26 Fla. L. Weekly Supp. 257a

Online Reference: FLWSUPP 2604ROIGInsurance — Personal injury protection — Coverage — Trial court erred in denying provider’s motion for directed verdict on insurer’s affirmative defense that provider submitted false or misleading statement relating to PIP claim where sole evidentiary support for insurer’s defense consisted of trial testimony by insurer’s corporate representative that she had “information” that there was a “possibility” of false billing by the provider

PACIFIC MEDICAL & REHAB CENTER, a/a/o Arelis Judit Roig, Appellant, vs. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Appellee. Circuit Court, 11th Judicial Circuit (Appellate) in and for Miami-Dade County. Case No. 15-319 AP. L.T. Case No. 07-16611 SP 05. June 12, 2018. An appeal from the County Court for Miami-Dade County, Florida, Wendell M. Graham, Judge. Counsel: David B. Pakula, P.A., for Appellant. Douglas H. Stein, Association Law Group, P.L., for Appellee.

(Before MARIA ESPINOSA DENNIS,¹ SPENCER EIG, AND MICHAEL A. HANZMAN, JJ.)

(EIG, Judge.) Pacific Medical & Rehab Center “(“Pacific”), appeals from a final judgment in its action for PIP benefits against State Farm Mutual Automobile Insurance Company (“State Farm”). Judgment was entered following a trial in which the jury found Pacific’s bills were medically necessary, and that a reasonable amount for its services was $7,795. The jury further found in favor of State Farm on its affirmative defense that Pacific submitted a false or misleading statement relating to its claim for PIP benefits — this jury verdict effectively negated any monetary award Pacific could recover. At the crux of the false statement defense is the question of whether the insured, Arelis Roig, received therapy upon her first visit to Pacific. At the conclusion of evidence, Pacific moved for a directed verdict on State Farm’s false statement defense — the motion was denied. For the reasons detailed below, this Court reverses the lower court’s denial of the directed verdict, and reinstates the jury’s monetary award.

At trial, Pacific introduced the insured’s medical records which included signed statements that she received various treatments and therapies during her initial visit to Pacific. Both parties agree that the sole evidentiary support for State Farm’s false statement defense consisted of trial testimony by State Farm’s corporate representative that she had “information” that there was a “possibility” of false billing by Pacific. These limited statements were insufficient for the jury to determine the nature or source of the corporate representative’s “information,” and provided no opportunity for the jury to determine its reliability or relevance.

“A motion for directed verdict should only be denied and the case submitted to the jury if conflicting evidence has been presented by the parties.” Riedel v. Sheraton Bal Harbour Assoc., 806 So. 2d 530, 533 (Fla. 3d DCA 2001) [26 Fla. L. Weekly D2635a] quoting Williamson v. Superior Ins. Co., 746 So. 2d 483, 485 (Fla. 2d DCA 1999) [24 Fla. L. Weekly D2014a]. The only evidence the instant jury had before it to support the false statement defense required the improper pyramiding of inferences — in such situations, a directed verdict should be granted, and the issue should not be submitted to the jury. Broward Executive Builders, Inc. v. Zota, 192 So. 3d 534, 537 (Fla. 4th DCA 2016) [41 Fla. L. Weekly D1126a]. The purpose of the rule against stacking inferences is “to protect litigants from verdicts based on conjecture and speculation.” Id. citing Stanley v. Marceaux, 991 So. 2d 938, 940 (Fla. 4th DCA 2008) [33 Fla. L. Weekly D2019b]. Based on the foregoing, the final judgment entered below is reversed, and Pacific is entitled to judgment in its favor.

REVERSED and REMANDED. (ESPINOSA DENNIS and HANZMAN, JJ., concur.)

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¹Judge Espinosa Dennis did not participate in oral argument.