4 Fla. L. Weekly Supp. 509c
Arbitration — Insurance — Personal injury protection — Statute requiring insurers to include within each PIP policy a provision offering arbitration as an option to dispute resolution does not provide for mandatory arbitration — Assignee of policy which did not contain a provision requiring arbitration of claims between insurer and insured was not required to submit to binding arbitration
PHYSICIANS DIAGNOSTIC AND REHAB, INC., Appellant, v. PROGRESSIVE CASUALTY INSURANCE COMPANY, Appellee. Circuit Court, 17th Judicial Circuit, Broward County. Case No. 96-09408 (12). December 23, 1996. ____, Judge.
O P I N I O N
The Appellant argues that as assignee to the benefits of a P.I.P. Policy for payment of services to the named insured, they are not obligated to arbitrate their claim with the insurer. The Appellee/Insurer contends that Florida Statute 627.736(5) is applicable regardless of the policy’s terms, and therefore, the Appellant must attend binding arbitration.
There is no issue as to whether the assignment took place; both parties concede as much. The Appellant’s position is that since the insured was not required to arbitrate all claims regarding benefits with the insurer under the terms of the policy, they, as assignee, step into the shoes of the insured, and therefore have no obligation to arbitrate.
The Statute in question provides that every policy offer arbitration, but not that in every situation, arbitration is binding and mandatory. This Court interprets the plain meaning of the Statute is that the only thing that is mandatory is the provision for arbitration within this type of P.I.P. Policy. The Statute reads,
“Every insurer shall include a provision in its policy for personal injury protection benefits providing arbitration of any claims disputed involving medical benefits arising between the insurer and any person providing medical services or supplies if that person has agreed to accept assignment of personal injury protection benefits …”
Nowhere in that sentence is a reference to mandatory arbitration, and the “shall” in the first line cannot be read to qualify anything other than the clause of that sentence referring to the type of provision (the sentence’s form is that of a run-on, in that it is composed of several prepositional phrases, but the word “shall” is only referring to the noun “provision.”) For the Appellee to prevail it would have to be interpreted that the Statute makes it mandatory that all medical providers which accept assignment of policy benefits participate in arbitration if the insurer requests it. In support therefore, the Appellee cited Antonio Costa v. Fidelity National Insurance, 4 Fl.L. Weekly Supp. 130, but this Court feels that that case is not on point because in that case, the policy between the insurer and the insured plainly stated that, “Any claims dispute between us and a medical services provider who has agreed to accept an assignment of benefits shall be decided by arbitration upon written request of either party.” The Court feels the Advanced Orthopedic Institute v. Bankers Insurance Company, 3 Fla.L. Weekly Supp. 673 (13th Judicial Cir. 1995), is more appropriate, where the Court there stated, “A provision in an automobile insurance policy requiring binding arbitration of any P.I.P. claims dispute involving medical benefits between an insurer and medical provider once the provider has accepted an assignment of the benefits is not enforceable against the medical provider who is neither a party to the arbitration agreement or intended beneficiary thereto.” In that case, the policy merely incorporated the exact language of section 627.736(5) into its policy, and the Court interpreted that to require only that binding arbitration be offered if both sides were seeking it, and additionally, that the insurance company was simply filing the mandate of the Florida Statutes by restating the statute, without modification, within its policy terms.
In our case, the policy was never presented, but both parties agreed that an arbitration clause was included in the policy, although the Appellee did not contend that the insured was bound by any agreement to arbitrate. There was never a stipulation that the policy required an arbitration of claims by the insured, and hence, this appeal. It appears that the policy does not provide for mandatory arbitration of the claims between the insurer and insured. If there is no term or provision in the policy for mandatory arbitration, done it is improper to rely on the Florida Statutes to require mandatory binding arbitration.
It is this Court’s interpretation that the Statute does not provide for mandatory arbitration, but for an obligatory provision within each policy offering arbitration as an option to dispute resolution. Since there is no contractual agreement of that nature in the matter before us, the Appellee really has no standing to seek arbitration based on the Statute. (Dr. Larry Legunn D.C. v. Fortune Insurance Company, etc.). Since the Statute does not appear to be requiring arbitration, but just a provision for it, the Court finds in favor of the Appellant, and remands to the prior Court for further proceedings consistent with this opinion.
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