24 Fla. L. Weekly Supp. 867a
Online Reference: FLWSUPP 2410EXPOInsurance — Summary judgment — Affidavit in opposition to motion for summary judgment creates genuine issue of material fact as to whether medical provider knowingly submitted false or misleading statement related to claim or charges — Insurer’s motion for summary judgment denied
PARADISE GENERAL MEDICAL CENTER (a/a/o Manuel Exposito), Plaintiff, v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 11th Judicial Circuit in and for Miami-Dade County. Case No. 13-2680 CC 24. December 7, 2016. Donald J. Cannava, Judge. Counsel: Erick Evans, The Patino Law firm, for Plaintiff. Jonathan Brooks, Managing Partner, Jonathan Brooks, P.A., for Defendant.
ORDER DENYING DEFENDANT’S MOTIONFOR SUMMARY JUDGMENT PURSUANT TOFLORIDA STATUTE §627.736(5)(b)(1)(c)
THIS CAUSE, having come before the Court for hearing on October 18, 2016, For Defendant’s Motion for Summary Judgment, and the Court, having reviewed the pleadings and motions, heard the argument of Counsel, and being otherwise duly advised in the premises, the Court finds and orders as follows:
The Court finds there to be a genuine dispute as to material issues of fact including but not limited to: whether the Plaintiff knowingly submitted a false or misleading statement related to the claim or charges.
The Court finds that the affidavit filed by the Plaintiff in response to the Defendant’s Motion for Summary Judgment creates a genuine issue of material fact relating to the treatment of the patient and the subsequent submission of the bills. The Court further finds that the affidavit testimony is based on both personal knowledge and the establishment of the routine practice of the Plaintiff organization in billing for treatment and the submission of medical bills to insurers. See Fla. Stat. 90.406; Tabb v. Fla. Birth-Related Neurological Injury Comp. Ass’n., 880 So.2d 1253, 1259 (Fla. 1st DCA 2004) [29 Fla. L. Weekly D1982b] (The existence of a routine practice creates an inference that an agent or employee of the organization acted according to the practice) quoting Lumbermens Mut. Cas. Co. v. Alvarez, 443 So.2d 279, 281 (Fla. 3d DCA 1983)(“The impact of Section 90.406 on the case at hand is that [the Defendant’s] testimony as to the routine practice of the insurance agency is not to be disregarded, as it was below, merely because it is uncorroborated and indeed is contradicted by [the Plaintiff’s] ‘eyewitnesses’ denial; instead, [the defendant’s testimony is to be weighed and considered by the trier of facts as any other type of evidence.”)(Emphasis Added); See also Shands Teaching Hosp. and Clinics v. Dunn; 977 So.2d 594, 599 (Fla. 1st DCA 2007) [32 Fla. L. Weekly D2755a]
Accordingly, the Defendant’s Motion for Summary Judgment Pursuant to Florida Statute §627.736(5)(b)(1)(c) is hereby DENIED.
