18 Fla. L. Weekly Supp. 1190a
Online Reference: FLWSUPP 1811GUZM
Insurance — Personal injury protection — Affirmative defenses — Summary judgment is granted in favor of medical provider with respect to affirmative defenses of NCCI edits, unbundling of CPT codes, and reasonableness, relatedness and necessity of treatment
KRYSTAL REHABILITATION SERVICES, CORP., a/a/o William Guzman, Plaintiff, vs. STATE FARM FIRE AND CASUALTY COMPANY, Defendant. County Court, 11th Judicial Circuit in and for Miami-Dade County, Civil Division. Case No. 10-4551 SP 25 (02). December 13, 2010. Lawrence D. King, Judge.
ORDER GRANTING (IN PART) PLAINTIFF’S MOTION FOR FINAL SUMMARY JUDGMENT
This matter came before the Court for hearing on December 13, 2010 for consideration of Plaintiff, Krystal Rehabilitation Services, Corp.’s Motion for Final Summary Judgment as to disputed claims regarding specific CPT codes and amounts billed by Plaintiff to Defendant in this Personal Injury Protection breach of contract case. All attorneys of record were present.
The Court having considered the subject motion and supporting affidavits, the affidavits and attached exhibits filed by Defendant, State Farm Fire and Casualty Company in opposition, documentary exhibits, case law authority, the oral argument of counsel, the Clerk’s docket sheet, the Court file and all relevant pleadings contained therein, and being otherwise apprised in the premises hereby enters the following ruling.
IT IS ORDERED AND ADJUDGED that Plaintiff, Krystal Rehabilitation Services, Corp.’s Motion for Final Summary Judgment is GRANTED, in part with respect to the affirmative defenses of NCCI Edits, Unbundling of Code Entries and RRN.
No genuine issues of material fact remain for the trier of fact to consider as to the matters framed by the pleadings. Moore v. Morris, 475 So. 2d 666, (Fla. 1985); Holl v. Talcott, 191 So. 2d 40 (Fla. 1966). Plaintiff’s supporting medical affidavit establishes by competent evidence a proper foundation sufficient to meet its burden as to the reasonableness of medical charges, necessity of treatment and relatedness to the automobile accident as otherwise require by Florida Statute. Derius v. Allstate Indemnity Company, 723 So. 2d 271 (Fla. 4th DCA 1998) [23 Fla. L. Weekly D1383a]. Respectfully, the Court finds that as a matter of law Defendant has not presented in its opposing affidavits relevant or material evidence to rebut same. See Landers v. Milton, 370 So. 2d 368 (Fla. 1979) (discussion of rebuttal evidence sufficient to create a genuine issue of material fact).
Moreover, the issues presented by the Plaintiff’s Motion for Final Summary Judgment warrant the relief sought therein. See generally United Automobile Insurance Company v. Adriana Amador, 15 Fla. L. Weekly Supp. 320a (Fla. 11th Cir. App. 2008); John S. Virga, D.C., PA. a/a/o Jennifer Crumpler v. State Farm Mutual Automobile Ins. Co., 17 Fla. L. Weekly Supp. 383a (Miami-Dade Cty. Ct. Dec. 13, 2009); Advanced Chiropractic & Medical Center a/a/o Sidoles Vilsinnor v. State Farm Fire and Casualty Co., 16 Fla. L. Weekly Supp. 1161d (Broward Cty. Ct. Aug. 27, 2009).
IT IS FURTHER ORDERED that Plaintiff, Krystal Rehabilitation Services, Corp.’s Motion for Final Summary Judgment as to Defendant, State Farm Fire and Casualty Company’s remaining affirmative defense of Defective Demand Letter is to be reset for hearing before this Court by stipulation of all counsel of record.
