Allstate Fire and Casualty Ins. Co. v. Hallandale Open Mri, LLC

CourtDistrict Court of Appeal of Florida
DecidedApril 19, 2017
Docket16-0038
StatusPublished

This text of Allstate Fire and Casualty Ins. Co. v. Hallandale Open Mri, LLC (Allstate Fire and Casualty Ins. Co. v. Hallandale Open Mri, LLC) is published on Counsel Stack Legal Research, covering District Court of Appeal of Florida primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Allstate Fire and Casualty Ins. Co. v. Hallandale Open Mri, LLC, (Fla. Ct. App. 2017).

Opinion

Third District Court of Appeal State of Florida

Opinion filed April 19, 2017. THIS OPINION IS NOT FINAL UNTIL DISPOSITION OF ANY MOTION FOR REHEARING AND/OR REHEARING EN BANC. ANY PREVIOUSLY-FILED MOTION FOR REHEARING EN BANC IS DEEMED MOOT.

________________

No. 3D16-38 Lower Tribunal No. 13-461 ________________

Allstate Fire and Casualty Insurance Company, Petitioner,

vs.

Hallandale Open MRI, LLC, a/a/o Alexia Blake, Respondent.

A Writ of Certiorari to the Circuit Court for Miami-Dade County, Appellate Division, Jacqueline Hogan Scola, Jorge Cueto, and Ariana Fajardo Orshan, Judges.

Shutts & Bowen, and Suzanne Youmans Labrit and Douglas G. Brehm (Tampa); Cozen O’Connor, and Peter J. Valeta (Chicago, IL), for petitioner.

Marlene S. Reiss, for respondent. Before SALTER, LOGUE and SCALES, JJ.

SALTER, J.

On Motion for Rehearing

On consideration of the petitioner’s motion for rehearing, the response, and

the decision of the Supreme Court of Florida in Allstate Insurance Co. v.

Orthopedic Specialists, No. SC15-2298, 2017 WL 372092 (Fla. Jan. 26, 2017)

(“Orthopedic Specialists II”), we withdraw our opinion in this case issued

September 28, 2016,1 and replace it with the opinion which follows.

In the September 2016 opinion, we dismissed a petition for second-tier

certiorari filed by Allstate Fire and Casualty Insurance Company (“Allstate”).

Allstate’s petition asked the Court to quash a 2015 circuit court appellate division

opinion affirming a county court judgment for a medical provider in a personal

injury protection (PIP) auto insurance case. The appellate division decided an

interpretive question regarding the sufficiency of PIP policy language following

the Legislature’s amendments to section 627.736, Florida Statutes, in 2008.

In Orthopedic Specialists II, the Supreme Court of Florida has now

determined that interpretive question. The Court held that a PIP policy term

providing that reimbursements “shall be subject to” the Medicare fee schedules in

1Allstate Fire & Cas. Ins. Co. v. Hallandale Open MRI, LLC, 41 Fla. L. Weekly D2208 (Fla. 3d DCA Sept. 28, 2016).

2 section 627.736(5)(a)2., Florida Statutes (2009), is unambiguous, resolving a

conflict in decisions previously issued by the First and Fourth District Courts of

Appeal: Allstate Fire & Cas. Ins. Co. v. Stand-Up MRI of Tallahassee, P.A., 188

So. 3d 1 (Fla. 1st DCA 2015) (finding the policy provision unambiguous and

mandatory), and Orthopedic Specialists v. Allstate Ins. Co., 177 So. 3d 19 (Fla. 4th

DCA 2015) (“Orthopedic Specialists I”) (finding the policy provision ambiguous).

At the time the circuit court appellate division ruled in the present case, this Court

had not addressed the underlying issue.2 The circuit court appellate division

concluded that the PIP policy language was ambiguous, following the reasoning

and opinion of the Fourth District in Orthopedic Specialists I.

Under the standard for second-tier certiorari review established in Custer

Medical Center v. United Automobile Insurance Co., 62 So. 3d 1086 (Fla. 2010),

and Allstate Insurance Co. v. Kaklamanos, 843 So. 2d 885 (Fla. 2003), we initially

concluded that we did not have jurisdiction in this case. With the conflict issue

pending before the Supreme Court of Florida, we discerned no violation of a

2 While the petition in this case was pending, however, a panel of this Court heard a direct appeal regarding the same issue certified to us by the county court based on conflicting circuit court decisions. Fla. Wellness & Rehab. v. Allstate Fire & Cas. Ins. Co., 201 So. 3d 169 (Fla. 3d DCA 2016) (“Fla. Wellness”). This Court concluded that the “shall be subject to” language in the PIP policy was unambiguous and mandatory, certifying conflict with the Fourth District opinion in Orthopedic Specialists I.

3 “clearly established principle of law resulting in a miscarriage of justice.” Custer

Med. Ctr., 62 So. 3d at 1092. The original dissenting opinion in this case,

however, argued against dismissal based on this Court’s decision in Florida

Wellness, which by then had concluded that the “shall be subject to” term in the

PIP policy was unambiguous:

It is clearly a miscarriage of justice to prevent further review in a manner that causes the identical cases of similarly situated persons in the same court to be decided differently based on conflicting legal interpretations. And this clear miscarriage of justice resulting from the failure to allow review reflects a departure from the most essential legal requirement—equality before the law. No other legal remedy exists to stop this miscarriage of justice here except a writ of certiorari.

Allstate Fire and Cas. Ins. Co. v. Hallandale Open MRI, LLC, 41 Fla. L. Weekly

D2208, D2210 (Fla. 3d DCA Sept. 28, 2016) (Logue, J., dissenting). The majority

concluded that the Supreme Court of Florida would itself ultimately resolve the

conflict in decisions, such that we could not yet hold in this case that the circuit

court appellate division had violated a clearly established principle of law resulting

in a miscarriage of justice. The pendency of the conflict issue in the Supreme

Court distinguished the present case, in the view of the majority, from our own

precedent relied upon by Allstate. United Auto Ins. Co. v. Garrido, 22 So. 3d 120

(Fla. 3d DCA 2009) (second-tier certiorari review appropriate to resolve an

internal conflict of decisions in the circuit court appellate division).

4 But the Supreme Court of Florida has now resolved the conflict issue in an

opinion which turns on a de novo statutory and contractual interpretation, quashing

Orthopedic Specialists I and approving Stand-Up MRI. Orthopedic Specialists II,

2017 WL 372092 at *1. Our colleague’s earlier dissent in the present case and our

own concern regarding the jurisdictional limits of second-tier certiorari as detailed

by the Supreme Court of Florida in Custer Medical Center can now be reconciled.

The statutory and policy language in question have been definitively analyzed and

interpreted for the entire state by its highest court.

Applying the Supreme Court’s opinion in Orthopedic Specialists II to the

petition in the present case, we conclude that the jurisdictional requirements of

Custer Medical Center are satisfied, such that the petition should be granted. From

the standpoint of the circuit court appellate division panel, this may seem

unwarranted, essentially quashing the panel’s opinion based on a subsequently-

decided appellate decision that was unavailable to the panel when called upon to

rule.

When the appellate division reached its decision in 2015, this Court had not

decided the issue and the appellate division followed one of the two conflicting

district court opinions. But with that conflict now eliminated by our Supreme

Court and a definitive interpretation available to (and binding upon) all Florida

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