25 Fla. L. Weekly Supp. 361a
Online Reference: FLWSUPP 2504SEWEInsurance — Personal injury protection — Coverage — Medical expenses — Statutory fee schedules — Notice — Policy which clearly states that it will be using schedule satisfies notice requirement
EXCEL MEDICAL IMAGING, P.L. (as assignee of William Sewell), Plaintiff(s), vs. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant(s). County Court, 6th Judicial Circuit in and for Pasco County, Civil Division. Case No. 51-2016-SC-1718-WS, Division W. May 30, 2017. Anne Wansboro, Judge. Counsel: Lindsay Porak, Deitsch & Wright, P.A., Lake Worth, for Plaintiff. Roy A. Kielich, Oxendine and Oxendine, P.A., Tampa, for Defendant.
AMENDED* ORDER GRANTING DEFENDANT’SMOTION FOR SUMMARY DISPOSITION
THIS CAUSE came before the Court on May 1, 2017 upon the Defendant’s Motion for Summary Judgment, which the Court treats as a Motion for Summary Disposition.
The issue is whether the Defendant complied with the statutory requirement that its policy include a notice that the insurer may limit payment pursuant to the schedule of charges specified in Florida Statute Section 627.726(5)(a)(5). The Court heard argument from both sides and has reviewed the case law.
The Defendant advised the insured that “[t]he most we will pay for such reasonable medical expenses is 80% of the ‘schedule of maximum charges’ found in the Florida Motor Vehicle No-Fault Law and in the Limits section of the Florida Car policy’s No-Fault Coverage.” The Plaintiff argues that the policy refers to both the reasonableness method of calculation and to the Schedule, and is therefore ambiguous.
The Court agrees with the analysis in the Order Granting Defendant’s Amended Motion for Partial Summary Judgment and Denying Plaintiff’s Motion for Partial Summary Judgment, Lake Worth Chiro. Assoc., Inc., d/b/a Chiro. Assoc. of Lake Worth a/a/o Ana Hernandez v. State Farm Mutual Auto. Ins. Co., No. 50-2016-SC-006521 XXXX SB RS (Fla. Palm Beach Cty. Ct. March 6, 2017) [24 Fla. L. Weekly Supp. 964a], which indicates that an insurer is not at liberty to remove the “reasonableness” coverage mandate, and concludes that a policy which clearly states it will be using the Schedule satisfies the notice requirement. In the case at bar, the policy clearly states it will be using the Schedule; therefore, the Defendant has satisfied the notice requirement, and the Defendant’s Motion for Summary Disposition is GRANTED as to the notice requirement.
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*Amended to change “Denying” to “Granting” in the title, and to change “Summary Judgment” to “Summary Disposition” in the penultimate paragraph.
