26 Fla. L. Weekly Supp. 509a
Online Reference: FLWSUPP 2606FRANInsurance — Personal injury protection — Discovery — Reasonableness of charges — Geozip or community pricing report — Insurer is compelled to produce documentation indicating what other medical providers within geographic region charged for CPT codes at issue during specific time frame
AMERICAN MEDICAL AND REHAB CENTER a/a/o Micheline Francois, Plaintiff, v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, a foreign corporation, Defendant. County Court, 11th Judicial Circuit in and for Miami-Dade County. Case No. 14-15577 SP 25 (2). July 31, 2018. Elijah Levitt, Judge. Counsel: Walter A. Arguelles, Arguelles Legal, P.L. Miami, for Plaintiff. Kevin Guerrero, Green, Murphy, Murphy & Kellam, Ft. Lauderdale, for Defendant.
ORDER ON PLAINTIFF’S MOTION TO OVERRULEOBJECTIONS AND TO COMPEL BETTER RESPONSESTO REQUEST FOR PRODUCTIONAND FOR ATTORNEY’S FEES AND COSTS
THIS CAUSE came before the Court on July 18, 2018, upon the Plaintiff’s Motion to Overrule Objections and to Compel Better Response to Request for Production and for Attorney’s Fees and Costs, and the Court having reviewed the motion and entire Court file, heard arguments from counsel for each party, and having been sufficiently advised in the premises, finds as follows:
The Plaintiff filed the subject action on the allegations that the Defendant failed to tender proper payment pursuant to its policy of insurance and Florida Statute § 627.736. During litigation, the Plaintiff propounded discovery upon the Defendant in the form of a Request for Production that requested, inter alia, documentation and information which indicates what other providers within the geographic region charged for the CPT Codes at issue during a specific timeframe. The Defendant objected to the Plaintiff’s Request for Production. In response, the Plaintiff filed its Motion to Overrule Objections and to Compel Better Response to Request for Production and set the matter for hearing.
Florida’s No Fault Statute indicates that, with respect to a determination of whether a charge for a service is reasonable, consideration may be given to reimbursement levels in the community and other information relevant to the reasonableness of the reimbursement for the service. § 627.736(5)(a)(1), Fla. Stat. The Court finds that the information requested falls squarely within the ambits of this statute. Plaintiff also provided the Court with copies of at least four Miami-Dade County Court orders in which insurance company defendants have been ordered to create Community Pricing Reports. Clearly, these Courts find the information is relevant for discovery purposes, and this Court is persuaded by their judgments on this same issue in favor of production.
Further, a Defendant may not object to a discovery request seeking the factual basis for its denial of a matter for which the Plaintiff has the burden of proof based upon a claim of “burden-shifting.” See South Florida Pain and Rehabilitation of Hialeah LLC a/a/o Fabian Rodriguez v. Star Casualty Insurance Co., 24 Fla. L. Weekly Supp. 49a (Fla. Broward Cty. Ct. March 8, 2016). Defendant’s objection on the argument of burden-shifting is overruled.
Lastly, Allstate Insurance Company v. Pinder, 746 So. 2d 1255 (5th DCA 1999) [25 Fla. L. Weekly D136a], is inapplicable to the present situation. The Court is ordering the Defendant to produce information in its computerized records database. Although the Defendant may have to provide the information in a certain format due to its own internal computer programs, the requested information contained within a zip code is certainly in the Defendant’s possession. The Court takes no position on whether the correct term of art for the production is “Geozip” or “Community Pricing Report.” The Defendant simply must produce the information described below in a format that is readily comprehensible.
Therefore, it is ORDERED and ADJUDGED that:
1. Plaintiff’s Motion to Overrule Objections and to Compel Better Response to Request for Production is hereby GRANTED IN PART. The Motion is DENIED as to the request for Attorney’s Fees and Costs.
2. The Defendant shall provide the information identified in paragraph 3 below for three months prior to the first date of service to three months after the last date of service for the CPT codes at issue within zip code 33032.
3. The information shall contain the identity of provider (to be identified numerically), the CPT Code, the date of service, the provider’s submitted charge for each CPT Code at issue, and the approved amount and/or allowed amount for each CPT Code at issue.
4. Defendant must provide this information within forty-five (45) days of this Order.
