that Universal failed to provide State Farm with a properly completed and timely notice of a covered loss.
In September 2006, Joselyn Belliard, an insured of State Farm, was injured in a car accident. She sought and received treatment from Universal, which provided mobile x-ray services, and to which she assigned her insurance benefits. Subsequently, Universal provided a notice of initiation of treatment and then timely submitted its original HCFA form, which State Farm received on October 6, 2006. Universal then had 75 days, or until December 10, 2006, to timely submit a properly completed bill. Box 32 of the HCFA form initially submitted by Universal was left blank. Box 32 requests information as to the name and address of the facility where the services were rendered, if the name and address of the facility is different from the entity submitting the form.1 On December 8, 2006 (the 73rd day after submission of the original), State Farm sent a letter alerting Universal to this omission. Universal submitted an amended form, with box 32 filled in. Box 32 then indicated that the services were provided at DOCPTA Medical Clinic, located at 5870 SW 8th Street, Miami, FL. 33144, a short distance from Universal’s office, at 8372 SW 8th Street, Miami, FL. 33144. The amended form was submitted 78 days after the notice of initiation of treatment.
On January 7, 2007, State Farm sent Universal a letter denying Universal’s bill on the basis that the amended bill was not submitted within the 75 days that Universal had to timely submit its bill. The amended form was submitted on the 78th day after Universal’s notice of initiation of treatment.
State Farm moved for summary judgment in October 2008. At the hearing, State Farm argued that Universal’s late bill did not provide the insurer with “notice of the covered loss” under Section 627.736(4)(b), Florida Statutes (2006).2 Relying on United Auto Ins. Co. v. Eduardo J. Garrido, D.C., P.A., 990 So. 2d 574 (Fla. 3d DCA 2008), the trial court granted State Farm’s motion. Universal appeals that decision.
On December 2, 2009, the Third District Court of Appeal rendered its opinion in United Automobile Insurance Company v. Professional Medical Group, Inc., 26 So.3d 21 (Fla. 3d DCA 2009), discussing an issue regarding the physician’s license number, which had been omitted from the form that was initially submitted to the insurer. The Third District reasoned:
[E]ven if the physician’s license number were deemed a material provision of the statements or bills, nothing in the statute’s plain language indicates that the absence of the license number cannot be cured by later submission of the number to the insurer on a claim form as described in section 627.736(5)(d). It is undisputed that PMG provided United the license number on another claim form that was mailed to United with a demand letter prior to litigation. Accordingly, any error or omission, if it existed, was sufficiently cured by PMG prior to the initiation of litigation.”
Id. at 25.
Accordingly, we hold that, even if the failure to complete box 32 can be deemed a material omission, it was cured by the amended and properly completed form subsequently submitted by Universal to State Farm, which was received well before the initiation of litigation.3
We therefore reverse the trial court’s entry of Final Summary Judgment and remand to the trial court for further proceedings. (Arthur L. Rothenberg, Kevin M. Emas, and Ivan F. Fernandez, JJ., CONCUR.)
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1Box 32 asks for “Name and address of facility where services were rendered (if other than home or office).”
2Sec. 627.736(4)(b), Fla. Stat. (2006) provides in pertinent part:
“(b) Personal injury protection insurance benefits paid pursuant to this section shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same.”
3In fact, the record reveals that State Farm became aware of the name and location of the facility no later than November 29, 2006, when the insured submitted to an Examination Under Oath and provided the name and address of the facility where the services were rendered. As a result of the EUO, State Farm sent its letter (dated December 8, 2006) to Universal, leading to Universal’s submission of an amended form.
