27 Fla. L. Weekly Supp. 302a
Online Reference: FLWSUPP 2703PIECInsurance — Personal injury protection — Coverage — Deductible — Even if PIP insurer improperly reduced medical provider’s bill through application of statutory fee schedule before applying deductible to charges, where it is undisputed that bill is less than PIP policy deductible, such that bill would not have been reimbursed by PIP insurer whether deductible was applied to 100% of bill or not, provider did not suffer any damages on which to base breach of contract action — Declaratory action is dismissed — There is no private right of action for violations of PIP statute
PIECAR COMMUNITY HEALTHCARE LLC, Plaintiff, v. PROGRESSIVE AMERICAN INSURANCE COMPANY, Defendant. County Court, 9th Judicial Circuit in and for Orange County. Case No. 2016-SC-021981-O. August 23, 2018. David P. Johnson, Judge. Counsel: Dave T. Sooklal, Orlando, for Plaintiff. Rebecca L. Bench and Robert M. Lyerly, Progressive PIP House Counsel, Maitland, for Defendant.
ORDER ON DEFENDANT’S MOTIONFOR FINAL SUMMARY JUDGMENT
This cause having come before this court on Defendant’s Motion for Final Summary Judgment, and the Court having reviewed the file and being fully advised in the premises, it is
ORDERED and ADJUDGED as follows:
That the Defendant’s Motion for Final Summary Judgment is GRANTED as discussed herein. The Plaintiff filed its Complaint for breach of contract and Amended Complaint adding a count for declaratory relief. It is undisputed that in processing the Plaintiff’s bill, the Defendant applied the Medicare fee schedule before applying the deductible to the charges, and, it is also undisputed that the Plaintiff’s bill is less than the deductible amount of the policy at issue and would not have been paid whether the deductible had been properly applied to 100% of the bill or not. Either way, the Plaintiff would not be entitled to any damages in this suit.
The Plaintiff has the burden in a breach of contract claim to prove; (1) a contract existed; (2) the contract was breached; and (3) that damages flowed from that breach. See A.R. Holland, Inc. v. Wendco Corp., 884 So. 2d 1006 (Fla. 1st DCA 2004) [29 Fla. L. Weekly D2209a]. Without damages, there is no basis for a bringing a suit for breach of contract, and, as stated above, the Court cannot find that the Plaintiff suffered any damages in this case.
The Plaintiff’s Amended Complaint asking for declaratory relief provides no remedy to the lack of damages issue. If the Court found that the deductible was applied improperly in resolving the declaratory relief requested, what would the damages be? Even if damages could be somehow determined, the basis for awarding anything would be that the Defendant failed to follow Fla. Stat. §627.736 and the Defendant correctly points out that there is no private right of action for the violating the statute. See United Auto Ins. Co. v. A 1st Choice Healthcare Systems, 21 So. 3d 124 (Fla. 3d DCA 2009) [34 Fla. L. Weekly D2268a].
Without damages, no count for breach of contract can stand, and without a private right of action for failing to comply with a statute there is no basis upon which the Court can find that the Plaintiff would be entitled to anything.
