9 Fla. L. Weekly Supp. 629b
Insurance — Personal injury protection — Preferred provider rates — Insurer could not reduce benefits paid to insured’s assignee to PPO rates as it did not have a PPO policy as required by statute
DUKES CHIROPRACTIC HEALTH CLINIC, P.A., (a/a/o Tressa Thomas), Plaintiff, vs. NATIONWIDE MUTUAL FIRE INSURANCE COMPANY, Defendant. County Court, 13th Judicial Circuit in and for Hillsborough County, Small Claims Division. Case No. 2000-17430-SC, Division J. July 19, 2002. Gaston J. Fernandez, Judge. Counsel: Timothy A. Patrick, Timothy A. Patrick, P.A., Tampa, for Plaintiff. J. Scott McMahon, for Defendant.
[Affirmed at 10 Fla. L. Weekly Supp. 868a. Prior order in this case at 8 Fla. L. Weekly Supp. 650c.]
ORDER GRANTING FINAL SUMMARY JUDGMENT
THIS CAUSE having come before the Court on June 27, 2002, on Plaintiff’s Motion for Final Summary Judgment, both parties appearing through counsel and the Court having heard argument of counsel, the court makes the following findings:
(1) The policy between the insured and Defendant was not a PPO policy as required by Florida Statutes Section 627.736(10).
(2) The Plaintiff medical provider, pursuant to the assignment of benefits, stands in the shoes of the insured and is entitled to the same rights and benefits as the insured.
(3) PPO rates should not apply.
(4) Defendant cannot decide which rates will be reasonable, necessary and related in this manner.
(5) Insured, by not purchasing a PPO policy, did not receive the benefit of lower premium rates. As such, pursuant to Section 627.736(10), Defendant cannot reduce benefits as PPO rates in this instance.
(6) The court adopts the reasoning of Judge Anderson in the case Jeff Davis, D. C., P. A. (as Assignee of Angela Richards) v. Nationwide Mutual Fire Ins. Co., 8 Fla. L. Weekly Supp. 846b (County Court, 13th Judicial Circuit, Hillsborough County, Case No. 2000-17951 SC, Div. I, October 23, 2001);
(7) Plaintiff is entitled to judgment in the amount of $393.45, FOR WHICH SUMS LET EXECUTION ISSUE.
ORDERED and ADJUDGED that PLAINTIFF’s MOTION FOR FINAL SUMMARY JUDGMENT IS GRANTED.
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