22 Fla. L. Weekly Supp. 123b
Online Reference: FLWSUPP 2201COMAInsurance — Personal injury protection — Discovery — Interrogatories — Where insurer utilized permissive statutory fee schedule to calculate reimbursement rates, reasonableness of medical provider’s charge is no longer at issue — Objections to interrogatories seeking information as to reasonableness of charge are sustained
FLORIDA HOSPITAL MEDICAL CENTER, as assignee of Paul Comazzi, Plaintiff, v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 9th Judicial Circuit in and for Orange County. Case No. 2013-SC-5303-O. April 21, 2014. A. James Craner, Judge. Counsel: William England, Bradford Cederberg, P.A., Orlando, for Plaintiff. John Eckard, II, Deerfield Beach, for Defendant.
ORDER ON PLAINTIFF’S OBJECTIONSTO DEFENDANT’S INTERROGATORIES
THIS MATTER having come before this Honorable Court on Plaintiff’s Objections to Defendant’s Interrogatories and this Honorable Court having heard arguments of counsel and being otherwise fully advised in the premises, it is hereby,
ORDERED AND ADJUDGED that:
1. Defendant utilized the permissive payment methodology set forth in Florida Statute 627.736(5)(a)(2)(b) to calculate reimbursement rates. By limiting reimbursement to 75% of the Hospital’s (Plaintiff’s) usual and customary charge, Defendant unilaterally determined reasonableness. Defendant cannot now seek to fall back to Florida Statute 627.736(5)(a)(1) to determine reasonableness, thus the reasonableness of Plaintiff’s charge is no longer at issue in this matter.
2. This Court in rendering its ruling, relies on the case law presented, the Explanation of Benefits produced by the Defendant in response to Plaintiff’s bill, previous rulings and orders in Florida Hospital Medical Center a/a/o Farrah Ignace-Jean v. Progressive American Insurance Company (case number 2013-SC-6527-O) and Florida Hospital Medical Center a/a/o Christine Fikry v. Progressive Select Insurance Company (case number 2013-SC-5771-O). Therefore, Plaintiff’s objections to Defendant’s discovery are hereby SUSTAINED as to Interrogatories 3, 5, 6, 9, 11, 12, 14, 15, 16, 17, 18, 19, 20, 21, 22, 24, 25, 26, 29 as they seek information as to reasonableness of Plaintiff’s charge, which is not at issue.
3. Plaintiff’s objections to Defendant’s Interrogatories are hereby OVERRULED as to Interrogatories 2, 4, 7, 8, 10, 13, 23, 27, and 28. As to Interrogatories 10 and 28, this Court finds that Plaintiff’s answers are sufficient. Plaintiff shall provide better responses to the Defendant’s Interrogatories 2, 4, 7, 8, 13, 23, and 27.
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