27 Fla. L. Weekly Supp. 638a
Online Reference: FLWSUPP 2707ODONInsurance — Personal injury protection — Stay — Denial — Motion to stay PIP case pending resolution by Florida Supreme Court of certified question as to whether 2013 PIP statute permits insurer to limit payment to 80% of reasonable charges while also limiting payment to 80% of statutory fee schedule is denied where district court of appeal that certified question focused on whether language of the policy before it permitted both methods of reimbursement
AMERICAN CHIROPRACTIC & REHABILITATION, LLC a/a/o Maria O’Donnell, Plaintiff, v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 4th Judicial Circuit in and for Duval County. Case No. 16-2018-SC-6138, Division I. July 9, 2019. Pauline M. Drake, Judge. Counsel: Adam Saben, Shuster & Saben, LLC, Jacksonville, for Plaintiff. Catherine V. Arpen, Dutton Law Group, Jacksonville, for Defendant.
ORDER DENYING MOTION TO STAYPENDING SUPREME COURT RESOLUTION ONMRI ASSOCIATES OF TAMPA, INC., V. STATE FARMMUTUAL AUTOMOBILE INSURANCE COMPANY(MRI ASSOCIATES)
Facts:
This Cause was heard on the Plaintiff’s Motion to Stay in which the Defendant opposed. The Plaintiff in this cause advised the Court that there were no conflicting opinions among the District Court of Appeals, however, this cause has been certified by the Second District Court of Appeals as one of “great public importance.”
The Defendant in this cause presented argument that although they had been granted a Stay in some cases, that they were opposing the Stay in this case as there was no conflicting opinions among the District Court of Appeals, therefore, this case should proceed.
Law:
It is clear to this Court that analysis or review of the jurisdiction of the Supreme Court must be reviewed. The appellate jurisdiction of Florida courts is derived primarily from Article V of the Florida Constitution. Article V confers appellate jurisdiction on the Florida Supreme Court and District Courts of Appeals, and authorizes appellate jurisdiction in the Circuit courts when provided by General Law.
The Second District Court of Appeals, however, certified an issue of “great public importance” which did not resolve the issue of “reasonableness” and fee schedules.
The question certified by the Second DCA is as follows:
DOES THE 2013 PIP STATUTE AS AMENDED PERMIT AN INSIURER TO CONDUCT A FACT-DEPENDENT CALCULATION OF REASONABLE CHARGES UNDER SECTION 627.736(5)(A) WHILE ALLOWING THE INSURER TO LIMIT ITS PAYMENT IN ACCORDANCE WITH THE SCHEDULE OF MAXIMUM CHARGES UNDER SECTION 627.736(5)(a)(1)?
This Court has read the opinion of State Farm Mut. Auto Ins. Co. v. MRI Associates of Tampa, Inc., d/b/a Park Place MRI, 252 So. 3d 773, (2018) [43 Fla. L. Weekly D1149a], in which the Second District Court held that policy validly permitted insurer to limit payment to 80% of schedule of maximum charges while also limiting payment to 80% of properly billed and documented reasonable charge. It would seem that in its holding the Court specifically focused on the language or clear meaning of the policy.
The Second DCA specifically referred to the policies created after the 2012 amendment to the PIP statute and found that the holdings in Virtual Imaging nor Orthopedic Specialist do not apply after the 2012 amendments.
Therefore, the Motion to Stay is DENIED. This case shall proceed with the issues dealing with the language of the policy in question. Although the question was certified to be of great public importance, it is the language of the policy that the Second DCA seemed to have focused.
