21 Fla. L. Weekly Supp. 82c
Online Reference: FLWSUPP 2101FRANInsurance — Personal injury protection — Late payment penalty — Where medical provider submitted two demand letters to insurer, each relating to different dates of treatment provided to insured, insurer was required to pay provider two separate $250 late payment penalties
5 STAR REHABILITATION CENTER, INC., a/a/o Jessika J. Francisco, Plaintiff, vs. UNITED AUTOMOBILE INSURANCE COMPANY. County Court, 11th Judicial Circuit in and for Miami-Dade County, Civil Division. Case No. 11-06505 SP 26 (04). September 26, 2013. Lawrence D. King, Judge. Counsel: Michael Campagna, Corredor, Husseini & Snedaker, P.A., Miami, for Plaintiff. Pablo Arrue, United Automobile Insurance Company, Office of the General Counsel, Miami, for Defendant.
ORDER GRANTING PLAINTIFF’S CROSS-MOTION FOR SUMMARY JUDGMENT AS TO COUNT II OF THE COMPLAINT ORDER DENYING DEFENDANT’S MOTIONFOR SUMMARY JUDGMENT AS TO COUNT II OF COMPLAINT AND FOR SANCTIONS
This matter came before the Court on September 19, 2013 for hearing and for consideration of Defendant’s Motion for Summary Judgment as to Count II of the Complaint, which motion was filed on April 30, 2012. Plaintiff also filed a Cross-Motion for Summary Judgment on the same legal issue.
The Court has reviewed the subject motions filed by the parties, has considered argument of counsel, the Clerk’s docket sheet, the Court file and pleadings contained therein, and being otherwise apprised in the premises regarding this matter hereby enters the following ruling.
ISSUE PRESENTED
Defendant contends that as a matter of law it is only required to pay once the $250.00 statutory penalty set forth in Section 627.736(10)(d), Florida Statutes (2011), even when the insurer receives more than one demand letter as to any one claimant, or health care provider pursuant to an assignment of benefits. Further, Defendant seeks an award of sanctions pursuant to Section 57.105, Florida Statutes (2011) related to Plaintiff’s maintaining this alleged meritless suit as to Count II of the Complaint.
Conversely, Plaintiff asserts that each demand letter warrants an assessment of the $ 250.00 statutory penalty which must be included in the total payment amount when timely paid by the insurer.
FACTUAL BACKGROUND
The record evidence in this matter reveals that two separate demand letters were submitted by Plaintiff, 5 Star Rehabilitation Center, Inc. to Defendant, United Automobile Insurance Company. One which was dated November 9, 2010 and one dated November 18, 2010. These demand letter notices pertained to billings for services rendered on different dates for the medical treatment provided to Jessika J. Francisco. The medical treatment was performed at times over several months. As the payment of these bills became overdue, Plaintiff then submitted two separate demand letters, which action was legally necessitated by Defendant’s failure to timely pay the medical bills in question.
Indeed the record also reveals that the medical bills of Jessika J. Francisco were contractually deemed by Defendant to be reasonable, related and necessary having arisen from an auto accident involving Francisco which occurred on July 28, 2010. Within the statutory time allowed, and prior to suit being filed as to the overdue medical benefits, Defendant paid the medical bills for PIP benefits including applicable interest, postage and the $250.00 penalty amount requested by Plaintiff in the demand letter dated November 9, 2010. Defendant also elected to pay the requested amounts for medical services billed, applicable interest, and postage for the November 18, 2012 demand letter. However, Defendant elected not to pay the $ 250.00 statutory penalty requested by Plaintiff in the demand letter dated November 18, 2012.
The Court notes that Defendant paid only one such $ 250.00 penalty related to the November 9, 2012 demand letter. Plaintiff ultimately brought suit for reimbursement for the unpaid penalty amount attendant with the second demand letter dated November 18, 2010.
LEGAL ANALYSIS
It is the finding of this Court that Defendant was appropriately required to pay to the Plaintiff two separate penalties of $ 250.00, as more specifically set forth in Section 627.736(10)(d), Florida Statutes (2011). Respectfully, a fair reading of the subject statutory language contained in section 627.736(10)(d), requires a late payment penalty ($250.00) to be paid for all statutory demand letters submitted to the insurance company by a claimant or health care facility seeking payment. The very essence of this penalty is to encourage timely payment of the bills, with a method for avoiding suit by an insurer’s timely tender of the reasonable amounts owed for medical treatment rendered, together with applicable interest, postage and a 10 percent or $ 250.00 maximum penalty.
Contrary to the arguments presented by Defendant in its Motion for Summary Judgment (Count II), had the Florida Legislature intended paragraph (10)(d) to be a one-time only penalty per claimant or health care provider for all bills submitted regardless of the number of demand letters required, it would have clearly inserted such language in the enactment. Moreover, there is support for the penalty assessment on each demand letter submitted when referencing Section 627.736(4)(b)(1), Florida Statutes (2011), which envisions multiple submissions of medical bills to insurers which may become overdue, and which may later necessitate more than one demand letter with respect to some claims. This is also true for Section 627.736(10)(c), Florida Statutes (2011).
Although section 627.736(10)(d) is silent as to multiple demand letters, Florida’s PIP statutory provisions must be read in pari materia with all related sections. To construe the provisions contained in section 627.736(10)(d), as suggested by Defendant, would otherwise render meaningless the clear intent of the Florida Legislature in creating the notice requirements and penalty provisions inherent in Florida’s No-Fault PIP enactment itself. See generally Bellamar Medical Center, Inc. a/a/o Matiana Garcia v. United Automobile Insurance Company, 17 Fla. L. Weekly Supp. 475a (13th Jud. Cir. Hillsborough County Ct. 2008).
Plaintiff has met its burden without rebuttal as the moving party pursuant to Rule 1.510(c), Fla. R. Civ. P. (2013), with respect to the Cross-Motion for Summary Judgment (Count II). See Volusia County v. Aberdeen at Ormand Beach, L.P., 760 So. 2d 126 (Fla. 2000) [25 Fla. L. Weekly S390a]; Itiat v. Foskey, 28 So. 3d 140 (Fla. 1st DCA 2010) [35 Fla. L. Weekly D313d]; John Miskoff Foundation v. Johnson, 588 So. 2d 675 (Fla. 3d DCA 1991) citing Holl v. Tolcott, 191 So. 2d 40 (Fla. 1966). As there is no genuine issue of material fact that remains as to the legal issue presented in Count II of the Complaint, Plaintiff is entitled to the entry of an Order of Summary Judgment in this case as to Count II only.
CONCLUSION
WHEREFORE, IT IS ORDERED AND ADJUDGED that Defendant, United Automobile Insurance Company’s Motion for Summary Judgment as to Count II of the Complaint (statutory penalty), and requested relief for an award of sanctions pursuant to Section 57.105, Florida Statutes (2011) is DENIED.
IT IS FURTHER ORDERED that Plaintiff, 5 Star Rehabilitation Center, Inc.’s Motion for Summary Judgment as to Count II (statutory penalty) is GRANTED. All other relief sought by Plaintiff pursuant to Section 57.105, Florida Statutes (2011) is DENIED. The Court hereby specifically reserves jurisdiction for the award of reasonable attorney fees and costs, if appropriate, in favor of Plaintiff, 5 Star Rehabilitation Center, Inc. and against Defendant, United Automobile Insurance Company arising from the entry of this Order.
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