25 Fla. L. Weekly Supp. 192a
Online Reference: FLWSUPP 2502ESTEInsurance — Personal injury protection — Demand letter with enclosed ledger did not comply with statute where ledger reflected a zero balance
INJURY CENTERS OF ST. PETE, INC., a/a/o Stetson Estes, Plaintiff, vs. GARRISON PROPERTY AND CASUALTY INSURANCE COMPANY A/K/A USAA, Defendant. County Court, 13th Judicial Circuit in and for Hillsborough County. Case No. 16-CC-009526, DIVISION U. March 22, 2017. Frances M. Perrone, Judge. Counsel: Stephen Cofer, for Plaintiff. Stephen B. Farkas, Dutton Law Group, P.A., Tampa, for Defendant.
ORDER ON DEFENDANT’S MOTION FOR SUMMARYJUDGMENT FOR FAILURE TO SERVE ASTATUTORILY COMPLIANTPRE-SUIT DEMAND
THIS CAUSE came on before the Court on March 6, 2017, upon Defendant’s Motion for Summary Judgment for Failure to Serve a Statutorily Compliant Pre-Suit Demand. Counsel for both parties appeared before the Court. After having heard arguments of counsel, considered the Defendant’s Motion and Affidavit, and being otherwise duly advised in the premises, the Court finds as follows:
1. Plaintiff directed a purported demand letter to Defendant, dated January 27, 2016, demanding payment of $1,097.77 for dates of service November 3, 2014 through March 13, 2015.
2. Plaintiff’s purported demand letter contained enclosures, one of which was an itemized billing ledger, listing the dates of service identified in the purported demand letter. In contrast to the amount demanded by Plaintiff’s letter, the ledger reflected a $0.00 balance for the “Patient,” “Insurance,” and the overall “Total” balance.
3. Section 627.736(10), Fla. Stat., sets forth the condition precedent to the filing of an action to recover personal injury protection benefits, and provides in pertinent part:
(10) DEMAND LETTER. —
(a) As a condition precedent to filing any action for benefits under this section, written notice of an intent to initiate litigation must be provided to the insurer. Such notice may not be sent until the claim is overdue, including any additional time the insurer has to pay the claim pursuant to paragraph (4)(b).
(b) The notice must state that it is a “demand letter under s. 627.736” and state with specificity:
* * *
3. To the extent applicable, the name of any medical provider who rendered to an insured the treatment, services. . . ; and an Itemized statement specifying each exact amount, the date of treatment, service, or accommodation, and the type of benefit claimed to be due. …
F.S. 627.736(10)(b)3.
4. The Court notes that the 13th Judicial Circuit Court, in its appellate capacity, has ruled on the issue of specificity with respect to demand letters required under § 627.736(10), Fla. Stat. Specifically, in Chambers Medical Group, Inc., (a/a/o Marie St. Hillare), v. Progressive Express Insurance Co., 14 Fla. L. Weekly Supp. 207a (Fla. 13th Cir. Ct. [Appellate] Dec. 1, 2006), the Court held that a medical provider must strictly comply with the requirements of § 627.736(10), Fla. Stat., and that “inaccurate, misleading, illegible or stale information contained in a demand does not strictly comply with the statutory requirement.” Further, in Chambers, the Court recognized that “[a] substantial compliance standard would trigger significant litigation as to the sufficiency of the papers attached to a demand letter, the result of which would be that payment of claims would cease to be automatic, and providers would be relieved of their obligation under the statute.”
5. This Court is bound by the decision in Chambers Medical Group, Inc., (a/a/o Marie St. Hillare), v. Progressive Express Insurance Co., 14 Fla. L. Weekly Supp. 207a, as it is the prevailing law in Hillsborough County and as such, this Court is bound to apply the strict compliance standard articulated therein.
6. The Court finds that Plaintiff’s purported demand letter, together with the enclosed ledger, do not satisfy the condition precedent as set forth in § 627.736(10), Fla. Stat.
7. The Court further finds that the ledger enclosed with Plaintiff’s purported demand letter is inaccurate and misleading, and as such, Plaintiff has not satisfied the condition precedent to filing this action for the recovery of personal injury protection benefits.
THEREFORE, IT IS ORDERED AND ADJUDGED AS FOLLOWS:
1. Defendant’s Motion for Summary Judgment for Failure to Serve a Statutorily Compliance Pre-Suit Demand is hereby GRANTED.Judgment is hereby entered in favor of Defendant, GARRISON PROPERTY AND CASUALTY INSURANCE COMPANY, and Defendant shall go hence without delay. Plaintiff, INJURY CENTERS OF ST. PETE, INC. a/a/o Steston Estes, shall take nothing by this action.
2. The Court reserves jurisdiction to determine Defendant’s entitlement to an award of fees and costs.
