25 Fla. L. Weekly Supp. 546c
Online Reference: FLWSUPP 2506IGNAInsurance — Personal injury protection — Coverage — Emergency services — Deductible — Insurer erred by applying bill from emergency service provider to deductible despite fact that bills from other medical providers were received before that of emergency service provider — All claims, including those of emergency service providers, are to be applied to PIP deductible in order that they are received
FLORIDA EMERGENCY PHYSICIANS KANG & ASSOCIATES, MD, PA a/a/o Crystal Ignacio, Plaintiff, v. USAA CASUALTY INSURANCE COMPANY Defendant. County Court, 9th Judicial Circuit in and for Orange County. Case No. 2013-SC-010715-O. August 5, 2017. Martha C. Adams, Judge. Counsel: William S. England, Bradford Cederberg, P.A., Orlando, for Plaintiff. Nishant P. Patel, Orlando, for Defendant.
ORDER ON PLAINTIFF’S AND DEFENDANT’SMOTIONS FOR SUMMARY JUDGMENT
This cause came on for consideration by the undersigned on the Plaintiff’s and Defendant’s Motions for Summary Judgment, a hearing was held July 26, 2017, and the court having heard arguments of counsel and being otherwise fully advised in the premises, finds the following:FINDINGS OF FACT
This is a claim for PIP benefits arising out of a motor vehicle collision that occurred on or about June 28, 2013. At the time of the crash, Crystal Ignacio (“Ignacio”) was insured under a Policy issued by the Defendant, USAA CASUALTY INSURANCE COMPANY (“USAA”) which provided $10,000 in PIP benefits and purportedly contained a $500 deductible.
The Plaintiff, FLORIDA EMERGENCY PHYSICIANS KANG & ASSOCIATES, M.D., P.A., (“FEP), are licensed physicians under chapters 458 or 459 who provide emergency services and care, as defined in s. 395.002(9).
Following the accident, Ignacio presented to Florida Hospital, where she received emergency services and care from FEP.
USAA received three bills for Ignacio’s care.
The FIRST medical bill was received by USAA on July 15, 2013, from Florida Hospital for $3,296.
The SECOND medical bill was also received on July 15, 2013 by USAA from Camol Health Services for $341.
USAA then received FEP’s bill of $674 on July 17, 2013.
USAA approved the charge and made payment to FEP for their bill, minus Ignacio’s full $500 deductible, for a partial payment of $139.20.CONCLUSIONS OF LAW
Both sides look to Mercury Insurance Company of Florida v. Emergency Physicians of Central Florida, LLP, 182 So.3d 661 (Fla. 5th DCA 2015) [40 Fla. L. Weekly D2364a] for their arguments. FEP argues Mercury requires all compensable medical bills to be applied to the deductible in the order in which they were received. USAA argues Mercury and the Florida PIP statute requires priority providers, like FEP, to be paid within thirty days.
This Court looks to the line of cases after Mercury from the Fifth District Court of Appeal in concluding USAA is incorrect in their logic. The Court wrote, “in Mercury, this court held that all claims, including EPCF’s priority claim, are properly applied to a personal injury protection deductible in the order that they are received.” Progressive American Insurance Company v. Emergency Physicians of Central Florida, etc., 187 So.3d 898, 899 (Fla. 5th DCA 2016) [41 Fla. L. Weekly D888b].
Accordingly, it is hereby ORDERED AND ADJUDGED that Plaintiff’s Motion for Summary Judgment is GRANTED and Defendant’s Motion for Summary Judgment is DENIED.
