7 Fla. L. Weekly Supp. 687a
Insurance — Personal injury protection — Insurer does not breach insurance contract with the insured by refusing to pay for all, as opposed to only the reasonable, health care services provided to insured — Correspondences from insurer to insured, agreeing to defend and indemnify insured if any cause of action is brought by healthcare provider against insured for outstanding bills, creates enforceable contractual obligation — As such, insured is removed from jeopardy and cannot suffer damages as matter of law
EARL HARPER, Plaintiff, v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 13th Judicial Circuit in and for Hillsborough County, Civil Division. Case No. 98-18407 SC, Division H. June 7, 2000. Frank A. Gomez, Judge. Counsel: Mark Tischhauser, Tampa. Robert H. Oxendine, Oxendine & Oxendine, P.A., Tampa.
ORDER ON DEFENDANT’S MOTION FOR SUMMARY JUDGMENT
THIS CAUSE came before the Court April 10, 2000, on Defendant’s Motion for Summary Judgment, and the Court having heard argument of counsel, reviewed the file, and being otherwise fully informed in the premises, it is hereby:
ORDERED AND ADJUDGED:
That based upon the pleadings, correspondences, affidavits and depositions, there is a complete absence of any material issues of fact and accordingly, as a matter of law, STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY is entitled to summary judgment pursuant to Florida Rule of Civil Procedure 1.510.
FINDINGS OF FACT
1. Plaintiff entered into a contract of insurance with STATE FARM and was insured under the subject policy.
2. Plaintiff has brought this cause of action, seeking payment of personal injury protection (PIP) benefits relating to injuries suffered as a result of an automobile accident that occurred on or about March 25,1997.
3. Plaintiff alleges that certain medical treatment was necessary and reasonable as related to that accident. Plaintiff was treated by Drs. C. Lorence, D. Reina and L. Crespo.
4. Each doctor submitted bills to STATE FARM for payment for the services rendered to Plaintiff.
5. Although STATE FARM did not pay the total amounts contained in the bills they paid what they deemed to be reasonable charges for medically necessary services.
6. Correspondences to the Plaintiff from Defendant informed the Plaintiff that if any of the health care providers pursued any type of legal action against the Plaintiff, STATE FARM agreed to defend and indemnify the Plaintiff.
7. The afore-recited material facts are undisputed.
LAW
1. This Court holds that an insurer does not breach its insurance contract by refusing to pay for all, as opposed to only the reasonable health care services provided to an insured.
2. Correspondences, from an insurer to an insured, agreeing to defend and indemnify in the event that any cause of action is brought by the healthcare provider against the insured for the outstanding bills creates an enforceable contractual obligation upon the insured.
3. Based upon the above mentioned enforceable contractual obligation, Plaintiff is removed from jeopardy and cannot suffer damages as a matter of law.
4. This Court finds the cases of La Mothe v. Auto Club Insurance Association, 543 N.W.2d 42 (Mich. App. 1995); McGill v. Automobile Association of Michigan, 526 N.W.2d (Mich. App. 1994) and Mc Queen v. Allstate Indemnity Company, 6 Fla. L. Weekly Supp. 185 (17th Jud. Cir. Broward County, December 7, 1998) to be persuasive, finding the facts of this case analogous to those cases and grants STATE FARM’s Motion for Summary Judgment.
WHEREFORE it is:
FURTHER ORDERED AND ADJUDGED:
1. That Plaintiff shall take nothing and go hence without day.
2. That this Court reserves jurisdiction to tax any applicable fees and costs.
* * *
