26 Fla. L. Weekly Supp. 326a
Online Reference: FLWSUPP 2604ANICInsurance — Personal injury protection — Coverage — Medical expenses — Reasonable charges — Summary judgment — Insurer’s corporate representative’s deposition testimony that other MRI facilities in provider’s zip code charge same amount as provider and that insurer has approved payment of that amount constitutes admission that provider’s charges are within reasonable range and satisfies provider’s prima facie burden to prove reasonableness of charges — Affidavit of insurer’s expert does not preclude summary judgment in favor of provider on reasonableness issue where affidavit is insufficient to create triable issue
SUMMIT RADIOLOGY, LLC a/a/o Brisly Anicette, Plaintiff, v. STATE FARM FIRE & CASUALTY COMPANY, Defendant. Circuit Court, 17th Judicial Circuit in and for Broward County. Case No. 12-013503 COCE 70. May 15, 2018. Jane D. Fishman, Judge. Counsel: Emilio R. Stillo, for Plaintiff. Joey Rodriguez, for Defendant.
ORDER ON PLAINTIFF’S MOTION FORPARTIAL SUMMARY JUDGMENT REGARDINGREASONABLENESS OF CHARGESAND MEMORANDUM OF LAW
THIS CAUSE having come on for consideration on Plaintiff’s, SUMMIT RADIOLOGY, LLC a/a/o BRISLY ANICETTE, Motion for Partial Summary Judgment Regarding Reasonableness of Charges and Memorandum of Law, and the Court being otherwise fully advised in the premises, it is hereby,
ORDERED AND ADJUDGED that Plaintiff’s Motion is hereby GRANTED.
Analysis and Findings of Fact re: Reasonableness
The Plaintiff filed this lawsuit against Defendant for breach of a contract of personal injury protection benefits under the Florida No-Fault law. It is undisputed that the Defendant’s policy requires the Defendant to pay 80% of all reasonable charges. Reasonableness is a range, not a set number and the Plaintiff argues its charge is within the range of what is reasonable. Plaintiff relies on the affidavit of the owner/operator of Summit Radiology George Rovito MD. Dr. Rovito’s comprehensive affidavit explains how the Plaintiff’s charges were set at $1,750.00 per scan as well as authenticating the bill in question and attesting that the services were rendered. The Plaintiff also relies on the deposition transcript of Defendant’s Corporate Representative Dee Credeur. Ms. Creuder testified that the results of her Geozip investigation revealed that the only other MRI facilities in the Plaintiff’s zip code also charged $1,750.00 per scan.1 Further, Ms. Creudur authenticated Explanations of Review generated by State Farm approving $1,800.00 for an MRI scan. The Court agrees with Plaintiff that payments by State Farm constitute an admission that those charges are within the range of a reasonable charge. The Court finds the Plaintiff has satisfied their prima facie burden as to reasonableness. Pan Am Diagnostics Services, Inc. (a/a/o Fritz Telusma) v. United Auto. Ins. Co., 21 Fla. L. Weekly Supp. 200a (Fla. Broward Cty.2013, Judge Robert W. Lee.); Sea World of Florida Inc. v. Ace American Ins. Co., 28 So.3d 158, 160 (Fla.5th DCA 2010) [35 Fla. L. Weekly D361a].
Dr. Dauer’s Affidavit is Legally and Factually Insufficient
Defendant relied on the affidavit of Dr. Dauer in an attempt to create a triable issue to defeat Plaintiff’s Motion for Partial Summary Judgment as to reasonableness. The Court finds the affidavit insufficient as a matter of law. State Farm Mutual Automobile Insurance Company v. Plantation Open MRI LLC (a/a/o Jessica Hall), 25 Fla.L.Weekly Supp. 698b (Fla.Broward Circuit Ct, September 27, 2017). The Plaintiff also provided the Court with a recent denial of a petition for certiorari from a Broward Circuit Court Order affirming a rejection of Dr. Dauer by Judge Zaccor. State Farm Mutual Automobile Insurance Company v. Pan Am Diagnostic Services , Inc. (a/a/o Richard Prince)(4D17-3848, April 20, 2018). The Court concludes that Dr. Dauer’s testimony is insufficient to demonstrate any disputed issue of material fact on the issue of Plaintiff’s charges and Plaintiff is entitled to Partial Summary Judgment as to the issue of reasonableness of charges.
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1Fountain Imaging and Sky Imaging were the other facilities identified by State Farm.
