Government Employees Insurance Co. v. Gomez-Cortes

District Court, S.D. Florida·Decided June 15, 2022·No. 1:20-cv-21558·Unknown

Opinion

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF FLORIDA

Case No. 20-21558-Civ-WILLIAMS/TORRES

GOVERNMENT EMPLOYEES INSURANCE CO., GEICO INDEMNITY CO., GEICO GENERAL INSURANCE COMPANY and GEICO CASUALTY CO.,

Plaintiffs,

v.

JOSE DEJESUS GOMEZ-CORTES, M.D., et al,

Defendants. _____________________________________/

OMNIBUS ORDER ON THE PARTIES’ MOTIONS

This matter is before the Court on Doctor Max Medical Center Corp.’s (“Doctor Max”), Irene Cabrera’s, and Dr. Jaqueline Leva’s (collectively “Defendants”) Amended Motion to Strike Government Employees Insurance Co.’s, GEICO Indemnity Co., GEICO General Insurance Company’s, and GEICO Casualty Co.’s (collectively, “GEICO” or “Plaintiffs”) Statements of Undisputed Facts [D.E. 243]. Also before the Court is Defendants’ Motion for Leave to file an Amended Statement of Facts and a Sur-reply, [D.E. 260], as well as the parties’ cross-motions in Limine [D.E. 264, 267]. The Motions have been fully briefed and are now ripe for disposition.1

1 On April 16, 2020, the Honorable Kathleen M. Williams referred all pretrial non- dispositive matters to the Undersigned Magistrate Judge for disposition. [D.E. 201]. After careful consideration of the motions and the record presented, Defendants’ Motion to Strike Plaintiffs’ Statements of Undisputed Facts [D.E. 243] and Motion in Limine [D.E. 267] are DENIED; Defendants’ Motion for Leave to file Amended

Statement of Facts and Sur-reply [D.E. 260] and Plaintiffs’ Motions in Limine [D.E. 264] are GRANTED in part and DENIED in part. I. BACKGROUND

GEICO commenced this action on April 13, 2020 against Defendants and their co-Defendants. [D.E. 1]. GEICO, a group of insurance companies, alleges that Defendants submitted fraudulent no-fault (“PIP”) insurance billing to GEICO. The complaint specifically alleges that Defendants submitted the fraudulent PIP billing through Doctor Max, a Florida healthcare facility. This PIP billing allegedly falsely represented that the underlying healthcare services were lawfully provided, lawfully billed to GEICO, and were eligible for reimbursement under Florida’s no-fault insurance laws. However, GEICO alleges that the healthcare services were not lawfully provided, lawfully billed, or eligible for PIP reimbursement because: (i) the vast majority of the purported “physical therapy” services that Defendants billed to

GEICO were performed—if performed at all—by unsupervised massage therapists; (ii) Defendants falsely represented that the services had been performed under the direct supervision licensed physician, when in fact they had not; and (iii) the billing for the services misrepresented the nature, extent, and medical necessity of the services, and in many cases falsely represented that the pertinent healthcare services actually had been performed at all. II. ANALYSIS

A. Defendants’ Motion to Strike Plaintiffs’ Statements of Fact Defendants first move this Court to strike certain statements from Plaintiffs’ Statement of Undisputed Facts [D.E. 212], alleging that the targeted statements are based on a Declaration that fails to comply with the “personal knowledge” requirement of Fed. R. Civ. P. 56(c)(4), and improperly relies on inadmissible evidence. Defendants also seek attorney fees and sanctions in connection with their motion to strike. For the reasons that follow, Defendants’ motion is DENIED. The granting of a motion to strike is a “drastic remedy” that is disfavored. Regions Bank v. TBG & CC Recreation, LLC, Case No. 10-80366-CIV, 2010 WL

3292909, at *1 (S.D. Fla. Aug. 19, 2010). A motion to strike should be granted “only when required for the purposes of justice,” and “should be granted only when the [filing] to be stricken has no possible relation to the controversy.” Augustus v. Bd. of Pub. Instruction of Escambia Cnty., Fla., 306 F.2d 862, 868 (5th Cir. 1962).2 According to Defendants, Plaintiffs’ Statements of Undisputed Facts should be stricken because a large portion of those statements rely on the Declaration of Victoria Spring (“Ms. Spring”), whom Defendants allege lacked personal knowledge

over most of the assertions she attested to in her Declaration. Although Defendants acknowledge that her Declaration was based on her review of a large number of business files and other records, some of which she attached to her Declaration, see

