22 Fla. L. Weekly Supp. 1146a
Online Reference: FLWSUPP 2210JIMEInsurance — Personal injury protection — Coverage — Medical expenses — Language in policy at issue clearly and unambiguously notified insured of insurer’s intent to use statutory fee schedule methodology to determine reasonable reimbursement rates for medical care expenses
ALLSTATE INDEMNITY COMPANY, Appellant, vs. GABLES INS. RECOVERY INC. a/a/o ILEANA JIMENEZ, Appellee. Circuit Court, 11th Judicial Circuit (Appellate) in and for Miami-Dade County. Case No. 13-067 AP. L.C. Case No. 11-21641-SP-25. June 8, 2015. An appeal from the County Court for Miami-Dade County, Judge Nuria Saenz. Counsel: Suzzane Y. Labrit, Douglass G. Brehm, and Peter J. Valeta, for Appellant. G. Bart Billbrough and Dagmar Llaudy, for Appellee.
(Before BERNSTEIN, HENDON, and MANNO SCHURR, JJ.)
(PER CURIAM.) The issue on appeal is whether language in Allstate’s insurance policy clearly and unambiguously notifies its insured of Allstate’s intent to use the fee schedule reimbursement methodology authorized by Florida Statute section 627.736(5)(a)(2)(f) to determine reasonable reimbursement rates for medical care expenses. Such clear and unambiguous notification is required in order for Allstate to utilize the fee schedule methodology to determine reimbursement rates. GEICO Gen. Ins. Co. v. Virtual Imaging Servs., Inc., 141 So. 3d 147 (Fla. 2013) [38 Fla. L. Weekly S517a].
The language at issue in Allstate’s policy provides:
Any amounts payable under this coverage shall be subject to any and all limitations authorized by section 627.736, or any other provisions of the Florida Motor Vehicle No-Fault Law, as enacted, amended, or otherwise continued in the law, including but not limited to, all fee schedules.
The trial court found that this language does not allow Allstate to utilize the applicable fee schedule when determining the amount it will reimburse. Allstate has appealed. Based upon recent controlling case law, we reverse.
On March 18, 2015, the First District Court of Appeal of Florida found that the exact same Allstate policy language quoted above gives sufficient notice of its election to limit reimbursements by using the fee schedules. Allstate Fire and Cas. Ins. v. Stand-Up MRI of Tallahassee, P.A., 40 Fla. L. Weekly D693b (Fla. 1st DCA 2015). We are required to follow this decision, which is binding upon us. See Gross v. State, 765 So. 2d 39, 48 (Fla. 2002) [25 Fla. L. Weekly S555a]; Pardo v. State, 596 So. 2d 665, 666 (Fla. 1992). We commend the ethics and professionalism of the Appellee’s attorney, who conceded, correctly, at oral argument that we are bound by the First DCA’ s decision.
Accordingly, we reverse the order on appeal, and remand for further proceedings consistent with this opinion. (BERNSTEIN, and HENDON, JJ., concur.)
