24 Fla. L. Weekly Supp. 883a
Online Reference: FLWSUPP 2410VENTInsurance — Personal injury protection — Standing — Assignment — Document assigning benefits, but not specifically assigning right to sue, is nonetheless sufficient to confer standing on medical provider
ORTHOPAEDIC CENTER OF SOUTH FLORIDA, P.A. (a/a/o Yosmany Romero Vento), Plaintiff, vs. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 17th Judicial Circuit in and for Broward County. Case No. COCE 16-002910 (52). November 29, 2016. Giuseppina Miranda, Judge. Counsel: Rafael Katz, Katz & Katz, P.A., Fort Lauderdale, for Plaintiff. Belayne D. Guerrero, Leiter & Belsky, P.A., Fort Lauderdale, for Defendant.
ORDER ON CROSS MOTIONS FOR SUMMARY JUDGMENT
This matter came before the Court for hearing on November 22, 2016 on the parties’ cross motions for summary judgment relative to Defendant’s Second, Third and Fourth Affirmative Defenses. The crux of these defenses rests on the Plaintiff’s “assignment of benefits.”
Plaintiff filed the instant suit for breach of contract alleging that Defendant failed to properly pay personal injury protection benefits for services Plaintiff rendered to Defendant’s insured. Plaintiff claims standing in this matter by virtue of an assignment of benefits given to Plaintiff by its patient, Yosmany Romero Vento, who is the Defendant’s insured. Defendant maintains that Plaintiff does not have standing because the document signed by Plaintiff’s patient is not a valid assignment of rights, but instead a direction to pay. Similarly, Defendant argues that Plaintiff’s suit cannot proceed because Plaintiff failed to comply with Florida Statute 627.736(10) which requires an assignment of benefits to be attached to the statutorily required Presuit Notice of Intent to Initiate Litigation. Because Defendant avers that the assignment is flawed, the Defendant takes the position that the demand letter is also flawed.
After considering the argument of counsel, the relevant case law and otherwise being fully advised in the premises, this Court DENIES Defendant’s Motion for Summary Judgment as to their Second, Third and Fourth Affirmative Defenses and finds in favor of Plaintiff. The Court’s reasoning is as follows.
The assignment of benefits which Plaintiff bases its claim of standing is entitled as follows:
ASSIGNMENT OF INSURANCE BENEFITS, POWER OF ATTORNEY AND RELEASE OF INFORMATION
The document states, in relevant part:
I, the undersigned patient/insured knowingly, voluntarily and intentionally assign the benefits of my No-Fault Policy of automobile insurance, also known as Personal Injury Protection (P.I.P.) and Medical Payments policy of insurance to the above medical provider. This assignment includes overdue interest payments and any potential claim for bad faith. I understand it is the express intention of the provider to accept this assignment of benefits in lieu of demanding payment at the time services are rendered.
The crux of Defendant’s argument is that this document only assigns benefits and not the right to sue and therefore, Plaintiff has no standing. The Court reviewed relevant case law, as cited by both parties and this Court relies on the Fourth District Court of Appeal’s decision in Schuster v. Blue Cross and Blue Shield of Florida, Inc., 843 So.2d 909 (Fla. 4th DCA 2003) [28 Fla. L. Weekly D505a]. In Schuster, the Fourth District held that:
Under Florida law, an insured may assign his right to benefits under a contract of insurance. See, e.g., Miami Children’s Hosp., Inc. v. Malakoff 765 F.Supp. 718 (S.D.Fla.1991)(holding that, under ERISA, an insured may assign his rights to benefits to the medical provider); Hartford Ins. Co. of Southeast v. St. Mary’s Hosp., Inc., 771 So.2d 1210, 1212 (Fla. 4th DCA 2000) [25 Fla. L. Weekly D2523a] (“Courts have recognized that medical service providers can assert claims for PIP benefits against insurers when an insured has assigned them the right to the benefits.”). The effect of such an assignment is to place the insured’s cause of action for such benefits in the provider. See Oglesby v. State Farm Mut. Auto. Ins. Co., 781 So.2d 469 (Fla. 5th DCA 2001) [26 Fla. L. Weekly D702a]. “[O]nly the insured or the medical provider ‘owns’ the cause of action against the insurer at any one time.” Id. at 470.
Id at 911-912.
This Court also relies on the opinion of Judge Rodolfo Ruiz in Center for Diagnostic Imaging A/A/O Sara Paredes v. State Farm Mutual Automobile Ins. Co., 21 Fla. L. Weekly Supp. 352b (Miami Dade County Court, December 23, 2013). In Paredes, Judge Ruiz was faced with a similar attack on standing as the result of an assignment of benefits with similar language. The assignment in Paredes stated:
I hereby assign payment to the Center for Diagnostic Imaging, Ltd., of all medical benefits applicable and otherwise payable to me by my insurance carrier, including HMO, PPO, or any other third-party payer, for services rendered at CDI facility. I understand that I am financially responsible to the Center for Diagnostic Imaging, LTD, for charges not covered by this assignment or for any and all charges which the carrier declines to pay.
As in the case sub judice, State Farm in the Paredes case argued that this language was insufficient to confer standing on Center for Diagnostic Imaging, Ltd., because the only right assigned was to receive payment. Judge Ruiz disagreed.
The most compelling argument advanced by Plaintiff was to direct this Court’s attention to Footnote 1 of Judge Ruiz’s opinion where he stated that he was “provided with copies of the two assignments introduced into evidence in Schuster, and compared the relevant language of these assignments to the assignment of benefits in [the Paredes] case.” Judge Ruiz noted that “the assignments are nearly identical in title and scope; both include strikingly similar direction-to-pay clauses and do not include any language conveying an additional right to file a lawsuit in the event benefits go unpaid.”
Judge Ruiz found the language of the assignment document in Schuster was similar to the language of the assignment of benefits before him in Paredes. In both of those cases, the assignment did not include specific language separately assigning the right to sue. Because the Fourth District Court of Appeal has ruled in Schuster that the assignment served to divest the insured/patient of standing (even though the assignment in the Schuster case did not separately assign the right to sue) this Court finds that the assignment in the instant case, likewise, does not require specific language to afford Plaintiff the right to sue to collect benefits that no longer belong to the insured/patient.
Therefore, the Court finds that the assignment of benefits in the instant case is more than sufficient to confer standing upon the Plaintiff.
Accordingly, it is hereby ORDERED and ADJUDGED that Plaintiff’s Motion for Summary Judgment is GRANTED as to standing to maintain the instant cause of action. Defendant’s Motion for Summary Judgment as to standing and as to the validity of the presuit notice of intent to initiate litigation is DENIED.
