20 Fla. L. Weekly Supp. 798a
Online Reference: FLWSUPP 2008FINLInsurance — Personal injury protection — Discovery — Insurer is ordered to provide better responses to interrogatories relating to its use of workers’ compensation fee schedule to adjust claims and to produce documents utilized in its decision to reduce medical provider’s bills
JOHN ORTOLANI, MD As assignee of JENNIFER FINLAY, Plaintiff, vs. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 7th Judicial Circuit in and for Volusia County. Case No. 2012-30924-COCI, Division 84. March 12, 2013. Honorable Dawn Fields, Judge. Counsel: Kimberly Simoes, The Simoes Law Group, Deland, for Plaintiff. Matthew Corker, Conroy Simberg, Orlando, for Defendant.
ORDER ON PLAINTIFF’S MOTION TOCOMPEL BETTER RESPONSE
This cause having come before the Court on the Plaintiff’s Motion to Compel Better Response to Discovery, finds as follows:
1. Plaintiff propounded Interrogatories and a Request to Produce to the Defendant regarding its affirmative defenses asserted in this action. Specifically, Plaintiff propounded the following interrogatories:
· Please state and explain with specificity the methodology utilized in calculating reimbursement for the medical bills at issue.
· Identify all persons involved in your decision to use the workers compensation fee schedule to calculate the reimbursement rate for the services at issue. For each such person identified in your answer, please state that person’s job title, and describe in detail that person’s involvement in the decision to use the workers compensation fee schedule .
· Please state with specificity each section and any language in Florida Statute 627.736 or any other Florida Statute that authorizes the Defendant to utilize the workers compensation fee schedule for claims made under F.S. 627.736(5).
· Identify when the Defendant began utilizing the workers compensation fee schedule to adjust Florida PIP and medpay claims.
· Prior to when the Defendant began utilizing the workers compensation fee schedule to adjust claims, identify the Defendant’s policies and guidelines for calculating reimbursement rates for Florida No Fault claims.
· Identify how the Defendant decides whether to use the workers compensation fee schedule to reduce payment for certain claims made by providers pursuant to F.S. 627.736(5)?
2. This information is relevant and discoverable in the current action and the Defendant shall serve better responses to the Plaintiff’s Interrogatories providing specific information in response to the foregoing Interrogatories.
3. Plaintiff served a Request for Production of Documents on the Defendant requesting information regarding documents utilized by State Farm in its decision to reduce the reimbursement of the Plaintiff’s bills. Specifically, Plaintiff requested the following documents:
· Any and all documents which support each of Defendant’s affirmative defenses which have been raised in this action.
· Any and all documents which support each of Defendant’s denials of the allegations contained in Plaintiffs Complaint.
· Copy of the materials relied upon by Defendant for its application of the workers compensation fee schedule to payment for the services at issue on 8/12/10.
· Communications between Defendant and any third party pertaining to Defendant’s utilization of the workers compensation fee shedule as described by Defendant in its Explanation of Review to the Plaintiff.
4. The information requested is relevant and discoverable in the current action and the Defendant shall produce the information requested.
5. The responses to Interrogatories and documents in response to the Requests to Produce shall be provided to the Plaintiff no later than March 20, 2013.
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