Progressive American Insurance Co. v. Emergency Physicians of Central Florida

District Court of Appeal of Florida

Progressive American Insurance Co. v. Emergency Physicians of Central Florida

187 So. 3d 898

CourtDistrict Court of Appeal of Florida

DecidedFebruary 29, 2016

Docket5D15-3314

StatusPublished

Cited by1 cases

This text of 187 So. 3d 898 (Progressive American Insurance Co. v. Emergency Physicians of Central Florida) 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

Progressive American Insurance Co. v. Emergency Physicians of Central Florida, 187 So. 3d 898 (Fla. Ct. App. 2016).

Pincite

Opinion

PER CURIAM.

This case arose after the insured, Asmaa Karani, was involved in a car accident and sought treatment from the respondent, Emergency Physicians of Central Florida, LLP, a/a/o Karani (“EPCF”). EPCF is an emergency services provider. It submitted its bill tc the petitioner, Progressive American Insurance Company (“Progressive”), in accordance with section 627.736(4)(c), Florida Statutes , (2011). However, its bill was applied to Karani’s deductible under section 627.739(2), Florida Statutes (2011). Therefore, Progressive did not. remit payment to EPCF.

EPCF, as Karani’s- assignee, initiated an action in county court against Progressive for breach of the insurance policy. The county court ruled in favor of EPCF, finding that EPCF was a member of a legislatively created and protected class of priority providers and therefore entitled to have its bill paid in full despite the existence of Karani’s deductible. The circuit court affirmed, holding that the deductible. was improperly applied to EPCF’s bill.

This matter comes before this court on second-tier certiorari review. In Mercury Insurance Company of Florida v. Emergency Physicians of Central Florida, LLP, 182 So.3d 661 (Fla. 5th DCA 2015), this court held that all claims, including EPCF’s priority claim, are properly applied 'to a personal injury protection deductible in the order that they are received. See also Metro. Cas. Ins. Co. v. Emergency Physicians of Cent. Fla., LLP, 178 So.3d 927 (Fla. 5th DCA 2015). Following Mercury, the circuit court in the instant appeal erred in holding that the benefits to be paid from the $5000 reserve imposed by section 627.736(4)(c) are not subject to an otherwise applicable deductible. Such an interpretation runs afoul of the plain language of section 627.739(2), which sets out that “[t]he deductible amount must be applied to 100 percent of the expenses and- losses described in s. 627.736.” Accordingly, EPCF is not entitled to payment from Progressive, as Progressive properly applied its claim to the deductible. We .grant Progressive’s petition for writ of certiorari and quash the circuit court’s order.

CERTIORARI GRANTED; ORDER QUASHED.

SAWAYA, COHEN and BERGER, JJ., concur.

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PER CURIAM.

This case arose after the insured, Asmaa Karani, was involved in a car accident and sought treatment from the respondent, Emergency Physicians of Central Florida, LLP, a/a/o Karani (“EPCF”). EPCF is an emergency services provider. It submitted its bill tc the petitioner, Progressive American Insurance Company (“Progressive”), in accordance with section 627.736(4)(c), Florida Statutes , (2011). However, its bill was applied to Karani’s deductible under section 627.739(2), Florida Statutes (2011). Therefore, Progressive did not. remit payment to EPCF.

EPCF, as Karani’s- assignee, initiated an action in county court against Progressive for breach of the insurance policy. The county court ruled in favor of EPCF, finding that EPCF was a member of a legislatively created and protected class of priority providers and therefore entitled to have its bill paid in full despite the existence of Karani’s deductible. The circuit court affirmed, holding that the deductible. was improperly applied to EPCF’s bill.

This matter comes before this court on second-tier certiorari review. In Mercury Insurance Company of Florida v. Emergency Physicians of Central Florida, LLP, 182 So.3d 661 (Fla. 5th DCA 2015), this court held that all claims, including EPCF’s priority claim, are properly applied 'to a personal injury protection deductible in the order that they are received. See also Metro. Cas. Ins. Co. v. Emergency Physicians of Cent. Fla., LLP, 178 So.3d 927 (Fla. 5th DCA 2015). Following Mercury, the circuit court in the instant appeal erred in holding that the benefits to be paid from the $5000 reserve imposed by section 627.736(4)(c) are not subject to an otherwise applicable deductible. Such an interpretation runs afoul of the plain language of section 627.739(2), which sets out that “[t]he deductible amount must be applied to 100 percent of the expenses and- losses described in s. 627.736.” Accordingly, EPCF is not entitled to payment from Progressive, as Progressive properly applied its claim to the deductible. We .grant Progressive’s petition for writ of certiorari and quash the circuit court’s order.

CERTIORARI GRANTED; ORDER QUASHED.

SAWAYA, COHEN and BERGER, JJ., concur.

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187 So. 3d 898, Counsel Stack Legal Research, https://law.counselstack.com/opinion/progressive-american-insurance-co-v-emergency-physicians-of-central-fladistctapp-2016.

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