22 Fla. L. Weekly Supp. 787a
Online Reference: FLWSUPP 2207LEONInsurance — Personal injury protection — Coverage — Medical expenses — PIP policy that subjects payments to any and all limitations authorized by PIP statute, including all fee schedules, clearly and unambiguously elects to limit reimbursement to permissive statutory fee schedule
ALLSTATE PROPERTY & CASUALTY INSURANCE COMPANY, Appellant, v. ROYAL DIAGNOSTIC CENTER, INC., a/a/o Iris Leon, Appellee. Circuit Court, 11th Judicial Circuit (Appellate) in and for Miami-Dade County. Case No. 13-462 AP. L.T. Case No. 13-00331 SP 25. January 29, 2015. An Appeal from the County Court for Miami-Dade County, Patricia Marino Pedraza, Judge. Counsel: Michael G. Brehm, Suzanne Youmans Labrit, Shutts & Bowen LLP, and Peter J. Valeta, Meckler Bulger Tilson Marick & Pearson LLP, for Appellant. Mark J. Feldman and Michael J. Feldman, Mark J. Feldman, P.A., for Appellee.
(Before MURPHY, RODRIGUEZ-CHOMAT and FAJARDO, JJ.)
(RODRIGUEZ-CHOMAT, Judge.) This appeal concerns a de novo application of the law to stipulated facts. The trial court ruled against Allstate, finding that its policy language was insufficient to put an insured on notice that it would apply the fee schedule reimbursement limitations authorized by Florida Statute §627.736(5)(a)(2)(f) in calculating the amount that it would pay to the Royal Diagnostic as a reasonable expense for the medical care.
We reverse and find the policy language provides sufficient notice. The Florida Supreme Court had found that in order to exercise the option to utilize the fee schedules authorized in §927.736, “the insured must provide notice in the policy of its election to use the fee schedules.” GEICO General Ins. Co. v. Virtual Imaging Service, Inc., 141 So. 3d 147, 159 (Fla. 2013) [38 Fla. L. Weekly S517a]. The notice must be clear and unambiguous. Id. at 158. The relevant police language at issue reads:
Any amount 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 fees schedules.
Identical language has been found to provide the “clear and unambiguous” notice to insureds required by Virtual Imaging. See Allstate Prop. And Cas. Ins. Co. v. Royal Diagnostic Center, Inc. a/a/o Dania Mondy, 21 Fla. L. Weekly Supp. 627a (Fla. 11th Cir. Ct. April 3, 2014 (Rehearing denied September 9, 2014); Allstate Fire and Cas. Ins. Co. v. Hallandale Open MRI, LLC a/a/o Elisson Politesse, 21 Fla. L. Weekly Supp. 989a (Fla. 11th Cir. Ct. June 23, 2014).
FOR THESE REASONS, we REVERSE and REMAND with instructions that the trial court enter an order consistent with this opinion. (MURPHY and FAJARDO, J.J., concur.)
