Southern Group Indem. v. Humanitary Health

975 So. 2d 1247, 2008 WL 649577
CourtDistrict Court of Appeal of Florida
DecidedMarch 12, 2008
Docket3D06-2788
StatusPublished
Cited by2 cases

This text of 975 So. 2d 1247 (Southern Group Indem. v. Humanitary Health) 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
Southern Group Indem. v. Humanitary Health, 975 So. 2d 1247, 2008 WL 649577 (Fla. Ct. App. 2008).

Opinion

975 So.2d 1247 (2008)

SOUTHERN GROUP INDEMNITY, INC., Petitioner,
v.
HUMANITARY HEALTH CARE, INC., as assignee of Martha Lopez, Respondent.

No. 3D06-2788.

District Court of Appeal of Florida, Third District.

March 12, 2008.

David P. Pakula, Pembroke Pines, for petitioner.

Stuart B. Yanofsky, Hollywood, for respondent.

Before WELLS, SHEPHERD, and ROTHENBERG, JJ.

Before GERSTEN, C.J., and COPE, GREEN, RAMIREZ, WELLS, SHEPHERD, SUAREZ, CORTI—AS, ROTHENBERG, LAGOA and SALTER, JJ.

On Motion for Rehearing

ROTHENBERG, Judge.

We grant the appellee's motion for rehearing, withdraw our former opinion dated May 30, 2007, and substitute the following opinion in its stead:

Southern Group Indemnity, Inc. ("Southern Group") petitions this Court for a writ of certiorari, seeking to quash the opinion of the circuit court sitting in its appellate capacity, which affirmed the county court's order granting summary judgment in favor of Humanitary Health Care, Inc. ("Humanitary Health") on its request for a declaratory judgment. We grant the petition.

Following an automobile accident, Martha Lopez ("Lopez") received medical services from Humanitary Health. She assigned her rights under an automobile insurance policy providing personal injury protection ("PIP") benefits issued by Southern Group to Humanitary Health. Southern Group denied benefits on the basis that the claimed medical services did not exceed the $2,000 deductible under the policy.

On December 29, 2003, Humanitary Health filed suit against Southern Group in county court, seeking to collect PIP benefits. Count I was for breach of contract, alleging that Southern Group failed to pay the benefits within thirty days as required by paragraph 627.736(4)(b), Florida Statutes (2003).[1] In Count II, Humanitary Health requested that the circuit court issue a declaratory judgment providing that it was entitled to presuit disclosure of Southern Group's PIP payout logs. Humanitary Health asserted that pursuant to paragraph 627.736(6)(d), as part of its presuit investigation, it requested information *1249 from Southern Group, including a PIP payout log, which would have allowed it to determine whether the medical bills it submitted to Southern Group were properly applied to the deductible, but that Southern Group failed to submit these documents. Humanitary Health asserted that paragraph 627.736(6)(d) requires an insurer, upon a request from the injured person, to furnish the PIP payout logs presuit, and that because Lopez executed an assignment of benefits, it was placed in Lopez's shoes.

In November 2004, Humanitary Health filed a motion for partial summary judgment as to its declaratory judgment count. It argued that Southern Group "has now provided a PIP payout sheet as part of its response to Plaintiff's First Request to Produce. . . . In doing so, Defendant has essentially confessed judgment, entitling Plaintiff to recover attorney's fees and costs."

In March 2005, Southern Group moved for summary judgment. As to the breach of contract count, Southern Group argued that Humanitary Health's bill for medical services was applied to the deductible. As to the declaratory judgment count, Southern Group argued that under paragraph 627.736(6)(d), it did not have a duty to produce the PIP logs presuit because this section does not refer to PIP logs or any other internal documents prepared by the insurance carrier, and that paragraph 627.736(6)(b) only refers to documents from physicians, hospitals, clinics or other medical institutions.

The county court judge granted Humanitary Health's motion for partial summary judgment; denied Southern Group's motion for summary judgment; and reserved jurisdiction to award attorney's fees.

Southern Group appealed the county court's order granting partial summary judgment in favor of Humanitary Health to the circuit court, appellate division. The circuit court issued a written opinion affirming, which provides, in part, "[i]n the event an assignee is forced to file a lawsuit because of an insurance company's pre-litigation refusal to provide the log, a post-litigation production of the document is tantamount to a confession of judgment."[2] The court also concluded that "[w]hile ß 627.736(6)(d) does not specifically identify the PIP log as a document that must be produced by an insurer presuit, . . . the statutory language is broad enough to encompass the PIP log." Southern Group filed a Motion for Rehearing or Clarification, which the circuit court denied. Thereafter, Southern Group filed its petition for writ of certiorari in this Court.

The issue presented in this petition is whether the circuit court, acting in its appellate capacity, applied the correct law when it determined that pursuant to paragraph 627.736(6)(d), Florida Statutes (2003), an insurer is required to provide in presuit discovery its payout log to its insured and/or its insured's assignee, which in this case is the insured's medical provider.

Section 627.736, Florida Statutes (2003), provides personal injury protection to the various persons identified in subsection (1). Subsection (6) of the statute pertains to the obligation of the various entities to provide discovery to the insurer. Paragraph 627.736(6)(a) pertains to the obligation of the insured's employer to provide information to the insurer. Paragraph 627.736(6)(c) provides a mechanism for the insurer to petition the court to resolve disputes regarding the insurer's right to the requested discovery, and paragraph *1250 627.736(6)(d) allows the insured to obtain a copy of all information obtained by the insurer through this process. Specifically, paragraph 627.736(6)(d), Florida Statutes (2003), provides as follows:

(6) DISCOVERY OF FACTS ABOUT AN INJURED PERSON; DISPUTES.—
. . . .
(d) The injured person shall be furnished, upon request, a copy of all information obtained by the insurer under the provisions of this section, and shall pay a reasonable charge, if required by the insurer.

Humanitary Health, standing in the shoes of the insured, argued below that pursuant to paragraph 627.736(6)(d), it was entitled to a copy of Southern Group's payout log presuit. The circuit court agreed that paragraph 627.736(6)(d) was applicable and, while recognizing that the statute did not expressly require the insurer to provide its PIP payout log to the insured, concluded that the statute is broad enough to include it.

Humanitary Health's arguments before this Court are that the circuit court correctly interpreted paragraph 627.736(6)(d), and that whether we agree or disagree with the circuit court's interpretation is not dispositive, as mere disagreement with the appellate court's interpretation of an applicable statute is not a sufficient basis for granting second-tier certiorari review. While we completely agree with Humanitary Health's premise, we disagree with its conclusion. We do not merely disagree with the circuit court's interpretation of paragraph 627.736(6)(d), we conclude that the statute is completely inapplicable.

In Haines City Community Development v. Heggs, 658 So.2d 523, 528 (Fla. 1995), the Florida Supreme Court held that the proper inquiry under second-tier certiorari review is whether the circuit court afforded procedural due process and whether it applied the correct law. The Court, however, cautioned in Ivey v. Allstate Insurance Co., 774 So.2d 679 (Fla.

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

Related

City of Miami v. Cortes
995 So. 2d 604 (District Court of Appeal of Florida, 2008)
Progressive American Ins. Co. v. Rural/Metro Corp.
994 So. 2d 1202 (District Court of Appeal of Florida, 2008)

Cite This Page — Counsel Stack

Bluebook (online)
975 So. 2d 1247, 2008 WL 649577, Counsel Stack Legal Research, https://law.counselstack.com/opinion/southern-group-indem-v-humanitary-health-fladistctapp-2008.