7 Fla. L. Weekly Supp. 414a
Insurance — Personal injury protection — Insurer is precluded from defending claim for PIP benefits on basis that medical bill in question was not reasonable, related or medically necessary because insurer failed to obtain, within 30 days after receipt of application for benefits, medical report providing reasonable proof that insurer is not responsible for payment — There is no issue to be tried on reasonableness and necessity of medical bill at issue — Insured entitled to partial summary judgment
CHRISTINA PEREZ, Plaintiff, vs. STATE FARM FIRE AND CASUALTY COMPANY, a foreign corporation, Defendant. County Court, 17th Judicial Circuit in and for Broward County. Case No. 99-06057-56. March 24, 2000. Linda R. Pratt, Judge. Counsel: Cris E. Boyar, Singer, Farbman & Associates, P.A., for Plaintiff. Christopher Esco, for Defendant.
ORDER ON PLAINTIFF’S MOTION FOR PARTIAL SUMMARY JUDGMENT
THIS CAUSE came on to be heard upon the Plaintiff’s Motion for Summary Judgment filed under Certificate dated February 1, 2000. Counsel for the respective parties having an opportunity to be heard, and the Court being otherwise fully advised in the premises, the court finds as follows:
1. The Plaintiff filed suit against the Defendant for personal injury protection benefits pursuant to Section 627.736, Fla. Stat. for failure to pay for medical treatment following an accident on July 31, 1996.
2. It is undisputed the Defendant issued a Florida No Fault policy of insurance which was in effect on the date of the accident and the Plaintiff was an insured under the policy.
3. It is undisputed the Plaintiff received diagnostic testing on January 17,1997 and said bill was submitted to the Defendant for payment.
4. It is undisputed the Defendant did not obtain, within thirty days, a medical report providing “reasonable proof” that the Defendant is not responsible for payment.
5. The Defendant insurance company had thirty days in which to verify the claim after receipt of an application for benefits. There is no provision in the statute to toll this time limitation. Having failed to obtain the report within thirty days the Defendant is precluded from defending the claim on the basis the medical bill in question was not reasonable, related or medically necessary. Perez v. State Farm Fire and Casualty Co., 746 So.2d 1123 (Fla. 3d DCA 1999); Martinez v. Fortune Insurance Co., 684 So.2d 201 (Fla. 4th DCA 1996) and Amador v. United Automobile Insurance Co., 748 So.2d 307 (Fla. 3d DCA 1999).
6. Accordingly, it is, ORDERED and ADJUDGED that said Motion be, and the same is hereby granted and there is no issue to be tried to the reasonableness and necessity of the bill at issue.
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