9 Fla. L. Weekly Supp. 877b
Insurance — Personal injury protection — Coverage — Exhaustion of benefits — Insurer had right to pay later-submitted bills during thirty-day period that it was allowed to pay or investigate assignee’s bill and was not obligated to pay the assignee’s bill once policy limits were exhausted by payment of those subsequent bills during the thirty-day period
M. EUGENE KAYE, D.C. d/b/a NETWORK CHIROPRACTIC OF ORLANDO, Plaintiff, v. ALLSTATE INSURANCE COMPANY, Defendant. County Court, 18th Judicial Circuit in and for Seminole County. Case No. 02-SC-348-19-R. October 3, 2002. Ralph E. Eriksson, Judge. Counsel: Michael H. Johnson, Boca Raton, for Plaintiff. Michael J. LaPorte, Orlando, for Defendant.
ORDER GRANTING MOTION FOR SUMMARY JUDGMENT(EXCLUSION OF BENEFITS)
THIS CAUSE came on to be heard before this Court upon the Defendant’s Motion for Summary Judgment/Benefits Exhausted. The Court heard argument of counsel and determined that the issue in this case boils down to whether an insurance company, during the 30 day time period that they have to pay a bill, has the right to pay various bills in the order that they choose; irrespective of when the bill came in (in relation to any other bill), as long as the bill was paid within the 30 days.
The Plaintiff essentially argues a “first in, first out” approach and cites State Farm v. Ray, 556 So. 2d 811 (Fla. 5th DCA 1990). That case is not directly applicable here because in that case the Court did not determine the order in which the insurance company was required to pay bills, it just said the payment was proper.
The Defendant in this case argues that they may pay any bill they choose within the 30 days and once the benefits are exhausted, they are no longer obligated to pay a bill even if it was submitted before a paid bill.
Thus this Court must determine if a submitted bill has priority over a later submitted bill if both are within the 30 days.
In answering the question before the Court it appears that the insurer has leeway during the 30 day period to pay the bill (immediately upon receipt) or investigate. See United Automobile Insurance Company v. Stat Technologies, Inc., 787 So.2d 920, at page 922 (Fla. 3rd DCA 2001). “Insurers are thus provided with a 30 day period in order to verify whether the loss is payable or whether it is barred because of fraud or some other policy exclusion, and to determine whether the services provided and amount of the bill were reasonable or necessary.” The only restriction appears to be the 30 days. The United Automobile case (supra) went on to state:
1. “We are not unmindful that the purpose of the PIP statute is to provide a swift and virtually automatic payment of PIP benefits,” and
2. “We do not believe the legislators intended to punish insurers for undergoing the appropriate investigation contemplated under the statute.”
Payment of a “simple, routine” bill that is paid after receipt of a “complicated” bill, appears to be encouraged by the first proposition cited above and certainly allowed by the second. It is, therefore
ORDERED AND ADJUDGED that the Motion for Summary Judgment/Benefits Exhausted is granted.
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