23 Fla. L. Weekly Supp. 172a
Online Reference: FLWSUPP 2302VILLInsurance — Personal injury protection — Discovery — Interrogatories — Motion to compel better responses to interrogatories regarding co-payments received by medical provider from insured and other patients is denied — Amount of co-payments is not relevant to reasonableness of charges
ULTRA CARE & DIAGNOSTIC, CORP. A/A/O ROBERTO VILLALOBOS, Plaintiff, v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 11th Judicial Circuit in and for Miami-Dade County. Case No. 13-0434 CC 24 (B). April 1, 2015. Donald J. Cannava, Judge. Counsel: Walter A. Arguelles, Shuster & Saben, LLC, Miami, for Plaintiff. Sara Randall, Roig Lawyers, Deerfield Beach, for Defendant.
ORDER ON DEFENDANT’S MOTION TOCOMPEL BETTER RESPONSESTO INTERRROGATORIES
This cause came before the Court for hearing on March 9, 2015, on Defendant’s Motion to Compel Better Responses to Interrogatory number 28 and Interrogatory number 29. The Court having reviewed the motion, read relevant legal authority, heard argument from counsel of each party, and been sufficiently advised in the premises, finds as follows:
The case arose out of a claim for failure to pay PIP benefits in connection with an automobile accident which occurred on or about December 18, 2012 accident. The issue before the Court involves whether discovery regarding co-payments is relevant as to whether Plaintiff’s charges for services rendered are reasonable.
The Plaintiff objects to the two interrogatory requests which seek information as to co-payments, not only regarding the subject patient, but other non-party patients.
The Defendant argues to the Court that Fla. Stat. 627.736(5)(a)(1) allows an insurer to consider the requested information in determining whether the Plaintiff’s charges are reasonable. The argument that co-payments are material and/or relevant to matters regarding a determination of reasonableness of charges is specious as a cause and effect relationship between the amount the Defendant is responsible for paying and the amount of co-payment collected or pursued does not exist. Without this relationship, the analysis of the reasonableness of the charge is not affected by a disclosure of co-payment information. See Windhaven Ins. Co. v. Right Choice Med. & Rehab., Corp.,19 Fla. L. Weekly Supp. 667c. This lack of cause and effect relationship combined with an absence of any contractual relationship between the provider and the insurance company is further evidence of a lack of relevance and absence of any duty to disclose the information as it pertains to copayments. See Windhaven Ins. Co. v. North Miami Therapy Cent., Inc., 20 Fla. L. Weekly Supp. 1166a.
Therefore, it is ORDERED and ADJUDGED that Defendant’s Motion to Compel Better Responses to Interrogatories is hereby DENIED.
