Kaklamanos v. Allstate Ins. Co.

796 So. 2d 555, 2001 WL 838198
CourtDistrict Court of Appeal of Florida
DecidedJuly 26, 2001
Docket1D00-2974
StatusPublished
Cited by12 cases

This text of 796 So. 2d 555 (Kaklamanos v. Allstate Ins. Co.) 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
Kaklamanos v. Allstate Ins. Co., 796 So. 2d 555, 2001 WL 838198 (Fla. Ct. App. 2001).

Opinion

796 So.2d 555 (2001)

Dino KAKLAMANOS and Keely Kaklamanos, Petitioners,
v.
ALLSTATE INSURANCE COMPANY, Respondent.

No. 1D00-2974.

District Court of Appeal of Florida, First District.

July 26, 2001.
Rehearing Denied October 5, 2001.

*556 David Lee Sellers, Pensacola, for Petitioners.

Yancey F. Langston of Moore, Hill & Westmoreland, P.A., Pensacola, for Respondent.

Katherine E. Giddings of Katz, Kutter, Haigler, Alderman, Bryant & Yon, P.A., Tallahassee, for Amicus Curiae, American Insurance Association.

BENTON, J.

At issue is whether an insured whose medical bills Allstate Insurance Company (Allstate) declines to pay can sue Allstate for personal injury protection (PIP) and automobile medical payments (medpay) benefits, without first paying the medical provider, if the medical provider has not yet brought suit against the insured. Dino Kaklamanos and Keely Kaklamanos, petitioners here, were plaintiffs in county court. Their complaint proceeded on the theory that Allstate's failure to pay a medical bill they had forwarded (or caused to be forwarded) to Allstate breached the PIP and medpay provisions of their motor vehicle insurance policy. On appeal from Escambia County Court, the Circuit Court, First Circuit, affirmed the final judgment a county judge entered in favor of Allstate after granting Allstate's motion for summary judgment. We quash the circuit court's judgment.

I.

The complaint the Kaklamanoses filed in county court on April 6, 1999, alleged that a medical provider, Nu Best Diagnostics (NBD), had performed medically reasonable treatment or testing on Keely Kaklamanos on January 27, 1999; that an automobile accident in which Ms. Kaklamanos had been injured on or about February 17, 1998, made the treatment or testing necessary; and that NBD's bill had been sent to Allstate, the Kaklamanoses' motor vehicle insurer; but that, despite the Kaklamanoses' compliance "with all statutory requirements precedent to ... entitlement to benefits," Allstate had refused to pay the bill, even in part.

Allstate disputed the allegation that the automobile accident made the services for which NBD billed reasonably medically necessary, but did not dispute other salient facts. The parties agreed that an automobile accident had occurred and that Allstate's policy was in effect at the time. The Kaklamanoses admitted that they had not paid NBD's bill and that NBD had not filed suit against them for nonpayment. Allstate admitted that it had been duly notified of the circumstances allegedly surrounding the injuries "by means of the `No Fault' application-for-benefits claim form."

Conceding that NBD's bill remained unpaid only because Allstate disputed its reasonable medical necessity in relation to the accident, Allstate moved for summary judgment on the basis of the following policy provision:

If an insured person incurs medical expenses which [Allstate] deem[s] to be unreasonable or unnecessary, [Allstate] may refuse to pay for those medical expenses and contest them.
If the insured person is sued by a medical services provider because [Allstate] refuse[s] to pay medical expenses *557 which [Allstate] deem[s] to be unreasonable or unnecessary, [Allstate] will pay resulting defense costs and any resulting judgment against the insured person. [Allstate] will choose the counsel. The insured person must cooperate with [Allstate] in the defense of any claim or lawsuit. If [Allstate] ask[s] an insured person to attend hearings or trials, [Allstate] will pay up to $50.00 per day for loss of wages or salary. [Allstate] will also pay other reasonable expenses incurred at [its] request.

On grounds that Ms. Kaklamanos had "eschewed the indemnification and defense provisions of her policy with" Allstate, the county court granted Allstate's motion for summary judgment, ruling that there were "no damages to pursue in this action nor can any result in the future," and entered summary judgment in favor of Allstate accordingly. On appeal, the circuit court affirmed.

II.

Initially, we must decide whether the certiorari petition the Kaklamanoses have addressed to the circuit court's decision falls within the limited "scope of common law certiorari jurisdiction." Ivey v. Allstate Ins. Co., 774 So.2d 679, 682 (Fla. 2000). Only if "the circuit court's decision constituted a denial of procedural due process, application of incorrect law, or a miscarriage of justice," Ivey, 774 So.2d at 683, do we properly decide the question their petition presents.

Certiorari is a common-law writ which issues in the sound judicial discretion of the court to an inferior court, not to take the place of an appeal, but to cause the entire record of the inferior court to be brought up in order that it may be determined from the face thereof whether the inferior court has exceeded its jurisdiction, or has not proceeded according to the essential requirements of law. Confined to its legitimate scope, the writ may issue within the court's discretion to correct the procedure of courts wherein they have not observed those requirements of the law which are deemed to be essential to the administration of justice.... Failure to observe the essential requirements of law means failure to accord due process of law within the contemplation of the Constitution, or the commission of an error so fundamental in character as to fatally infect the judgment and render it void....
It seems to be the settled law of this state that the duty of a court to apply to admitted facts a correct principle of law is such a fundamental and essential element of the judicial process that a litigant cannot be said to have had the remedy by due course of law, guaranteed [by the Florida Constitution], if the judge fails or refuses to perform that duty.

State v. Smith, 118 So.2d 792, 795 (Fla. 1st DCA 1960) (footnotes omitted) (quoted with approval in Haines City Cmty. Dev. v. Heggs, 658 So.2d 523, 527 (Fla.1995)). Examination of the record, including the briefs filed in circuit court, persuades us that the circuit court applied[1] the incorrect law in the present case. We reach and decide the merits of the petition because the court's purely legal error was *558 "sufficiently egregious or fundamental." Haines City Cmty. Dev., 658 So.2d at 531. See, e.g., Rader v. Allstate Ins. Co., 789 So.2d 1045, D1431 (Fla. 4th DCA 2001); Progressive Express Ins. Co. v. MTM Diagnostics, Inc., 754 So.2d 150, 152 (Fla. 2d DCA 2000); Globe Life & Accident Ins. Co. v. Preferred Risk Mut. Ins. Co., 539 So.2d 1192, 1193 (Fla. 1st DCA 1989).

III.

The policy language on which Allstate relies does not in terms purport to place any restrictions on an insured's right to sue, if PIP or medpay benefits are not paid in a timely fashion. Allstate cannot legally, moreover, diminish[2] the extent of its PIP and medpay undertakings by adding or amending policy provisions. See generally Young v. Progressive Southeastern Ins. Co., 753 So.2d 80 (Fla.2000) (holding uninsured motorist policies must conform[3] to statutory requirements). Section 627.736(4), Florida Statutes (1997) makes PIP and medpay benefits "due and payable as loss accrues, upon receipt of reasonable proof of such loss and the amount of expenses and loss incurred which are covered by the policy."

As the Ivey

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Bluebook (online)
796 So. 2d 555, 2001 WL 838198, Counsel Stack Legal Research, https://law.counselstack.com/opinion/kaklamanos-v-allstate-ins-co-fladistctapp-2001.