9 Fla. L. Weekly Supp. 708a
Insurance — Personal injury protection — Statute does not require person receiving service or treatment to countersign HCFA-1500 form, nor does it require medical provider actually providing service or treatment to sign HCFA-1500 form — Summary judgment granted in favor of assignee where insurer’s sole basis for nonpayment of bills was absence of signature and countersignature on HCFA-1500 forms
MEDICAL SPECIALISTS AND DIAGNOSTIC SERVICES, as assignee of RICHARD NAVAS, Plaintiff, vs. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 9th Judicial Circuit in and for Orange County. Case No. 01-8264-CC. August 28, 2002. C. Jeffery Arnold, Judge. Counsel: Alexander Billias, Morgan, Colling & Gilbert, P.A., Orlando, for Plaintiff. David J. Millheiser, Troy D. Ferguson & Associates, P.A., Coral Gables, for Defendant.
AFFIRMED. 11 Fla. L. Weekly Supp. 508a
ORDER ON PLAINTIFF’S MOTION FORSUMMARY JUDGMENT AND DEFENDANT’SMOTION FOR SUMMARY JUDGMENT
This matter having come before the Court on August 5, 2002 on Plaintiff’s Motion for Summary Judgment and Supporting Memorandum of Law, (certificate date June 21, 2002), and Defendant’s Motion for Summary Judgment and Response to Plaintiff’s Motion for Summary Judgment, (certificate date July 3, 2002), the Court having reviewed the file, having heard the following argument of counsel and being fully advised in the premises:
FACTS AND PROCEDURAL BACKGROUND
1. This is a claim for personal injury protection benefits arising out of an automobile accident that occurred on January 3, 2001.
2. The medical bills at issue in this litigation were submitted by Plaintiff for treatment provided to RICHARD NAVAS on dates of service 2/14/01 through 3/30/01, in the total amount billed of $765.00.
3. The deposition of Carlos Plana took place on December 11, 2001 and the deposition transcript of Carlos Plana has been separately filed with this Court.
4. Carlos Plana is the litigation adjuster employed by the Defendant and assigned to this case.
5. Defendant timely received every HCFA-1500 form at issue in this case within thirty (30) days of the date of service.
6. Defendant has paid nothing to Plaintiff or RICHARD NAVAS for the medical bills at issue in this case.
7. Defendant has failed to pay statutory interest on any of the bills at issue in this case.
8. Defendant’s basis for nonpayment of each of the medical bills at issue in this case is identical. Specifically, Defendant has denied payment to Plaintiff for the medical bills at issue in this case because the person receiving the treatment did not countersign the HCFA-1500 forms and because the doctor did not sign box 31 of the HCFA-1500 form.
9. Carlos Plana testified this was the only reasonable proof Defendant relied upon to deny payment of the instant bills.
10. It is Plaintiff’s position that pursuant to Florida Statutes § 627.736(5)(a), HCFA-1500 forms do not have to be countersigned by the insured if the medical provider has accepted an assignment of benefits. In support thereof, Plaintiff has cited South FL Open MRI, as assignee of Conrad Aviles v. United Auto. Ins. Co., 9 Fla. Supp. 397a (Fla. Dade Cty. Ct. 2002); Health Care Assoc. of South FL, Inc., as assignee of Caridad Valdes Dilme v. United Auto. Ins. Co., 9 Fla. Supp. 397b (Fla. Dade Cty. Ct. 2002); USA Diag., Inc. v. Star Cas., 9 Fla. Supp. 410b (Fla. Broward Cty. Ct. 2002); Dr. Steven Chase, as assignee of Alex Ruiz v. United Auto. Ins. Co., 8 Fla. Supp. 458a (Fla. Dade Cty. Ct. 2001); The Premier Ctr. for Personal Injuries v. United Auto. Ins. Co., 8 Fla. Supp. 501a (Fla. Dade Cty. Ct. 2001); and ROM Diag., on behalf of Roland Medley v. Allstate Ins. Co., 9 Fla. Supp. 392a (Fla. Orange Cty. Ct. 2002).
11. It is also Plaintiff’s position that under Florida Statutes § 627.736(5)(d), HCFA-1500 forms do not have to be signed by the doctor or medical provider who provided the service or treatment. In support thereof, Plaintiff has cited ROM Diag., on behalf of Roland Medley v. Allstate Ins. Co., 9 Fla. Supp. 392a (Fla. Orange Cty. Ct. 2002).
12. It is Defendant’s position that pursuant to Florida Statutes §§ 627.736(5)(a) and 627.736(5)(d), regardless of whether or not the medical provider has accepted an assignment of benefits, both the person receiving the service or treatment and the doctor or medical provider who provided the service or treatment are required to sign the HCFA-1500 form. In support of its position, Defendant has cited Security Nat. Ins. Co. v. Biotronix, 6 Fla. Supp. 314 (Fla. 11th Cir. Ct. 1999) and Rodriguez v. Ocean Harbor Cas. Ins. Co., 8 Fla. Supp. 500 (Fla. Dade Cty. Ct. 2001).
LAW AND ANALYSIS
13. There is no language in Florida Statutes § 627.736(5)(a) that requires the person receiving the service or treatment to countersign an HCFA-1500 form.
14. There is no language in Florida Statutes § 627.736(5)(d) that requires the doctor or medical provider who actually provided the service or treatment to sign an HCFA-1500 form.
15. Although there is no language in Florida Statutes § 627.736(5)(d) that requires the doctor or medical provider who actually provided the service or treatment to sign an HCFA-1500 form, this Court would prefer it if the doctor or medical provider who actually provided the service or treatment, or the representative of the doctor or medical provider who actually provided the service or treatment, did sign HCFA-1500 forms.
16. This Court believes that if the doctor or medical provider who actually provided the service or treatment, or the representative of the doctor or medical provider who actually provided the service or treatment, did sign HCFA-1500 forms, it would aid the insurance adjuster who actually receives the HCFA-1500 forms, thereby potentially leading to a decrease in litigation on this issue.
Based upon the foregoing, it is hereby ORDERED and ADJUDGED that:
17. Plaintiff’s Motion for Summary Judgment and Supporting Memorandum of law is GRANTED.
18. Defendant’s Motion for Summary Judgment and Response to Plaintiff’s Motion for Summary Judgment is DENIED.
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