20 Fla. L. Weekly Supp. 598a
Online Reference: FLWSUPP 2006JEANInsurance — Personal injury protection — Coverage — Insurer cannot rely on statutory permissive Medicare Part B fee schedule where insurer did not mention that payment methodology in its policy, and clear language in policy provides that insurer will pay 80% of reasonable expenses
LAKE WORTH CHIRO. ASSOC., INC. DBA CHIRO. ASSOC. OF LAKE WORTH (ASSIGNEE OF JEAN, LUCIANA), Plaintiff, v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 15th Judicial Circuit in and for Palm Beach County. Case No. 502011SC005007XXXXSB. July 10, 2012. Reginald R. Corlew, Judge. Counsel: Abraham S. Ovadia, Florida PIP Law Firm, PA, Boca Raton, for Plaintiff. Matt Hellman, Matt Hellman, PA, Plantation, for Defendant..
ORDER ON PLAINTIFF’S MOTION FOR PARTIALSUMMARY JUDGMENT, SPECIFICLANGUAGE OF THE INSURANCE POLICYCONTROLS OVER THE PERMISSIVE LANGUAGEOF FLORIDA STATUTE 627.736 (5) (a)
THIS CAUSE having come before this court on Plaintiff’s Motion for Partial Summary Judgment that Specific Language Of The Insurance Policy Controls Over The Permissive Language Of Florida Statute 627.736 (5) (a), and the court having heard argument of counsel and being otherwise advised in the premises, it is hereupon;
ORDERED and ADJUDGED:
1. Plaintiff’s Motion for Partial Summary Judgment Re; Kingsway is GRANTED.
2. The Defendant’s policy language is controlling over the permissive statutory language. The Court finds that under the holdings of Kingsway Amigo Insurance Company v. Ocean Health, Inc. (a/a/o Belizaire Gomez) 63 So. 3d 63 (Fla. 4th DCA 2011) [36 Fla. L. Weekly D1062a] and Geico Indemnity Company v. Virtual Imaging Services, Inc. 79 So.3d 55 (Fla. 3rd DCA 2011) [36 Fla. L. Weekly D2597a], the fee schedule was not permitted to be applied in this case as the applicable policy “made no reference to the permissive methodology of subsection 627.736(5)(a)2” Id.
3. The Defendant must pay in accordance with its policy of insurance and pay 80% of reasonable medical expenses. The reasonableness of the charges is still at issue.
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