22 Fla. L. Weekly Supp. 129c
Online Reference: FLWSUPP 2201PIMEInsurance — Personal injury protection — Declaratory actions — Complaint seeking declaration as to scope of coverage under policy and PIP statute when medical record contains conflicting opinions as to whether insured had emergency medical condition meets requirements for declaratory action — Motion to dismiss is denied
SUNSET MEDICAL GROUP, INC. a/a/o SONIA M. PIMENTEL, Plaintiff, v. PROGRESSIVE SELECT INSURANCE COMPANY, Defendant. County Court, 11th Judicial Circuit in and for Dade County. Case No. 13-18527 CC 23. June 25, 2014. Linda Singer Stein, Judge. Counsel: Yasmin Gilinsky and Russel Lazega, Florida Advocates, Dania Beach, for Plaintiff.
ORDER DENYING DEFENDANT’S MOTION TODISMISS PLAINTIFF’S AMENDED COMPLAINT FOR DECLARATORY RELIEF
THIS CAUSE came before the Court on Defendant’s Motion to Dismiss Plaintiff’s Complaint for Declaratory Relief.1 The Court has carefully considered the motion, responses, legal authorities and presided over a hearing. Plaintiff has framed the issue set forth in the Amended Complaint as follows:
Plaintiff’s declaratory action seeks to resolve the legal dispute between the parties as to the scope of coverage and, specifically, a declaration as to whether F.S. s. 627.736(1) provides for $10,000 in PIP coverage or $2,500 in PIP coverage where the medical record contains both 1) a determination by the patient’s own treating provider that the patient had an emergency medical condition and 2) a determination by a provider other than the insured patient’s own treating provider that there is no emergency medical condition.
The Supreme Court of Florida has set forth the requirements to sustain an action for declaratory relief.
The purpose of a declaratory judgment is to afford parties relief from insecurity and uncertainty with respect to rights, status, and other equitable or legal relations. Martinez v. Scanlan, 582 So.2d 1167, 1170 (Fla. 1991). Parties who seek declaratory relief must show that
there is a bona fide, actual, present practical need for the declaration; that the declaration should deal with a present, ascertained or ascertainable state of facts or present controversy as to the state of facts; that some immunity, power, privilege or right of the complaining party is dependent upon the facts or the law applicable to the facts; that there is some person or persons who have, or reasonably may have an actual, present, adverse and antagonistic interest in the subject matter, either in fact or law; that the antagonistic and adverse interest are all before the court by proper process or class representation and that the relief sought is not merely the giving of legal advice by the courts or the answer to questions propounded from curiosity. These elements are necessary in order to maintain the status of the proceeding as being judicial in nature and therefore within the constitutional powers of the courts.
Id. (alteration in original) (quoting May v. Holley, 59 So.2d 636, 639 (Fla. 1952)).
Santa Rosa County v. Administration Commission, Division of Administrative Hearings, et al., 661 So.2d 1190, 1192-1193 (Fla. 1995) [20 Fla. L. Weekly S536c]. The Florida Supreme Court has held that even if the declaratory judgment requires a finding of fact, it may be a proper cause of action. See Higgins v. State Farm Fire and Casualty Co., 894 So.2d 5, 10 (Fla. 2005) [29 Fla. L. Weekly S533a].
The Court finds that Plaintiff’s Complaint for Declaratory Relief and the issue for the Court to decide meet the requirements under the statute and case law, as Plaintiff is unsure of its rights under the policy and PIP statute. Accordingly, Defendant’s motion to dismiss is DENIED.
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1After the filing of Defendant’s Motion to Dismiss, Plaintiff filed an Amended Complaint. This Court has considered Defendant’s motion to be directed to the Amended Complaint.
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