24 Fla. L. Weekly Supp. 433b
Online Reference: FLWSUPP 2406HOPKInsurance — Personal injury protection — Settlement agreement — Where assignment of benefits provides that insured is responsible for all services received and promises to pay regardless of insurance payments or lawsuit settlements, settlement agreement between medical provider and insured in which provider accepted payment from insured as full and final satisfaction of outstanding balance settled any claim by provider against PIP insurer — No merit to argument that term “outstanding balance” is ambiguous and, therefore, parol evidence should be admissible to prove that intent of parties was to settle only 20% of bills not covered by PIP benefits
CLAYTON W. HOPKINS, DC, d/b/a HOPKINS CLINIC a/a/o Douglas Miller, Plaintiff, v. TRAVELERS HOME AND MARINE INSURANCE COMPANY, Defendant. County Court, 6th Judicial Circuit in and for Pinellas County. Case No. 14-329-SC-44. February 26, 2016. Kathleen T. Hessinger, Judge. Counsel: William K. Saron, Law Offices of William K. Saron, P.A., St. Petersburg, for Plaintiff. David B. Kampf, Ramey & Kampf, P.A., Tampa, for Defendant.
FINAL SUMMARY JUDGMENT
This Cause came to be heard before this Court on Defendant’s Motion for Summary Judgment with the parties present, through counsel, and this Court having reviewed the pleadings, motion, deposition, and affidavits and being otherwise advised of the premises, it is hereby Ordered and Adjudged as follows,FACTS
1. On January 13, 2014, Plaintiff sued Defendant for breach of contract for failure to pay PIP benefits. On December 8, 2015, Defendant filed this Motion for Summary Judgment claiming Plaintiff settled the outstanding medical bills with the patient/assignor/insured, Douglas Miller.
2. The undisputed facts reflect as follows,
a. Douglas Miller, hereinafter referred to as Miller, was involved in a motor vehicle accident on September 6, 2011.
b. Miller sought chiropractic medical treatment with Plaintiff, Clayton W. Hopkins, D.C., P.A., hereinafter referred to as Hopkins, on or about October 11, 2011.
c. On October 4, 2011, Douglas Miller signed a “Consent to Treat with Assignment of Benefits” form, hereinafter referred to as the Consent.
d. Paragraph 5 of the Consent states as follows:
ATTORNEY LIEN: In the event I receive medical payment benefits, no-fault benefits, health and accident benefits, workers compensation benefits, or other reimbursement from any settlement, judgment or verdict on my behalf, I hereby authorize and direct my attorney to FIRST PAY THE OFFICE directly the amount due for services rendered before any other disbursements are made from any funds received by the attorney’s office on my behalf. . .
e. Paragraph 6 of the Consent states as follows:
GUARANTEE OF PAYMENT: I understand and agree I am personally responsible for all services received at THE OFFICE, and promise to pay regardless of my health insurance benefits and/or possible future payment from any judgment or verdict on my behalf. . . . (emphasis added)
f. As part of the Consent, Miller assigned his benefits under his personal injury protection insurance with the Defendant, Travelers Home and Marine Insurance Company to Hopkins. The document provided by the parties is missing the second page and has two copies of the third page, so the specific assignment language is not available to this Court. However, the parties agree an assignment of benefits exists in this matter.
g. Miller treated with Hopkins from October 11, 2011 through August 28, 2012.
h. Travelers stopped paying personal injury protection benefits under Miller’s policy of insurance, on March 26, 2012, as a result of a chiropractic IME.
i. Hopkins, as assignee of Miller, filed this breach of contract claim against Travelers, on January 13, 2014. Hopkins alleges Travelers breached the contract by failing to pay personal injury protection benefits pursuant to Miller’s policy of insurance. Hopkins alleged that Travelers owed 80% of the billed chiropractic services for the following dates, 3/27/12, 4/2/12, 4/17/12, 5/9/12, 5/16/12, 6/5/12, 6/12/12, 6/21/12, 7/24/12, and 8/28/12.
j. During the pendency of this personal injury protection claim, Miller settled a personal injury claim wherein he was represented by Ronald I. Croft, Esq.
k. On May 2, 2014, four months after Hopkins filed this lawsuit, Mr. Croft sent a letter to Hopkins stating in part,
…
This letter is being sent to respectfully request that Hopkins Clinic for Physical Medicine consider accepting the amount of $1,000.00 in full and final satisfaction of the outstanding balance. If agreement can be reached, we would be able to mail payment promptly.
Please complete the below, indicating your decision, and fax this letter back to my office. Please feel free to contact me if you should wish to discuss this request. Any courtesy you could extend would be greatly appreciated.
l. Page 2 of the May 2, 2014 letter stated as follows,
Clayton W. Hopkins, D.C., agrees to accept the amount of $1,000.00 in full and final satisfaction of the outstanding balance of Douglas Miller with regard to treatment of injuries he sustained in the above referenced collision. (emphasis added)
Date: 5-5-14 Hopkins signature
Name (Printed): C. Hopkins
On behalf of Clayton W. Hopkins, D.C.
