27 Fla. L. Weekly Supp. 751a
Online Reference: FLWSUPP 2708KINGInsurance — Personal injury protection — Coverage — Medical expenses — Exhaustion of policy limits — Where insurer exhausted benefits in payment to other medical providers, and plaintiff’s allegations of payment of invalid or untimely claims are not supported by record, summary disposition is entered in favor of insurer — Plaintiff cannot raise defense of statute of limitations on behalf of insurer with respect to other providers’ claims
QUALITY PERFORMANCE REHABILITATION, INC. a/a/o Adele King, Plaintiff, v. GEICO GENERAL INSURANCE COMPANY, Defendant. County Court, 19th Judicial Circuit in and for St. Lucie County. Case No. 562018SC000534AXXXHC. September 16, 2019. Isenhower, Judge. Counsel: Jonathan Phillips, West Palm Beach, for Plaintiff. Manshi Shah, The Law Office of Jeffrey R. Hickman, West Palm Beach, for Defendant.
ORDER ON DEFENDANT’S MOTION FOR SUMMARYDISPOSITION — EXHAUSTION OF PIP BENEFITS
THIS CAUSE having come on to be heard on August 28, 2019, on Defendant’s Motion for Final Summary Disposition — Exhaustion of PIP Benefits and Memorandum of Law1, and the Court having reviewed the aforementioned motion, the relevant legal authority, heard argument of counsel, and been sufficiently advised on the premises, it is hereby ordered:
1. Defendant’s Motion for Final Summary Disposition — Exhaustion of PIP Benefits is granted.
2. Adele King purchased an automobile insurance policy from the Defendant. The insurance policy provided for $10,000.00 in Personal Injury Protection (PIP) benefits.
3. Prior to April 1, 2013, Defendant received numerous bills for services provided to Adele King from various providers. The total charged in these bills was $13,512.25.
4. Prior to April 1, 2013, Defendant issued payments related to those bills totaling $9,232.10.
5. On April 6, 2013, Defendant received a bill for services provided to Adele King from Omar David Hussamy M.D., P.A. The total charged in this bill was $12,254.88.
6. On April 8, 2013, Defendant received a bill for services provided to Adele King from Vero Beach Surgery Center LLC. The total charged in this bill was $6,000.00.
7. On April 15, 2013, Defendant received a bill for services provided to Adele King from Anesthesia of Indian River. The total charged in this bill was $765.00.
8. On April 26, 2013, Defendant exhausted benefits when Defendant issued payment to Omar David Hussamy M.D., P.A. for $767.90 for the bill received on April 6, 2013.
9. After April 26, 2013, Defendant received the bills at issue here.
10. On February 20, 2018, Plaintiff served Defendant with a Complaint alleging overdue PIP benefits.
11. On June 20, 2019, Defendant filed Defendant’s Motion for Final Summary Judgment (Disposition) — Exhaustion of PIP Benefits and Memorandum of Law.
12. Defendant argues the following:
a. The benefits became exhausted in this matter when Defendant issued payment to Omar David Hussamy M.D., P.A. for $767.90 for the bill received on April 6, 2013.
b. If gratuitous payments, improper payments, or payment of invalid claims occurred, those amounts would be less than the amounts owed Omar David Hussamy M.D., P.A., Vero Beach Surgery Center LLC, and Anesthesia of Indian River for those bills submitted to Defendant prior to the bills at issue here.
13. Plaintiff argues the following:
a. There were “gratuitous payments, improper payments, and payment of invalid claims.”
b. Bills do not have to be paid in the order received.
c. The claims of other providers are past the statute of limitations.
14. In Coral Imaging Servs. v. GEICO Indemnity Co., the Court ruled when an insurer paid untimely PIP bills, then those payments were “gratuitous payments” and did not count toward the $10,000.00 in PIP benefits. 955 So.2d 11 (Fla. 3rd DCA 2006) [31 Fla. L. Weekly D2478a]. See also Geico Indem. Co. v. Gables Ins. Recovery, 159 So.3d 151 (3rd DCA 2014) [39 Fla. L. Weekly D2561a] (wherein the 3rd DCA narrowed its own ruling in Coral Imaging).
15. Here, there is no record evidence that Defendant paid untimely bills, and therefore, there are no “gratuitous payments.”
16. Moreover, Plaintiff’s allegations of “improper payments and payment of invalid claims” is not supported by the record.
17. Insurers are wise to pay compensable bills in the order received in order avoid allegations that the insurer prefers one provider over another.
18. Statute of Limitations is an affirmative defense. There is no authority suggesting Plaintiff may raise it on behalf of the Defendant with respect to other providers.
Based on the foregoing, the Court finds that there is no triable issue. Therefore, it is hereby ORDERED AND ADJUDGED:
Defendant’s Motion for Final Summary Disposition — Exhaustion of PIP Benefits is GRANTED. Plaintiff shall take nothing from this action, and Defendant shall go hence without day.
The Court reserves jurisdiction to determine Defendant’s entitlement to and amount of attorneys’ fees and costs.
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1Although an Order Invoking the Rules of Civil Procedure was entered in this case, the Court specifically retained Small Claims Rule 7.135 Summary Disposition which states:
At pretrial conference or at any subsequent hearing, if there is no triable issue, the court shall summarily enter an appropriate order or judgment.
