27 Fla. L. Weekly Supp. 637a
Online Reference: FLWSUPP 2707NORTInsurance — Personal injury protection — Coverage — Medical expenses — Statutory fee schedules — Clear and unambiguous election by insurer — Motion to stay proceedings pending Florida Supreme Court’s resolution of question certified by district court of appeal denied — Because there are material differences between the certified question and the issue before the court in the instant case, it is clear that Florida Supreme Court’s decision will not affect outcome of lawsuit
MONUMENT 9A IMAGING & DIAGNOSTIC CENTER, LLC a/a/o Britt Norton, Plaintiff(s), v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant(s). County Court, 4th Judicial Circuit in and for Duval County. Case No. 2016-SC-7445, Division CC-M. September 10, 2019. Mose Floyd, Judge. Counsel: Todd Landau, for Plaintiff. Kara K. Cosse, Kubicki Draper, Jacksonville, for Defendant.
ORDER DENYING PLAINTIFF’S MOTION TO STAY
THIS MATTER, having come before the Court at the August 26, 2019 hearing on Plaintiff’s Motion to Stay Proceedings, it is:
ORDERED AND ADJUDGED:
1. Plaintiff’s Motion to Stay Proceedings pending the Florida Supreme Court’s decision in MRI Assocs. of Tampa, Inc. v. State Farm Mutual Auto. Ins. Co., (Case No. SC-18-1390) (July 17, 2019 Order accepting jurisdiction) is hereby DENIED.
2. The question certified by the Second District Court of Appeal, and accepted by the Florida Supreme Court, in MRI Assocs. of Tampa is:
DOES THE 2013 PIP STATUTE AS AMENDED PERMIT AN INSURER 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)?
However, the sole issue in the case at bar, as stated by Plaintiff in Plaintiff’s Motion to Stay Proceedings, is “. . . whether State Farm’s insurance policy notifies State Farm’s insureds (and their medical providers) of State Farm’s supposed election to use the fee schedule reimbursement limitations authorized by section 627.736(5)(a)1 a.-f., Florida Statutes (2013).” In support of Plaintiff’s Motion, Plaintiff advises this Court that the “Florida Supreme Court has recently accepted jurisdiction to review precisely the same question presented in this action” and their opinion “will be controlling.” The Court disagrees with Plaintiff’s statement. The Florida Supreme Court was not asked to confirm the Second District Court of Appeals’ decision that State Farm’s 9810A policy clearly and unambiguously elected to limit reimbursement to the schedule of maximum charges; rather, the Florida Supreme Court was asked to determine whether the PIP Statute permits a fact-dependent reasonable charge calculation when the insured has limited payment based on the schedule of maximum charges.
3. Due to the material differences between the certified question in MRI Assocs. of Tampa and the issue before the Court in this case, it is clear that the Florida Supreme Court decision will not affect the outcome of this lawsuit. Therefore, it is unnecessary to stay the case, and Defendant’s Motion for Summary Judgment regarding its 9810A policy election to limit reimbursement to the schedule of maximum charges shall be set for hearing.
