22 Fla. L. Weekly Supp. 238b
Online Reference: FLWSUPP 2202PROGInsurance — Personal injury protection — Coverage — Lawfully rendered services — Where medical provider was not licensed by state and did not fall within licensing exemption for clinics that are wholly owned by licensed health care practitioners, neither insurers nor insureds are liable to provider for charges for services
PROGRESSIVE AMERICAN INSURANCE COMPANY; PROGRESSIVE EXPRESS INSURANCE COMPANY; and PROGRESSIVE SELECT INSURANCE COMPANY, Plaintiffs, v. BEST MEDICAL HEALTHCARE SOLUTION, LLC (F/K/A TROPICAL HEALING POWER, LLC), Defendant. Circuit Court, 13th Judicial Circuit in and for Hillsborough County. Case No. 14-CA-000327, Division J. July 29, 2014. Honorable James D. Arnold, Judge. Counsel: Chad C. Guzzo, Martinez Denbo, LLC, Tampa, for Plaintiffs. Best Medical Healthcare Solution, LLC (f/k/a Tropical Healing Power, LLC), Tampa, pro se Defendant.
FINAL JUDGMENT IN FAVOR OF PLAINTIFFS
THIS CAUSE, having come for consideration upon Plaintiffs’ Motion for Entry of Final Judgment After Default, and the Court being fully advised in the premise finds as follows:UNDISPUTED FACTS
1. On January 9, 2014, PROGRESSIVE AMERICAN INSURANCE COMPANY, PROGRESSIVE EXPRESS INSURANCE COMPANY, and PROGRESSIVE SELECT INSURANCE COMPANY (hereinafter collectively referred to as “PROGRESSIVE”) filed the underlying Complaint.
2. Service of the Summons, Complaint, and Exhibits was perfected on the registered agent and corporate representative of BEST MEDICAL HEALTHCARE SOLUTION, LLC (f/k/a TROPICAL HEALING POWER, LLC) (“BEST MEDICAL”) on March 5, 2014.
3. Defendant has failed to undertake a defense in this matter.
4. Defendant: (1) has not filed a response with the Clerk; (2) has not served a response upon the Plaintiffs; (3) has not made entry of appearance in this matter; and (4) has not otherwise responded to the civil action instituted against it by Plaintiffs.
5. At all times material, BEST MEDICAL listed Florida licensed massage therapist Jorge Montoya Romero (“LMT Romero”) as its 100% owner.
6. At no time did LMT Romero own, in whole or part, BEST MEDICAL. Pl.’s Compl. Ex. “B” ¶5 (Jan. 9, 2014); see also Pl.’s Compl. Ex. “C.”
7. BEST MEDICAL paid LMT Romero $2,000.00 per month for eight months, from April 2009 through approximately November 2009, for the ability to use LMT Romero’s credentials and claim LMT Romero was the owner of BEST MEDICAL. PL’s Compl. Ex. “B” ¶10.
8. BEST MEDICAL then asserted LMT Romero as its owner and utilized his credentials to apply for and obtain a Certification of Exemption from Licensure as a Health Care Clinic from Florida’s Agency for Health Care Administration.
9. The PROGRESSIVE entities previously issued payments of PIP benefits to BEST MEDICAL that totaled $97,202.65 and encompassed individual claims as follows:
| Claim # | PIP Payments | Underwriting Company | Injured Party |
| 09-1433524 | $7,232.70 | Progressive American Ins. Co. | Jorge L. Ramirez-Soris |
| 09-1544880 | $4,588.73 | Progressive American Ins. Co. | Shana Davis |
| 09-1544880 | $9,481.91 | Progressive American Ins. Co. | Tony Cato |
| 09-1544880 | $5,242.91 | Progressive American Ins. Co. | Geneshia Cato |
| 09-2738615 | $5,080.14 | Progressive American Ins. Co. | Marisol Mendez |
| 09-4925505 | $7,296.36 | Progressive American Ins. Co. | Nelson P. Tejeda |
| 09-4925505 | $7,710.77 | Progressive American Ins. Co. | Obdulia Tejeda |
| 09-5231164 | $218.13 | Progressive American Ins. Co. | Jose Martinez |
| 09-5231164 | $280.39 | Progressive American Ins. Co. | Diana Rodriguez |
| 09-5231164 | $219.83 | Progressive American Ins. Co. | Giovanni Nunez |
| 09-5732992 | $8,075.53 | Progressive American Ins. Co. | German Suarez |
| 09-5732992 | $7,309.16 | Progressive American Ins. Co. | Luz M. Garcia |
| 09-5732992 | $8,549.64 | Progressive American Ins. Co. | Anuar C. Candanil |
| 09-1438578 | $5,411.30 | Progressive Express Ins. Co. | Melido Dotel |
