24 Fla. L. Weekly Supp. 362a
Online Reference: FLWSUPP 2405KERNInsurance — Personal injury protection — Demand letter — Sufficiency — Demand letter seeking payment for treatment provided after insurer issued letter withdrawing payment for further treatment does not comply with statutory requirements where letter withdrawing payment for further treatment is not attached to demand letter and demand letter does not contain itemized statement of treatment
FLORIDA DISC INSTITUTE, a/a/o Keitha Kernizan, Plaintiff, vs. TRAVELERS HOME AND MARINE INSURANCE COMPANY, Defendant. County Court, 13th Judicial Circuit in and for Hillsborough County, Civil Division. Case No. 13-CC-023416. June 21, 2016. Frances Perrone, Judge. Counsel: Keith Petrochko, Pardy & Rodriguez, P.A., Kissimmee, for Plaintiff. David B. Kampf, Ramey & Kampf, P.A., Tampa, for Defendant.
ORDER GRANTING DEFENDANT’S MOTION FORSUMMARY JUDGMENT BASED ON NON-COMPLIANCEWITH FLORIDA STATUTE §627.736(10)
THIS CAUSE, having come before the Court on June 1, 2016, on Defendant’s Motion for Summary Judgment, and the Court having heard argument of counsel and being otherwise fully advised in the Premises, it is hereby
ORDERED AND ADJUDGED that:
1. The Defendant sought summary judgment in this matter based on Plaintiff’s failure to comply with Florida no-fault law, particularly Florida Statute §627.736(10). The statute requires a demand letter be submitted to the insurer prior to the filing of any suit and that the letter provides that it is the written notice of intent to initiate litigation. Such demand letters must only seek payment of overdue charges.
2. The facts reveal that Travelers issued a letter withdrawing payment of future treatment effective January 27, 2012, based upon an independent/compulsory medical examiner’s opinion pursuant to paragraph (7)(a). There is no dispute that the Insurer’s Notice withdrawing payment clearly notified the insured that further treatment would not be paid.
3. The assignor continued treating with the Plaintiff but the bills were not paid by the Defendant based on the discontinuation of further care.
4. Thereafter, Plaintiff submitted a pre-suit demand letter seeking payment for services rendered after January 27, 2012, the date in which Defendant would no longer pay for future treatment. The demand letter only sought payment of service rendered prior to the date of the demand letter since services after the demand must not be included in a pre-suit demand letter. Thus, demand letter sought payment of future treatment beyond the date of letter withdrawing payment. That treatment had not been rendered as of the date of the letter withdrawing payment.
5. It is undisputed that the demand letter did not attach a copy of the Insurer’s Notice withdrawing payment of further/future benefits and there was not an itemized statement of the type, frequency, and duration of future treatment claimed to be reasonable and medically necessary. The statute provides that both requirements must be met.
6. Based upon there being no factual issue in dispute and pursuant to the opinions provided by the Defense including 14 Fla. L. Weekly Supp. 207a (December 1, 2006) this Court grants Defendant’s Motion for Summary Judgment.
7. The Court finds that this provision of Florida Statute §627.736(10) must be complied with as a condition to suit.
8. Based on the above, Final Summary Judgment shall hereby be granted in favor of Defendant and Plaintiff shall take nothing from this action and Defendant shall go hence without a day.
9. The Court reserves jurisdiction to address and consider entitlement and reasonableness of Defendant’s attorneys’ fees and costs.
