State Farm Mutual Automobile Insurance v. Physicians Injury Care Center, Inc.

427 F. App'x 714
CourtCourt of Appeals for the Eleventh Circuit
DecidedMay 23, 2011
Docket10-10816, 10-10819, 10-10813, 10-10817, 10-10818
StatusUnpublished
Cited by37 cases

This text of 427 F. App'x 714 (State Farm Mutual Automobile Insurance v. Physicians Injury Care Center, Inc.) is published on Counsel Stack Legal Research, covering Court of Appeals for the Eleventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
State Farm Mutual Automobile Insurance v. Physicians Injury Care Center, Inc., 427 F. App'x 714 (11th Cir. 2011).

Opinion

PER CURIAM:

After two jury trials and oral argument on appeal, the parties are familiar with the facts of this case so we only summarize them for our purposes here. In November 2006, State Farm Mutual Automobile Insurance Company and State Farm Fire and Casualty Company (collectively “State Farm”) filed suit against Physicians Injury Care Center, Inc. (“PICC”), Dr. Irving Colvin, and Robert Colvin (collectively “Defendants”). State Farm alleged that the Defendants unlawfully obtained personal injury protection benefits (“PIP benefits”) from State Farm by “push[ing] State Farm’s insureds through a sham course of treatment and evaluation designed specifically to exhaust the patients’ insurance benefits.” Under the Florida Motor Vehicle No-Fault Law, insurers are required to provide PIP benefits up to a limit of $10,000 for losses sustained “as a result of bodily injury, sickness, disease, or death arising out of the ownership, maintenance, or use of a motor vehicle.” Fla. Stat. § 627.736(1). As to medical benefits, insurers must pay “[ejighty percent of all reasonable expenses for medically necessary medical, surgical, X-ray, dental, and rehabilitative services.” Id. § 627.736(l)(a). State Farm sought to recover the benefits it says were improperly paid to the Defendants under a variety of theories, including common law fraud. State Farm also requested a ruling by way of declaratory judgment that it was not required to pay any charges for treatments rendered by the Defendants that were pending or presented for payment during this litigation.

Before the first jury trial, eight State Farm policyholders intervened in the action as defendants. 1 All the intervenors *718 were injured in automobile accidents and received treatment at PICC. In light of the claims made in this litigation, State Farm declined to pay for those treatments. The intervenors asserted counterclaims against State Farm for, among other things, breach of contract. The first jury trial ended in a mistrial, and the case was tried again in November 2009. The second jury found in favor of State Farm on all counts. The district court denied the Defendants and intervenors’ post-trial motions and entered judgment in favor of State Farm. The Defendants and intervenors now appeal.

1. State Farm’s common law fraud claim is not preempted by Fla. Stat. § 627.736(12).

The Defendants contend that the district court should have entered judgment in their favor on State Farm’s common law fraud claim because that claim is preempted by Fla. Stat. § 627.736(12). 2 That statute creates a civil cause of action on behalf of an insurer “against any person convicted of, or who, regardless of adjudication of guilt, pleads guilty or nolo contendere to insurance fraud under § 817.234 ... associated with a claim for personal injury protection benefits in accordance with this section.” Fla. Stat. § 627.736(12). 3 A prevailing insurer may recover compensatory, consequential, and punitive damages as well as attorney’s fees and costs. Id.

Under Florida law, “[wjhether a statutory remedy is exclusive or merely cumulative depends upon the legislative intent as manifested in the language of the statute.” Thornber v. City of Ft. Walton Beach, 568 So.2d 914, 918 (Fla.1990). “Even where the legislature acts in a particular area, the common law remains in effect in that *719 area unless the statute specifically says otherwise.” State v. Ashley, 701 So.2d 338, 341 (Fla.1997); see also Essex Ins. Co. v. Zota, 985 So.2d 1036, 1048 (Fla.2008) (“A statute ... designed to change the common law rule must speak in clear, unequivocal terms, for the presumption is that no change in the common law is intended unless the statute is explicit in this regard.” (quoting Carlile v. Game & Fresh Water Fish Comm’n, 354 So.2d 362, 364 (Fla.1977))). “Unless a statute unequivocally states that it changes the common law, or is so repugnant to the common law that the two cannot coexist, the statute will not be held to have changed the common law.” Thornber, 568 So.2d at 918.

The express language of Fla. Stat. § 627.736(12) does not state that it precludes an insurer from bringing a claim for common law fraud. Nor is that statute “so repugnant to the common law that the two cannot coexist.” See id.; Thornber, 568 So.2d at 918. Accordingly, we conclude that Fla. Stat. § 627.736(12) does not preempt an insurer’s right to bring a claim for common law fraud.

2. State Farm’s common law fraud claim is not barred by the economic loss mle.

The Defendants also contend that State Farm’s common law fraud claim is barred by Florida’s economic loss rule. The economic loss rule is a judicially created doctrine. Generally, the doctrine prohibits tort actions when the only damages suffered are economic losses. Indem. Ins. Co. of N. Am. v. Am. Aviation, Inc., 891 So.2d 532, 536 (Fla.2004). The economic loss rule applies “when the parties are in contractual privity and one party seeks to recover damages in tort for matters arising from the contract.” 4 Id. The purpose of the rule is “to prevent parties to a contract from circumventing the allocation of losses set forth in the contract by bringing an action for economic loss in tort.” Id.

The economic loss rule does not preclude tort actions for “intentional or negligent acts that are independent from acts that breach the contract.” Brown v. Chamax, LLC, 51 So.3d 552, 556 (Fla. 2d DCA 2010). Nor does the economic loss rule “bar tort actions based on fraud if the fraud alleged does not relate to an act of performance under the contract but instead relates to a term in the agreement.” Id.; see also D & M Jupiter, Inc. v. Friedopfer, 853 So.2d 485, 487 (Fla. 4th DCA 2003) (“The test to determine if the economic loss rule applies is to ask if the fraud alleged is an act of performance or in a term of the bargain. When the fraud relates to the performance of the contract the economic loss doctrine will limit the parties to their contractual remedies.” (citations and quotation marks omitted)).

In this case, the Defendants argue that they were in privity of contract with State Farm because policyholders assigned their right to payment of PIP benefits to PICC. See Price v. RLI Ins. Co., 914 So.2d 1010, 1013 (Fla. 5th DCA 2005) (“An assignment is a transfer of all the interests and rights to the thing assigned. The assignee ...

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Bluebook (online)
427 F. App'x 714, Counsel Stack Legal Research, https://law.counselstack.com/opinion/state-farm-mutual-automobile-insurance-v-physicians-injury-care-center-ca11-2011.