| 09-5040900 | $312.88 | Progressive Express Ins. Co. | Yeoryi M. Fonseca |
| 09-5040900 | $262.26 | Progressive Express Ins. Co. | Yescia Avila |
| 09-2243026 | $8,630.24 | Progressive Select Ins. Co. | Belinda A. Gilmore |
| 09-2243026 | $5,383.34 | Progressive Select Ins. Co. | Xiaver Forster |
| 09-2243026 | $5,916.43 | Progressive Select Ins. Co. | Kennady Hayes |
ANALYSIS
10. When a party does not respond to a served Complaint and ignores a duly issued and properly served Notice of Action, a default judgment is an appropriate recourse. If a party does not attempt to defend an action, a Court must enter a default judgment against the party as the default is the only avenue available to conclude the action. Donohue v. Brightman, 939 So. 2d 1162 (Fla. 4th DCA 2006) [31 Fla. L. Weekly D2661a] (When no answer or Motion to Set Aside the Default has been filed, then the court must make an entry for final judgment in the Plaintiff’s favor.). Accordingly, when a party is in default, the factual allegations of a complaint, seeking legal or equitable relief, are taken as true. See State Farm Mut. Auto. Ins. Co. v. Horkheimer, 814 So. 2d 1069, 1072 (Fla. 4th DCA 2001) [27 Fla. L. Weekly D44a] (When a default is entered, the defaulting party admits all well-pled factual allegations of the complaint.).
11. Florida Statute § 627.736 (2008) requires medical services to be lawfully rendered and corresponding bills to be lawfully submitted. See Allstate Ins. Co. v. Vizcay, 2011 WL 5870016 (M.D. Fla. Nov. 22, 2011). As stated in Florida Statute § 627.736(5)(d) (2008):
No statement of medical services may include charges for medical services of a person or entity that performed such services without possessing the valid licenses required to perform such services. For purposes of paragraph (4)(b), an insurer shall not be considered to have been furnished with notice of the amount of covered loss or medical bills due unless the statements or bills comply with this paragraph. . . .
12. Additionally, Florida Statute § 627.736(4)(b) (2008) provides an insurer, such as PROGRESSIVE, with the right to challenge a violation of Florida Statute § 627.736(5) (2008), including potential licensure violations, which encompasses a determination of the ownership of a medical clinic, such as BEST MEDICAL. See State Farm Fire & Cas. Co. v. Silver Star Health & Rehab, 739 F. 3d 579 (11th Cir. 2013) [24 Fla. L. Weekly Fed. C834a]; Allstate Ins. Co. v. Vizcay, 2011 WL 5870016.
13. Florida’s Health Care Clinic Act (“Act”) controls the licensing of medical clinics. The Act “requires that all medical clinics operating in Florida be licensed by the State unless they fall within a statutory exemption. [citation omitted]. One of the exemptions is for clinics that are ‘wholly owned by one or more licensed health care practitioners.’ [citation omitted].” Silver Star Health & Rehab, 739 F. 3d at 582.
14. Accordingly, in order for medical services to be lawfully rendered and corresponding bills lawfully submitted under Florida’s No-Fault law a medical clinic, such as BEST MEDICAL, is required to possess valid licenses, including licenses under the Act. See Silver Star Health & Rehab, 739 F. 3d 579; Allstate Ins. Co. v. Vizcay, 2011 WL 5870016.RULING
15. At no time was Jorge Montoya Romero the 100% owner of BEST MEDICAL HEALTHCARE SOLUTION, LLC (f/k/a TROPICAL HEALING POWER, LLC).
16. This precluded BEST MEDICAL from complying with the licensing requirements found in the Act at all times material to this lawsuit.
17. Because of this and at all times material to this Complaint, BEST MEDICAL lacked the ability to lawfully render medical services and lawfully submit corresponding bills as required by Florida’s No-Fault law.
18. More specifically, BEST MEDICAL’S failure to obtain the proper licensure, including licensure under the Act, violated Florida Statutes §§627.736(1)(a), (5)(a), 5(b)(1) and 5(d); Florida Statute §627.732(11); and Florida Statute §400.9935(3).
