9 Fla. L. Weekly Supp. 170b
Insurance — Personal injury protection — Standing — Equitable assignment — Trial court erred in failing to put aside jury’s determination that an assignment existed and denying insured’s motion for directed verdict on issue of existence of an assignment in absence of any meaningful evidence to support the existence of an assignment where there was no document formally assigning insured’s rights under her PIP policy to medical provider, provider and insured testified that they had no agreement as to an assignment, provider testified that she did not intend to enter into an assignment with insured, and insured testified that she did not understand the significance of an assignment and merely wanted the care she needed — Direct payment from insurer to provider and assertion on claim form that there was an assignment, in absence of an additional writing or other understanding, are not evidence of an equitable assignment — Fact that other medical providers accepted assignments from insured is irrelevant as to the agreement between insured and this provider
JEANNE LAPENSEE, Appellant, vs. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Appellee. Circuit Court, 13th Judicial Circuit (Appellate) in and for Hillsborough County. Case No. 01-1609. County Case No. 97-17380-CC, Division X. Opinion filed January 17, 2002. Claudia R. Isom, Judge. Review of a final order of the County Ct., Hillsborough County, Florida. The Honorable Eric R. Myers, County Court Judge. Counsel: Lorraine E. Robinson, Clearwater, for Appellant. Karen Barnett, Tampa, for Appellee.
(PER CURIAM.) Appellant appeals the final judgment of the county court. We have jurisdiction pursuant to Florida Rule of Appellate Procedure 9.030(c)(1)(A).
Appellant Jeanne Lapensee was injured in an automobile accident on November 8, 1996. She received treatment for her injuries from Dr. Laurie Woloshen and several other physicians; however, the only claim that is the subject of this dispute is that relating to the claim for payment to Dr. Woloshen. In the lawsuit, Appellee State Farm filed a motion for summary judgment which challenged Appellant’s standing to bring the action in light of an alleged assignment of benefits. Pursuant to a jury trial held on September 11, 2000, a jury rendered a verdict in favor of Appellee that there was an assignment of benefits, effectively removing Appellant’s standing to bring the action. Appellant renewed a previous motion for directed verdict and moved for a new trial on September 22, 2000. The trial court entered final judgment on October 3, 2000, denying both of Appellant’s motions.
Appellant asserts error on three issues, however, because the issue with respect to the assignment and directed verdict requires this Court to reverse the final judgment, we do not address the remaining issue.
Appellant argues that the Court erred in denying her motion for directed verdict on the issue relating to the existence of an assignment. Appellee counters that the motion for a directed verdict was properly denied by the trial court. We agree with Appellant that the trial court should have directed the verdict in favor of Appellant in the absence of any meaningful evidence to support the existence of an assignment.
The record reflects that there was no document formally assigning Dr. Woloshen Appellant’s rights under her insurance policy; therefore, any assignment would have had to be equitable in nature. An equitable assignment arises when one party intends to assign certain rights and duties to another party and the other party intends to receive those rights and duties. Giles v. Sun Bank, N.A., 450 So.2d 258 (Fla. 5th DCA 1984). Courts may find an equitable assignment where it is necessary to effect the plain intent of the parties or to hold otherwise would be unjust. Id. However, in this case Dr. Woloshen does not claim to be an assignee. Both Appellant and Dr. Woloshen, the necessary parties to an assignment, testified that they had no agreement as to an assignment of benefits, and, indeed there is no formal writing signed by Appellant assigning her rights under her policy to Dr. Woloshen. Additionally, Dr. Woloshen testified that she did not intend to enter into an assignment with Appellant. Appellant testified that she did not understand the significance one way or the other, she merely wanted the care she needed. Appellee contends that there was compelling evidence to prove that an assignment of Appellant’s insurance benefits was created by operation of law in that Dr. Woloshen submitted claim forms directly to Appellee and received payment directly from Appellee. Additionally, the claim forms specifically stated that Dr. Woloshen accepted an assignment of Appellant’s insurance benefits. Moreover, Dr. Woloshen never submitted a bill to Appellant or otherwise seek direct payment from Appellant for an outstanding balance, suggesting the existence of, or an intent to create, an equitable assignment. However, Appellee is, in essence, asking the court to create an assignment when the parties to the assignment, and especially the party who would benefit from the assignment, contend there is no assignment. Since the law no longer requires healthcare providers to arbitrate disputes with insurance companies, we see no benefit to Appellee if Appellant is removed from the case. It is merely a question to whom the insurer will be liable.
In the absence of a formal writing or clear intent of the parties, we determine that the direct payment and the assertion on the claim form, in the absence of an additional writing or other understanding, are not evidence of an equitable assignment. Medical Rehab & Therapy Center v. State Farm, 8 Fla. L. Weekly Supp. 605a (13th Judicial Circuit, July 16, 2001). Indeed, Florida law appears to allow the insured to arrange for direct payment by the insurance company to the healthcare provider without its operating as an assignment. Cf. Section 627.736(5)(a) and 627.736(c), Florida Statutes. Section 627.736(c), Florida Statutes, does not suggest that an insured’s arranging for direct payment operates as an assignment. Accordingly, the jury determination that an assignment existed should be set aside and a directed verdict entered in Appellant’s favor. That other practitioners accepted assignments from Appellant is irrelevant to as to the agreement between Appellant and Dr. Woloshen, and such evidence should not have been admitted.
Because our decision on the substantive issue of assignment requires us to reverse the decision of the trial court, we do not address Appellant’s remaining issue. It is therefore
ORDERED that the decision of the trial court be REVERSED and the cause REMANDED for proceedings consistent with this opinion. (Maye and Pendino, JJ., concur.)
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