Progressive Specialty Insurance Company v. Florida Hospital Ocala, Inc. D/B/A Adventhealth Ocala A/A/O Sandra Thomas

CourtDistrict Court of Appeal of Florida
DecidedOctober 14, 2024
Docket6D2023-1347
StatusPublished

This text of Progressive Specialty Insurance Company v. Florida Hospital Ocala, Inc. D/B/A Adventhealth Ocala A/A/O Sandra Thomas (Progressive Specialty Insurance Company v. Florida Hospital Ocala, Inc. D/B/A Adventhealth Ocala A/A/O Sandra Thomas) 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 Specialty Insurance Company v. Florida Hospital Ocala, Inc. D/B/A Adventhealth Ocala A/A/O Sandra Thomas, (Fla. Ct. App. 2024).

Opinion

SIXTH DISTRICT COURT OF APPEAL STATE OF FLORIDA _____________________________

Case No. 6D2023-1347 Lower Tribunal No. 2019-SC-034548-O _____________________________

PROGRESSIVE SPECIALTY INSURANCE COMPANY,

Appellant, v.

FLORIDA HOSPITAL OCALA, INC. d/b/a ADVENTHEALTH OCALA a/a/o SANDRA THOMAS,

Appellee. _____________________________

Appeal from the County Court for Orange County. Brian S. Sandor, Judge.

October 14, 2024

GANNAM, J.

Progressive Specialty Insurance Company appeals the entry of summary

judgment for Florida Hospital Ocala, Inc., as assignee of Sandra Thomas. 1 Because

the out-of-state coverage provision of Thomas’s Maryland car insurance policy does

not increase the policy’s $2,500 PIP coverage limit to conform to Florida PIP

requirements, Progressive is not liable for payment of PIP benefits to Florida

1 This case was transferred from the Fifth District Court of Appeal to this Court on January 1, 2023. Hospital beyond the $2,500 Progressive already paid. Accordingly, we reverse the

judgment and remand for entry of judgment for Progressive.

I.

A.

In July 2018, Thomas purchased a Maryland car insurance policy from

Progressive. At the time, Thomas resided and garaged her car in Maryland. The

policy provides $2,500 in PIP benefits in addition to other coverages. The policy

begins with a declarations page summarizing the limits of her coverages, including

the following limits pertinent to this appeal:

Limits Liability To Others Bodily Injury Liability $30,000 each person/$60,000 each accident Property Damage Liability $15,000 each accident Personal Injury Protection $2,500

The substantive coverage provisions of the policy track the coverage

categories shown on the declarations page. “PART I—LIABILITY TO OTHERS”

obligates Progressive to pay damages “for bodily injury and property damage for

which an insured person becomes legally responsible because of an accident.”

“PART II—PERSONAL INJURY PROTECTION COVERAGE” obligates

Progressive to pay “the reasonable and necessary covered expenses incurred because

2 of bodily injury . . . sustained by an insured person . . . arising from a motor vehicle

accident.”

Part I of the policy also includes an “OUT-OF-STATE COVERAGE”

provision, which potentially increases certain coverages by conforming the policy to

the requirements of other states’ laws:

If an accident to which this Part I applies occurs in any state . . . other than the one in which a covered auto is principally garaged, and the state . . . has: 1. a financial responsibility or similar law requiring limits of liability for bodily injury or property damage higher than the limits shown on the declarations page, this policy will provide the higher limits; or 2. a compulsory insurance or similar law requiring a non- resident to maintain insurance whenever the non- resident uses an auto in that state . . . this policy will provide the greater of: a. the required minimum amounts and types of coverage; or b. the limits of liability under this policy.

B.

In October 2018, Thomas began working and residing in Ocala, Florida.

Around eight months later, in July 2019, Thomas was injured in an accident while

driving her car in Florida and received medical treatment from Florida Hospital.

Thomas assigned her PIP insurance benefits to Florida Hospital, and Florida

Hospital billed Progressive $8,870.71 for her treatment. Progressive paid Florida

Hospital $2,377.72, and paid another medical provider $122.28, for a total of $2,500.