19. Accordingly, pursuant to Florida Statute § 627.736(5)(b)1.b. none of the PROGRESSIVE entities or their Insureds listed below are liable to BEST CARE for reimbursement of the purported medical services provided in relation to the subject claims:
| Claim # | PIP Payments | Underwriting Company | Injured Party |
| 09-1433524 | $7,232.70 | Progressive American Ins. Co. | Jorge L. Ramirez-Soris |
| 09-1544880 | $4,588.73 | Progressive American Ins. Co. | Shana Davis |
| 09-1544880 | $9,481.91 | Progressive American Ins. Co. | Tony Cato |
| 09-1544880 | $5,242.91 | Progressive American Ins. Co. | Geneshia Cato |
| 09-2738615 | $5,080.14 | Progressive American Ins. Co. | Marisol Mendez |
| 09-4925505 | $7,296.36 | Progressive American Ins. Co. | Nelson P. Tejeda |
| 09-4925505 | $7,710.77 | Progressive American Ins. Co. | Obdulia Tejeda |
| 09-5231164 | $218.13 | Progressive American Ins. Co. | Jose Martinez |
| 09-5231164 | $280.39 | Progressive American Ins. Co. | Diana Rodriguez |
| 09-5231164 | $219.83 | Progressive American Ins. Co. | Giovanni Nunez |
| 09-5732992 | $8,075.53 | Progressive American Ins. Co. | German Suarez |
| 09-5732992 | $7,309.16 | Progressive American Ins. Co. | Luz M. Garcia |
| 09-5732992 | $8,549.64 | Progressive American Ins. Co. | Anuar C. Candanil |
| 09-1438578 | $5,411.30 | Progressive Express Ins. Co. | Melido Dotel |
| 09-5040900 | $312.88 | Progressive Express Ins. Co. | Yeoryi M. Fonseca |
| 09-5040900 | $262.26 | Progressive Express Ins. Co. | Yescia Avila |
| 09-2243026 | $8,630.24 | Progressive Select Ins. Co. | Belinda A. Gilmore |
| 09-2243026 | $5,383.34 | Progressive Select Ins. Co. | Xiaver Forster |
| 09-2243026 | $5,916.43 | Progressive Select Ins. Co. | Kennady Hayes |
20. Based upon the foregoing, it is hereby ORDERED AND ADJUDGED:
a Plaintiffs’ Motion for Entry of Final Judgment After Default is hereby GRANTED.
b. Final Judgment on Plaintiffs’ Motion for Entry of Final Judgment After Default is entered in favor of:
i. PROGRESSIVE AMERICAN INSURANCE COMPANY of 4221 West Boyscout Boulevard, Suite 500, Tampa, Florida 33607, and against Defendant, BEST MEDICAL HEALTHCARE SOLUTION, LLC (f/k/a TROPICAL HEALING POWER, LLC) of 10912 North 19th Street, Tampa, Florida 33612. PROGRESSIVE AMERICAN INSURANCE COMPANY shall recover from Defendant damages in the amount of $71,286.20 with apportioned costs in the amount of $171.67 for a TOTAL SUM of $71,457.87*, for which let execution issue forthwith.
ii. PROGRESSIVE EXPRESS INSURANCE COMPANY of 4221 West Boyscout Boulevard, Suite 500, Tampa, Florida 33607, and against Defendant, BEST MEDICAL HEALTHCARE SOLUTION, LLC (f/k/a TROPICAL HEALING POWER, LLC) of 10912 North 19th Street, Tampa, Florida 33612. PROGRESSIVE EXPRESS INSURANCE COMPANY shall recover from Defendant damages in the amount of $5,986.44 with apportioned costs in the amount of $171.67 for a TOTAL SUM of $6,158.11*, for which let execution issue forthwith.
iii. PROGRESSIVE SELECT INSURANCE COMPANY of 4221 West Boyscout Boulevard, Suite 500, Tampa, Florida 33607, and against Defendant, BEST MEDICAL HEALTHCARE SOLUTION, LLC (f/k/a TROPICAL HEALING POWER, LLC) of 10912 North 19th Street, Tampa, Florida 33612. PROGRESSIVE SELECT INSURANCE COMPANY shall recover from Defendant damages in the amount of $19,930.01 with apportioned costs in the amount of $171.66 for a TOTAL SUM of $20,101.67*, for which let execution issue forthwith.
* The TOTAL SUM shall bear interest from the date of this final judgment forward at the prevailing statutory interest rate of 4.75% per annum in accordance with Florida statutes.
c. This Court retains jurisdiction of this case for entry of further orders that are proper.
