25 Fla. L. Weekly Supp. 1038a
Online Reference: FLWSUPP 2512SEIJInsurance — Personal injury protection — Coverage — Medical expenses — Statutory fee schedules — Clear and unambiguous election by insurer — Declaratory action — Motion to dismiss declaratory action seeking determination as to whether PIP policy clearly and unambiguously elects payment methodology is denied — Fact that insured has available remedy through breach of contract action does not preclude declaratory relief
PROFESSIONAL MEDICAL BUILDING GROUP, INC., a/a/o Daniel Seijas, Plaintiff, v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 11th Judicial Circuit in and for Miami-Dade County. Case No. 2014-7479SP25. February 6, 2018. Linda Diaz, Judge. Counsel: Walter A. Arguelles, Arguelles Legal, P.L., Miami, for Plaintiff. Gregory Willis, Cole, Scott & Kissane, P.A., for Defendant.
ORDER DENYING DEFENDANT’S MOTION TODISMISS COUNT III OF PLAINTIFF’S COMPLAINTFOR DECLARATORY RELIEF
THIS CAUSE, having come before the Court on February 5, 2018, upon Defendant’s Motion to Dismiss Count I and III of Plaintiff’s Complaint for Declaratory Relief, and the Court having heard argument of counsel, reviewed the complaint, the motion, the Court file, and all relevant legal authorities, and otherwise having been fully advised in the premises, the Court finds as follows:
Both parties have agreed to voluntarily dismiss Count I of Plaintiff’s Complaint.
Count III of Plaintiff’s complaint seeks declaratory relief pursuant to Chapter 86, Florida Statutes. Count III of Plaintiff’s Complaint requests a declaratory judgment. Plaintiff contends that State Farm’s insurance policy fails to clearly and unambiguously notify its insureds of the method in which it will reimburse “medical benefits” as its insurance policy contains numerous different payment methodologies and possibilities for calculating PIP benefits. Plaintiff contends that an insurer is allowed to choose between two different payment calculation methodology options and the insurer must make a choice between those two options. Specifically, whether State Farm can combine the two methods, or pick and choose among the terms and conditions of both in order to create a new hybrid method.
The Defendant alleges that a Declaratory Judgment is not the proper vehicle for the Plaintiff, that Plaintiffs Declaratory Action is better addressed by way of an action for breach of contract, that Plaintiff is seeking an advisory opinion and that the complaint fails to state a cause of action. Defendant also contends that the Court granted Plaintiff’s Motion for Summary Judgment as to the Application of the Medicare Part B and Worker’s Compensation Fee Schedules and as such there is no dispute.
Pursuant to Florida Statute Section 86.011, a court may render a declaratory judgment on the existence, or non-existence of any immunity, power, privilege or right. The court finds that Plaintiff’s Complaint more than adequately sets out a short and plain statement of the ultimate facts Plaintiff is alleging in its complaint. Plaintiff’s complaint demonstrates from the four corners of the complaint that there is a bona fide, actual, present practical need for the declaration sought.
In this instant case Plaintiff files its declaratory action in order to determine whether State Farm’s insurance policy is unambiguous and clear as to its chosen methodology of payment under the policy.
Defendant contends that Plaintiffs declaratory action is better addressed by way of an action for breach of contract. This Court finds that the Plaintiff has the right to choose its legal strategy and the right to pursue its chosen legal path. The mere existence of another remedy at law does not preclude a judgment for declaratory relief. Maciejewski vs. Holland, 441 So.2d 703 (1983).
When reviewing a motion to dismiss, the Court must view the complaint in the light most favorable to the Plaintiff and the court is only limited to the facts alleged within the four corners of the Complaint. Minor v. Brunetti, 43 So.3d 178, 179 (Fla. 3d DCA 2010) [35 Fla. L. Weekly D2013a]; Swerdlin v. Florida Municipal Insurance Trust, 162. So.3d 96, 97 (Fla. 4th DCA 2014) [39 Fla. L. Weekly D2164c].
As such, it is therefore ORDERED AND ADJUDGED that Defendant’s Motion to Dismiss Count III of Plaintiff’s complaint for Declaratory Relief is hereby DENIED. Defendant shall respond to the Plaintiff’s Complaint within 20 days of this Order.