2 In Bonner v. City of Prichard, 661 F.2d 1206, 1207 (11th Cir. 1981) (en banc), the Eleventh Circuit adopted as binding precedent all decisions of the former Fifth Circuit rendered prior to the close of business on September 30, 1981. [D.E. 243-1], Defendants seem to suggest that because she was not personally involved in the receipt, issuance, or processing of these files she lacks personal knowledge over them and her Declaration runs afoul of Rule 56(c)(4). This argument

is flawed. The Eleventh Circuit has held that district courts may consider statements from declarants who rely on business records and their professional knowledge when attesting to certain facts in their declarations. See Star2Star Commc'ns, LLC v. AMG Grp. of Brunswick, LLC, No. 21-13698, 2022 WL 1157776, at *3 (11th Cir. Apr. 19, 2022) (upholding denial to strike premised on lack of personal knowledge where

declarant reviewed business records and was qualified to discuss their contents); see also Silva v. Baptist Health S. Fla., Inc., No. 14-CV-21803, 2015 WL 12030094, at *1 (S.D. Fla. Apr. 14, 2015) (“[Declarant] sets forth the requisite foundation for personal knowledge gained from review of records of regularly conducted activity.”); United States v. Kneapler, 733 F. Supp. 2d 1308, 1319 (S.D. Fla. 2010) (“[P]ersonal knowledge can come from a review of the contents of business files and records.”). Contrary to Defendants’ allegations, Ms. Spring is not just a random employee

of Plaintiffs. Rather, Ms. Spring is GEICO’s Personal Injury Protection (“PIP”) Litigation Manager, which makes her competent to understand and discuss the contents of documents relevant to litigations dealing with allegations of fraudulent PIP insurance claims, such as the one at hand. Indeed, a review of her Declaration reveals that her knowledge regarding the matters discussed therein derives from her review of documents that were produced by either Defendants or Plaintiffs in their regular course of business, and pieces of evidence that have already been admitted in the record, including deposition transcripts. Accordingly, Ms. Spring’s Declaration sufficiently sets forth the foundational bases required by Rule 56, and Defendants’

argument fails. See Cargo Airport Servs. USA, LLC v. Transcarga Int'l Airwaus, C.A., Inc., 2017 WL 4898292, at *2 (S.D. Fla. Oct. 27, 2017) (“An affidavit submitted by a corporate representative in support of summary judgment is properly considered when the corporate representative expressly verifies that the matters stated therein are based on his personal knowledge gained through the review of business records.”); Ramirez v. Scottsdale Ins. Co., No. 20-CV-22324, 2021 WL 5050184, at *6 n.3 (S.D.

Fla. Oct. 29, 2021), appeal dismissed, No. 21-14207-BB, 2022 WL 1741355 (11th Cir. Apr. 28, 2022) (refusing to strike declaration “based upon personal knowledge and a review of files which are routinely made and maintained in the ordinary course of business[.]”); Hines St. Lucia, LLC v. I.H.M. Inc. Ltd., No. 16-CV-80562, 2016 WL 10803525, at *3 n.2 (S.D. Fla. Dec.

Free access — add to your briefcase to read the full text and ask questions with AI

Government Employees Insurance Co. v. Gomez-Cortes, (S.D. Fla. 2022).

Government Employees Insurance Co. v. Gomez-Cortes (Government Employees Insurance Co. v. Gomez-Cortes) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

Related

Old Chief v. United States
519 U.S. 172 (Supreme Court, 1997)
Larry Bonner v. City of Prichard, Alabama
661 F.2d 1206 (Eleventh Circuit, 1981)
United States v. Jayyousi
657 F.3d 1085 (Eleventh Circuit, 2011)
Federal Trade Commission v. Stephen Lalonde
545 F. App'x 825 (Eleventh Circuit, 2013)
Highland Capital Management, L.P. v. Schneider
551 F. Supp. 2d 173 (S.D. New York, 2008)
United States v. Kneapler
733 F. Supp. 2d 1308 (S.D. Florida, 2010)
United States v. Gonzalez
718 F. Supp. 2d 1341 (S.D. Florida, 2010)
Patricia Wingster v. Frederick Head
318 F. App'x 809 (Eleventh Circuit, 2009)
Palmieri v. Defaria
88 F.3d 136 (Second Circuit, 1996)
United States v. King
713 F.2d 627 (Eleventh Circuit, 1983)