23 Fla. L. Weekly Supp. 265b
Online Reference: FLWSUPP 2303CARPInsurance — Personal injury protection — Declaratory action — Action for declaratory judgment on issue of whether PIP and Med Pay coverage existed on date of accident is proper — Action for declaratory judgment on issues of whether insurer is obligated to pay all medical bills incurred as result of accident and whether insurer breached contract is not proper at this stage in pleadings
TIMOTHY CARPENTER, Plaintiff, vs. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 10th Judicial Circuit in and for Polk County. Case No. 2014-CC-001633, Division M0. November 21, 2014. Honorable Gerald Paul Hill, II, Judge. Counsel: V. Rand Saltsgaver, Orlando, for Plaintiff. Roy A. Kielich, Oxendine and Oxendine, P.A., Tampa, for Defendant.
ORDER GRANTING IN PART AND DENYINGIN PART DEFENDANT’S MOTION TO DISMISS
THIS CAUSE having come to be heard on October 16, 2014 upon the Defendant’s Motion to Dismiss, and the Court having reviewed the file, having heard arguments from counsel, and being otherwise fully advised in the premises, the Court makes the following findings of fact and conclusions of law:
PLAINTIFF’S ALLEGATIONS
1. The Plaintiff has brought the instant cause of action seeking declaratory judgment pertaining to an automobile policy issued by the Defendant, and pertaining to Personal Injury Protection (“PIP”) and Medical Payment (“MedPay”) coverage provided under said insurance policy.
2. The Plaintiff alleges that he was injured in an automobile accident on or about October 23, 2012 in Winter Haven, Polk County, Florida and that as a result, he received medical care and treatment from various healthcare providers. The Plaintiff further alleges that the Defendant has denied coverage under the PIP and MedPay provisions of the subject insurance policy for the reasonably necessary medical bills incurred as a result of the aforementioned motor vehicle accident.
3. The Plaintiff therefore requests a declaration from this Court that:
(a) There is coverage under the PIP and medical payment benefit provisions under the subject policy as a result of Plaintiff’s motor vehicle accident of October 23, 2012;
(b) State Farm’s denial of coverage to [Plaintiff] is in violation of F.S. §627.736 and/or the subject policy and/or applicable Florida law;
(c) State Farm is obligated, pursuant to the terms and conditions of the policy, to pay all of the medical bills incurred by [Plaintiff] as a result of the motor vehicle accident of October 23, 2012; and
(d) State Farm breached the contract by failing or refusing to honor its obligations under it. See Plaintiff’s Complaint, ¶¶ 11(a)-(d).
CONCLUSIONS OF LAW
4. A motion to dismiss is a question of law which tests the legal sufficiency of the Plaintiff’s complaint. It is well settled law that all reasonable inferences in the complaint are to be taken as true and a court is not to look beyond the four corners of the complaint and its attachments in making its decision on a motion to dismiss. See Swope Rodante, P.A. v. Harmon, 85 So. 3d 508, 509 (Fla. 2d DCA 2012) [37 Fla. L. Weekly D725c] (citing Al-Hakim v. Holder, 787 So. 2d 939, 941 (Fla. 2d DCA 2001) [26 Fla. L. Weekly D1380d]); Fla. R. Civ. P. 1.131(b).
5. In order to maintain an action for declaratory relief, the pleader must demonstrate that (1) there is a bona fide, actual, present practical need for the declaration; (2) the declaration deals with a present, ascertained, or ascertainable state of facts or controversy; (3) that there is some person who has or reasonably may have and actual, present, adverse, and antagonistic interest in the subject matter; and (4) that the relief sought is not merely the giving of legal advice by the Court. See Santa Rosa County v. Admin. Comm’N, Div. of Admin. Hearings, 661 So. 2d 1190, 1192-93 (Fla. 1995) [20 Fla. L. Weekly S333a] (citing May v. Holley, 50 So. 2d 636, 639 (Fla. 1952)). Absent a bona fide need for a declaration based on present, ascertainable facts, this Court lacks jurisdiction to render declaratory relief. Id. at 1193.
6. The Court has reviewed the following cases provided by counsel: Health-Aide Pain & Weight Mgt., Inc. a/a/o Olga Betancourt v. Allstate Property & Cas. Ins. Co., 20 Fla. L. Weekly Supp. 287a (Fla. 13th Jud. Cir., Hillsborough Cty. Ct., March 1, 2012); Mary Hardy v. Infinity Indem. Ins. Co., 20 Fla. L. Weekly Supp. 622a (Fla. 4th Jud. Cir., Duval Cty. Ct., Feb. 27, 2013); Doctors Urgent Care Walk-In Clinic, Inc. a/a/o Latoya Simmons v. First Acceptance Ins. Co., Inc., 15 Fla. L. Weekly Supp. 624b (Fla. 13th Jud. Cir., Hillsborough Cty. Ct., March 18, 2008); South Tampa Injury & Rehab, PA a/a/o Raquel Torres v. USAA Cas. Ins. Co., 16 Fla. L. Weekly Supp. 260a (Fla. 13th Jud. Cir., Hillsborough Cty. Ct., Dec. 6, 2008); Doc Schroeder, Inc. d/b/a Back Pain Relief Clinics a/a/o Hucan Edwards v. S. Group lndem., Inc., 12 Fla. L. Weekly Supp. 256b (Fla. 13th Jud. Cir., Hillsborough Cty. Ct., Dec. 13, 2004); Cruz v. Union Gen. Ins., 536 So. 2d 91 (Fla. 3d DCA 1991); and Sunset Medical Group, Inc. a/a/o Sonia M. Pimentel v. Progressive Select Ins. Co., (Fla. 11th Jud. Cir., Dade Cty. Ct., June 25, 2014) [22 Fla. L. Weekly Supp. 129c].
7. The Court finds that an action for declaratory judgment is proper in this instance pertaining to the sole issue of whether or not coverage existed under the subject insurance policy on the date of the motor vehicle accident and medical services at issue.
8. The Court further finds that an action for declaratory judgment is not proper at this stage in the pleadings pertaining to the Plaintiff’s request that this Court declare that the Defendant is obligated to pay all medical bills incurred as a result of the motor vehicle accident at issue, and pertaining to the Plaintiff’s request that this Court declare that the Defendant breached the contract.
Accordingly, it is hereby
ORDERDED AND ADJUDGED that the Defendant’s Motion to Dismiss is hereby GRANTED in part as to subparagraphs 11(c) and 11(d) of the Plaintiff’s Complaint, and Plaintiff’s counsel has made an ore tenus motion to withdraw subparagraphs 11(c) and 11(d) of the Complaint.
IT IS FURTHER ORDERED AND ADJUDGED that the Defendant’s Motion to Dismiss is hereby DENIED in part as to the portion of the Complaint which requests this Court to declare whether or not coverage existed under the subject insurance policy at the time of the motor vehicle accident at issue.
IT IS FURTHER ORDERED AND ADJUDGED that the Plaintiff shall have fifteen (15) days from the date of this order in which to file an amended Complaint for Declaratory Judgment. This Complaint shall be limited to the sole issue of whether or not coverage existed under the subject insurance policy at the time of the motor vehicle accident and medical services at issue.
IT IS FURTHER ORDERED AND ADJUDGED that the Defendant shall have twenty (20) days from the date of service of the Plaintiff’s Amended Complaint in which to file its Amended Answer.