ISSUE
Whether the settlement agreement signed by Hopkins, on May 5, 2014, settled the claim in the present lawsuit against Travelers.RULING
Defendant, Travelers, argues that the settlement agreement signed by Hopkins reflects he agreed to accept $1,000.00 in full and final satisfaction of the outstanding balance of Douglas Miller. Douglas Miller’s outstanding balance includes the amount for which Hopkins attempts to collect from Travelers through this personal injury protection breach of contract lawsuit. Defendant argues if Miller does not owe Hopkins any more payments for medical services as a result of injuries sustained in the motor vehicle accident, neither does Travelers as Hopkins stands in the shoes of Miller as his assignee. Defendant, Hopkins, argues that the settlement agreement only included the 20% of the medical bills not covered by personal injury protection benefits.
A settlement agreement is a contract. An unambiguous contract provision must be afforded its plain meaning. Lazzaro v. Miller & Solomon Gen. Contractors, Inc. 48 So. 3d 974, 975 (Fla. 4th DCA 2010) [35 Fla. L. Weekly D2635d]. The original Consent to Treat, signed by Miller on October 4, 2011, reflects, under the “Guarantee of Payment” provision, that Miller was personally responsible for all services received by Hopkins and promised to pay regardless of any insurance benefits or settlements. The settlement signed by Hopkins, on May 5, 2014, agreed to accept $1,000.00 in full and final satisfaction of the outstanding balance of Douglas Miller with regard to treatment of injuries he sustained in the collision. The language of the agreement is very clear; the payment by Miller to Hopkins satisfied the outstanding balance for medical services. If Miller no longer owes Hopkins any outstanding balance for medical services then Miller no longer has a claim with Travelers for personal injury protection benefits. If Miller does not have a claim with Travelers, Hopkins does not have a claim with Travelers as Hopkins stands in the shoes of the insured assignor, Miller.
Defendant wants this Court to accept affidavits from Miller’s personal injury attorney, Ronald I. Croft, Esq., and Plaintiff, Hopkins, to overcome the summary judgment by creating an issue of fact as to the meaning of the agreement. Those affidavits state the settlement was only for “Miller’s portion of his balance that his PIP coverage did not pay.” If a contract provision is clear and unambiguous, a Court may not consider extrinsic or “parol” evidence to change the plain meaning set forth in the contract. Jenkins v. Eckerd Corp., 913 So. 2d 43, 52 (Fla. lst DCA 2005) [30 Fla. L. Weekly D2291a]. It is a fundamental tenet of contract law that a phrase in a contract is ambiguous only when it is of uncertain meaning, and may be fairly understood in more ways than one. In the event of such ambiguity, a trial court is authorized to admit parol evidence to explain the words and how the contracting parties intended them to be interpreted. However, before a trial court can consider such extrinsic evidence in interpreting a contract, the words used must be unclear such that an ambiguity exists on the face of the contract. Emergency Assoc. of Tampa, P.A. v. Sassano, 664 So. 2d 1000, 1002 (Fla. 2d DCA 1995) [20 Fla. L. Weekly D2313b]. In the present matter, Plaintiff argues that “outstanding balance” referenced in the settlement agreement is ambiguous as two outstanding balances existed, the 20% owed by Miller and the 80% owed by Travelers. Plaintiff’s argument is without merit as only one outstanding balance existed, the balance for the services performed by Hopkins for Miller. Hopkins may submit bills to the insurer for payment of 80% of the balance, but only one balance existed. The Consent to Treat clearly reflects that Miller is responsible for the all services received and promised to pay regardless of insurance benefits or lawsuit settlements. As such, an ambiguity does not exist as it relates to the settlement agreement; thus, this Court cannot rely on the parol evidence in the two affidavits.
This matter is similar to the issue in Sassano, 664 So. 2d at 1000. In Sassano, the parties entered into a noncompetition employment agreement wherein Sassano agreed not to engage in a similar practice within five square miles of his previous employer. (emphasis added) Emergency Associates sued Sassano for violation of the agreement claiming the parties meant a five-mile radius, not five square miles. (emphasis added) The trial court deemed five square miles ambiguous and allowed parol evidence that the intent of the parties was a five-mile radius. The trial court applied the new meaning and found Sassano liable for damages. Id. The Second District Court of Appeal reversed the trial court stating that “when faced with an unambiguous contractual provision such as this one, a trial court cannot give it any other meaning beyond that expressed and must construe the provision in accord with its ordinary meaning.” Id., 664 So. 2d at 1003. The Court further held that in the absence of an ambiguity on the face of a contract, it is well settled that the actual language used in the contract is the best evidence of the intent of the parties and the plain meaning of that language controls. Id. In the present case, the plain meaning of the settlement agreement satisfies the outstanding balance of Douglas Miller. By agreement between Miller and Hopkins, Miller is responsible for payment of all services. No other meaning can be given to “outstanding balance.”
This Court further notes that if the agreement was interpreted as Hopkins and Mr. Croft suggest, Miller is open for additional liability for the services rendered by Hopkins. If Hopkins does not prevail on this claim against Travelers, pursuant to the Consent for Treatment, Miller is responsible for these unpaid bills for chiropractic treatment. As such, Miller has a settlement agreement stating that his outstanding balance is fully satisfied, but his personal injury attorney and chiropractor state this agreement only satisfied 20% of the outstanding balance, not the full outstanding balance.
It is therefore Ordered and Adjudged that Defendant’s Motion for Summary Judgment is GRANTED and Plaintiff, Clayton W. Hopkins, D.C., P.A., takes nothing from Defendant, Travelers Home and Marine Insurance Company, and said Defendant shall go hence without day. This Court reserves jurisdiction to address any issues of attorney’s fees and costs.
