8 Fla. L. Weekly Supp. 350a
Insurance — Personal injury protection — Trial court correctly held that insured had standing to sue insurer for failure to timely pay medical bills submitted by health care provider for treatment of injuries sustained in covered accident where there was no evidence of assignment of medical benefits to health care provider, and insured had not even signed claim form through which assignment was allegedly made — Where insurance policy allows amendments to policy only by endorsement signed by an executive officer or by revision to policy form to give broader coverage without extra charge, trial court erred in concluding that letter sent to insured by insurer after accident, promising to indemnify insured if sued by his health care provider for unpaid bills, amounted to amendment to policy since letter was signed by claims representative, was addressed only to insured and did not amend policy form, and does not afford greater coverage — Insurer could not modify policy to remove insured’s standing to sue where insured’s right to PIP benefits resulting from covered accident had vested
SCOTT WELLS, Appellant/Cross-appellee, vs. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Appellee/Cross-appellant. Circuit Court, 13th Judicial Circuit (Appellate) in and for Hillsborough County, Civil Division. Case No. 00-1412, Division X. Lower Ct. Case No. 98-3091 CC. Opinion filed March 8, 2001. Counsel: Roberto R. Alayon, Tampa, for Appellant/Cross-appellee. Karen A. Barnett, Tampa, for Appellee/Cross-appellant.
OPINION
(PER CURIAM.) Scott Wells and State Farm appeal the Order Granting Partial Summary Judgment of the County Court. This Court has jurisdiction.
Appellant/Cross-appellee Wells contends that the trial court erred when it granted partial summary judgment in favor of State Farm when it held that correspondence sent from State Farm to Wells after his involvement in an automobile accident amended the policy issued by State Farm on behalf of Wells. Appellee/Cross-appellant State Farm contends that the trial court erred in holding that Wells had not assigned his medical benefits to his health care provider, Harry Wassel, M.D. We affirm in part and reverse in part.
Wells filed suit against State Farm when State Farm allegedly failed to timely pay medical bills submitted by a health care provider for treatment rendered as the result of injuries Wells received in a covered automobile accident. State Farm filed for summary judgment, asserting that Wells made a de facto assignment to the health care provider in the form of a claim form (HCFA), and therefore, had no standing to sue. The county court held that there was insufficient evidence that an assignment had taken place. We agree and affirm the trial court’s ruling thereupon.
The trial court did not address the issue whether, as a matter of law, State Farm’s direct payment to a health care provider based on a HCFA form operates as a de facto assignment, and we do not reach the question here. However, the record is devoid of any evidence whatsoever that an assignment took place. In fact, the HCFA was not signed by Wells. The trial court properly found that there was no evidence to support a finding that an assignment took place. Thus, Wells had standing to sue State Farm on his own behalf. See, Comptech International, Inc. v. Milam Commerce Park, Ltd., etc., et al., 753 So. 2d 1219 (Fla. 1999).
Wells contends that the trial court erred when it found that a letter dated August 19,1997 sent to Wells by State Farm after the subject accident, promising to indemnify Wells if he is sued by his healthcare provider for unpaid bills, amounted to a policy amendment. We agree and reverse the trial court’s decision that the letter effects an amendment to the policy.
The policy between Wells and State Farm allows amendment to the policy only by endorsement signed by one of the executive officers or by a revision to the policy form to give broader coverage without extra charge. The August 19, 1997 letter meets neither of these requirements. First, the letter was signed by Linda McGee, a claims representative. She is not an executive officer with State Farm. Second, the letter, addressed only to Wells, is not an amendment to the policy form.
Finally, the letter does not afford Wells greater coverage. To the contrary, the indemnification letter purports to divest Wells of his rights to personal injury protection (PIP) benefits while subjecting him to the risk of a lawsuit against him (not State Farm) for unpaid medical bills. Under basic contract law, State Farm may not modify the insurance policy where, as here, Wells’ right to PIP benefits resulting from a covered accident has vested. Were we to accept State Farm’s reasoning, the effect of the letter would be to remove the ability of Wells to sue his insurer on his own behalf by creating a situation which removed Wells’ standing to sue. Cf. Heard v. Mathis, 344 So. 2d 651 (Fla. 1st DCA 1977). Wells’ right to sue his insurer for failing to pay benefits in a timely manner is a statutory right, pursuant to section 627.427, Florida Statutes, which he neither voluntarily nor impliedly waived. Miami Dolphins, Ltd. v. Genden & Bach, P.A., 545 So. 2d 294 (Fla. 3rd DCA 1989).
ACCORDINGLY, the Partial Summary Judgment appealed herein is AFFIRMED, in part, and REVERSED, in part.
This cause is REMANDED for proceedings consistent with this opinion. (Sam D. Pendino, Presiding Circuit Judge, Barton and Simms, JJ., concur.)
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