8 Fla. L. Weekly Supp. 458a
Insurance — Personal injury protection — Assignment — Insured’s failure to countersign medical bills does not relieve the insurer from liability for the payment of PIP benefits to medical provider who has accepted assignment of PIP benefits from the insured — Section 627.736(5), which provides that insurer may pay the medical provider directly when bills are countersigned, does not mean that insurer may not pay medical provider when bills are not countersigned
DR. STEVEN CHASE, as assignee of Mr. Alex Ruiz, Plaintiff, vs. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 11th Judicial Circuit in and for Dade County. Case No. 00-1725 SP 26 (1). April 24, 2001. Bonnie Rippingille, Judge. Counsel: Kenneth B. Schurr, Manno & Schurr, P.A., Coral Gables. Alexander Garcia.
ORDER ON DEFENDANT’S MOTIONFOR FINAL SUMMARY JUDGMENT
This matter came before this Court on March 21, 2001 at 10:45 a.m. on Defendant’s Motion for Summary Judgment, and the Court having reviewed all of the memoranda filed by the parties and all other items of record, and having heard argument of counsel and being otherwise fully advised in the premises, this Court hereby finds as follows:
The issue to be resolved is whether or not the insured’s failure to countersign the medical bills in an action for Personal Injury Protection Benefits relieves the insurer from liability for the payment of said Personal Injury Protection benefits.
On July 8, 1997 the insured, Alex Ruiz, was involved in an automobile accident and as a result required medical treatment which was provided by the Plaintiff, Dr. Stephen Chase, at an expense of $4,235. Dr. Chase has accepted an assignment of PIP benefits from the insured for said medical services. All of the medical bills at issue herein were timely submitted and received on Health Care Administration Financing Act (HCFA) 1500 forms and the Defendant, United, has paid nothing toward satisfaction of the medical bills. Thereafter, the Plaintiff brought this action.
Summary judgment should not be granted unless the facts are so crystallized that nothing remains but issues of law. Moore v. Morris, 475 So.2d 666 (Fla. 1985). If the existence of such issues or the possibility of their existence is reflected in the record, or the record raises even the slightest reasonable doubt in this respect, the judgment must be reversed. Braidi Trading Co. v. Anthony Abraham Trading Ent., Inc., 469 So.2d 955 (Fla. 3d DCA 1985). It is axiomatic that on a motion for summary judgment, it is the burden of the movant to demonstrate the non-existence of any disputed issue of material fact. Moore, supra; Connelly v. Arrow Air, Inc., 568 So.2d 448 (Fla. 3d DCA 1990).
It is well established that the fundamental objective of the PIP statute is to guarantee swift and virtually automatic payment of benefits and the PIP statute should not be interpreted in a manner that leads to an unreasonable or absurd result or a result obviously not intended by the legislature. United Automobile Insurance Co. v. Viles, 726 So.2d 320 (Fla. 3d DCA 1999). See also Nationwide Mutual Fire Insurance Co. v. Pinnacle Medical, Inc., 753 So.2d 55 (Fla. 2000) and Crooks v. State Farm, 659 So.2d 1266 (Fla. 3d DCA 1995), rev. denied 662 So.2d 933 (Fla. 1993). In reaching the goal of swift and prompt payment of benefits, the long standing policy of the courts of Florida when construing provisions of the Florida No-Fault Act has always been to construe the act liberally in favor of the insured.” Palma v. State Farm Fire & Cas. Co., 489 So.2d 147 (Fla. 4th DCA 1986). The Florida Supreme Court has further indicated that the PIP statute should be construed in order to give effect to the legislative purpose of providing a broader and more liberal standard of coverage. Blish v. Atlanta Casualty Co., 736 So.2d 1151 (Fla. 1999) and Race v. Nationwide Mutual Fire Ins. Co. 542 So.2d 347 (Fla. 1989). Indeed, the application of broad coverage of benefits is found throughout the cases involving personal injury protection benefits in the state of Florida. See, GEICO v. Novak, 453 So.2d 11 (Fla. 1984) and Pena v. Allstate, 463 So.2d 1256 (Fla. 3d DCA 1985).
Under Florida law, the PIP insured is the owner of PIP benefits due and payable. Therefore, the insurer is required to remit PIP benefits to the insured. However, if the insured has countersigned the medical bills or HCFA forms, then the insurer is granted a statutory option of paying either the medical provider directly or the insured. This mechanism is triggered only in the absence of an assignment of benefits or a direction to pay. When the insured assigns his or her rights to the medical provider, the insurer loses the option of paying either the medical provider directly or the insured, and becomes obligated to pay the medical provider directly.
Fla. Stat. 627.736(5) states, in pertinent part:
The insurer providing such coverage may pay for such charges directly to such person or institution lawfully rendering such treatment, if the insured receiving such treatment … has countersigned the invoice, bill or claim form …upon which such charges are to be paid for as having actually been rendered, to the best knowledge of the insured …. (emphasis supplied).
The use of the word “MAY” in the above provision indicates an option on the part of the insurer, not a requirement. If the legislature had intended to make this a mandatory requirement, it would have used the word “SHALL” which is normally used in a statute to impose mandatory requirement. See Drury v. Harding, 461 So.2d 104 (Fla 1984); In the interest of S.R. v. State, 346 So.2d 1018 (Fla. 1977); Holloway v. State, 342 So.2d 966 (Fla. 1977); City of Orlando v. County of Orange, 276 So.2d 41 (Fla. 1973); Neal v. Bryant, 149 So.2d 529 (Fla. 1962). It has long been a rule of statutory construction that statutes must be given their plain and obvious meaning and courts should assume that the legislature knew the plain and ordinary meaning of the words when it chose to include them in a statute. Hankey v. Yarian, M.D., 755 So.2d 93 (Fla. 2001) citing Aetna Cas. & Surety Co. v. Huntington Nat’l Bank, 609 So.2d 1315 (Fla. 1992).
Thus, the use of the word “MAY” indicates that the insurance company can pay the medical provider, but more importantly, it also indicates that the insurance company, at its option, MAY also pay the insured for those same benefits. The statute cited above (Fla. Stat. 627.736(5)) simply provides an optional mechanism to facilitate the payment of PIP benefits directly to a medical provider.
The Defendant, United, contends that if the insurer may pay the medical provider directly when the medical bills are countersigned, then the opposite must also be true, i.e., the insurer may NOT pay the medical provider when the medical bills are not countersigned. This is contrary to the axiomatic rule of statutory construction wherein a statute which mentions one thing, necessarily implies the exclusion of the other. Indeed, under the ancient principal of expressio unius est exclusion alterius, the enumeration of conditions or things in the statute is to be construed as excluding from its operation all those not expressly mentioned. See, 49 Fla. Jur. 2d. Section 126 (1984).
The language of a statute is clear and unambiguous and conveys a clear and definite meaning, there is no occasion for resorting to the rules of statutory interpretation and construction; the statute must be given its plain and obvious meaning. Arthur Young & Co. v. Mariner Corp., 630 So.2d 1199 (Fla. 4th DCA 1994) citing Holly v. Auld, 450 So.2d 217 (Fla. 1985). Thus, had the legislature intended to relieve the insurer of its obligation to pay medical bills simply because an insured did not countersign same, it would have done so clearly and expressly in the statute.
CONCLUSION
For the foregoing reasons, it is ordered and adjudged that the Defendant’s Motion for Summary Judgment is hereby Denied.
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