3 Florida Hospital sent Progressive a presuit demand letter seeking the balance of the

amount it billed for Thomas’s treatment, but Progressive responded that the policy’s

$2,500 in PIP benefits had been exhausted.

In October 2019, Florida Hospital, as Thomas’s assignee, sued Progressive

for breach of contract. Relevant to this appeal, Progressive’s answer to Florida

Hospital’s complaint alleged in defense that Thomas failed to comply with the PIP

coverage requirements of the Florida Motor Vehicle No-Fault Law, sections

627.730–627.7405, Florida Statutes, and that Progressive had fully satisfied its

contractual obligation to Thomas by exhausting the Maryland policy’s $2,500 in PIP

benefits coverage.

Florida Hospital moved for summary judgment, claiming that the Maryland

policy’s out-of-state coverage provision increased the PIP coverage to $10,000 to

conform the policy to the requirements of the Florida No-Fault Law. Progressive

countered with its own summary judgment motion asserting several grounds,

including its contractual defense that it had exhausted the PIP benefits due Thomas

and its defense that Thomas failed to obtain a Florida insurance policy providing the

PIP benefits required by the No-Fault Law, making Thomas alone liable for those

benefits. The trial court denied Progressive’s summary judgment motion, concluding

Progressive’s defenses failed as a matter of law. But the court granted Florida

Hospital’s summary judgment motion and entered judgment against Progressive for

4 $2,944.71.2 On appeal, Progressive asks us to reverse the judgment and remand with

instructions to enter judgment against Florida Hospital.

II.

Because only legal issues are presented, our review of the order granting

summary judgment is de novo. See Fiddlesticks Country Club, Inc. v. Shaw, 363 So.

3d 1177, 1181 (Fla. 6th DCA 2023). The primary question on appeal is whether the

out-of-state coverage provision of Thomas’s Maryland insurance policy conformed

the policy to Florida coverage requirements, thereby increasing Thomas’s PIP

coverage from $2,500 to $10,000, and obligating Progressive to pay Florida Hospital

for her medical expenses beyond the $2,500 Progressive already paid. Answering

this question requires not only interpretation of the insurance policy, but also

interpretation of several lengthy and interconnected Florida statutes on car

registration and insurance.3 This is because the conformity clauses of the Maryland

out-of-state coverage provision depend on what Florida law says about nonresidents

2 This is the amount claimed by Florida Hospital in its summary judgment motion, representing eighty percent of seventy-five percent of the $8,870.71 billed to Progressive, less Progressive’s payment of $2,377.72. See § 627.736(5)(a)1.b., Fla. Stat. (2019) (“The insurer may limit reimbursement to 80 percent of . . . 75 percent of the hospital’s usual and customary charges.”). 3 “Fear not, keep reading.” Shiloh Christian Ctr. v. Aspen Specialty Ins. Co., 65 F.4th 623, 624 (11th Cir. 2023).

5 and PIP insurance, which in turn depends on what Florida law says about

nonresidents and car registration (with one exception).

In interpreting legal texts, Florida courts “follow the supremacy-of-text

principle—namely, the principle that the words of a governing text are of paramount

concern, and what they convey, in their context, is what the text means.” Ham v.

Portfolio Recovery Assocs., LLC, 308 So. 3d 942, 946 (Fla. 2020) (cleaned up)

(quoting Antonin Scalia & Bryan A. Garner, Reading Law: The Interpretation of

Legal Texts 56 (2012)). Thus, we interpret both insurance contracts and statutes

according to the plain meaning of their text, Allstate Ins. Co. v. Revival Chiropractic,

LLC, 385 So. 3d 107, 113 (Fla.

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Progressive Specialty Insurance Company v. Florida Hospital Ocala, Inc. D/B/A Adventhealth Ocala A/A/O Sandra Thomas, Counsel Stack Legal Research, https://law.counselstack.com/opinion/progressive-specialty-insurance-company-v-florida-hospital-ocala-inc-fladistctapp-2024.