24 Fla. L. Weekly Supp. 162a
Online Reference: FLWSUPP 2402ZUNIInsurance — Personal injury protection — Discovery — Admissions — Motion for relief from technical admissions that insurer approved certain charges for CPT code in past is denied — Presentation of merits of action will not be subserved by withdrawal of technical admissions since documents attached to request for admissions show approval of charges on their face, and insurer indicated in tardy response to request for admissions that documents appear to be genuine
APPLE MEDICAL CENTER, LLC, (a/a/o Zuniga, Ana), Plaintiff, v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 11th Judicial Circuit in and for Miami-Dade County. Case No. 12-22859 SP 23. April 28, 2016. Jason Emilios Dimitris, Judge. Counsel: Robert B. Goldman, Florida Advocates, Dania Beach, for Plaintiff. Melissa G. McDavitt, Conroy Simberg, for Defendant.
ORDER GRANTING PLAINTIFF’S MOTION FORSANCTIONS, AND DENYING DEFENDANT’S MOTIONFOR RELIEF FROM TECHNICAL ADMISSIONS
THIS CAUSE came before the Court on April 13, 2016 upon Plaintiff’s Motion to Enforce Court Order and Motion for Sanctions filed November 25, 2015 and Defendant’s Motion for Relief from Technical Admissions filed November 30, 2015, and the Court having reviewed the motions, having reviewed the Plaintiff’s Second Request for Admissions filed June 18, 2015 and the attachments thereto and Defendant’s Response to Plaintiff’s Second Request for Admissions filed November 30, 2015, having heard argument of counsel and being otherwise fully advised, it is
ORDERED, that Plaintiff’s Motion for Sanctions is GRANTED and Defendant’s Motion for Relief from Technical Admissions is DENIED, for the following reasons:
1. On June 18, 2015, Plaintiff Apple Medical Center, LLC (“Apple Medical”) served its Second Request for Admissions to Defendant State Farm Mutual Automobile Insurance Company (“State Farm”), requesting that State Farm admit that it had approved Apple Medical’s charge of $600 for CPT Code 99205 procedures performed on June 13, 2009 and April 10, 2010.
2. Apple Medical attached to the Second Request for Admissions a document which on its face, appears to be an Explanation of Review from State Farm containing identifying claim numbers and policy numbers, indicating a “submitted charge” of $600 for a CPT/HCPCS 99205 procedure on which the date of service is reflected as June 13, 2009, and an “approved amount” of $600.00.
3. Apple Medical also attached to the Second Request for Admissions another document which on its face, appears to be an Explanation of Review from State Farm containing identifying claim numbers and policy numbers, indicating a “submitted charge” of $600 for a CPT/HCPCS 99205 procedure on which the date of service is reflected as April 10, 2010, and an “approved amount” of $600.00.
4. Apple Medical also attached to the Second Request for Admissions documents which on their face, appear to be copies of State Farm checks payable to Apple Medical, each containing identifying claim numbers, identifying loss dates and identifying check numbers, and each in the exact amount of $600.00.
5. In addition to requesting that State Farm admit that it had approved Apple Medical’s charge of $600 for CPT Code 99205 procedures performed on June 13, 2009 and April 10, 2010, Apple Medical’s Second Request for Admissions requested that State Farm admit that the Explanations of Review and State Farm checks were genuine copies of the documentation evidencing the fact that State Farm had approved Apple Medical’s charges for the 99205 procedures performed.
6. On July 30, 2015, this Court granted State Farm’s motion for extension of time to respond to Apple Medical’s Second Request for Admissions, allowing an additional 30 days for State Farm to respond.
7. When State Farm failed to respond to the Second Request for Admissions as required by this Court’s July 30, 2015 Order, the admissions requests were deemed technically admitted.
8. On November 30, 2015, State Farm served its tardy Response to Plaintiff’s Second Request for Admissions, in which State Farm admitted only that the referenced attachments to the Second Request for Admissions appear to be genuine copies.
9. Although Rule 1.370(b) allows for technical admissions to be withdrawn “when the presentation of the merits of the action will be subserved by it,” it does not appear to this Court that presentation of the merits of this action will be subserved by the withdrawal of the technical admissions that State Farm had approved Apple Medical’s charge of $600 for CPT Code 99205 procedures performed on June 13, 2009 and April 10, 2010, particularly where the documents on their face indicate that State Farm had approved Apple Medical’s charge of $600 for CPT Code 99205 procedures performed on June 13, 2009 and April 10, 2010, and State Farm has indicated in its tardy response that the documents appear to be genuine.
