State Farm Mutual Automobile Insurance v. Warren

805 So. 2d 1074, 2002 Fla. App. LEXIS 952, 2002 WL 125608
CourtDistrict Court of Appeal of Florida
DecidedFebruary 1, 2002
DocketNo. 5D00-3064
StatusPublished
Cited by3 cases

This text of 805 So. 2d 1074 (State Farm Mutual Automobile Insurance v. Warren) 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
State Farm Mutual Automobile Insurance v. Warren, 805 So. 2d 1074, 2002 Fla. App. LEXIS 952, 2002 WL 125608 (Fla. Ct. App. 2002).

Opinion

PETERSON, J.

State Farm Mutual Automobile Insurance Co. (State Farm), appeals a final judgment awarded to Dan Ray Warren, State Farm’s insured, and Dr. Jack Rot-stein, M.D., Warren’s physician. The county court entered the judgment after holding section 627.736(5)(b), Florida Statutes (1999), unconstitutional as violative of Dr. Rotstein’s rights to equal protection, due process and access to the courts.1

Section 627.736(5)(b)2 provides that “the insurer is not required to pay [for] charges for treatment or services rendered more than 30 days before the postmark date of the statement [of charges]_” The statute also provides that, “[t]he injured party is not hable for, and the provider shall not bill the injured party for, charges that are unpaid because of the provider’s failure to comply with this paragraph.”

Warren was injured in a motor vehicle accident on March 22, 1999 and received treatment from Dr. Jack Rotstein on May 27, June 16, and July 6, 1999. Dr. Rot-stein, failed to submit statements for his medical services to State Farm until August 9, 1999, more than thirty days after the services were rendered. Because the statements were statutorily delinquent, State Farm denied payment to Dr. Rot-stein.

Although Warren incurred no liability for the treatments because he enjoyed immunity under the statute for Dr. Rotstein’s tardy statements, he initiated an action for non-payment against State Farm and eventually joined Dr. Rotstein as a party plaintiff.

The county court agreed with Dr. Rot-stein’s allegations that the thirty-day billing requirement of section 627.736(5)(b) is an “irrational legal hoop” and should be declared unconstitutional. The court found that “it [the statute] denies equal protection under the Florida Constitution to health care providers such as Dr. Rot-stein by differentiating his bills from hospital and ambulance bills,” that the statute “is not reasonably related to a legitimate legislative object [sic]”, “violates the due process provisions of the Florida Constitution,” and that it “denies medical providers who are not hospitals and ambulance companies access to the courts.” The court then entered judgment for $1,640.25 plus interest to Dr. Rotstein and awarded attorney’s fees and costs in the amount of $12,699.26 pursuant to section 627.736(8), Florida Statutes (1999).

State Farm urges that we dismiss the appeal because the Florida Attorney General was not joined in this action as required by section 86.091, Florida Statutes (1999), when the constitutionality of a statute is challenged. However, State Farm raises the non-joinder for the first time on this appeal and invited the county court to determine constitutionality in its joint pre-trial statement. Because State Farm requested that the trial court determine the issue of the statute’s constitutionality and ignored the requirement at the trial level, we find it has waived the right to challenge the non-joinder. Additionally, [1077]*1077we have ignored the requirement since we find the statute to be constitutionally valid.

It is well established that when the constitutionality of a statute is at issue, courts must find the statute valid if there is any reasonable basis for doing so. See generally 10 Fla. Jur.2d Constitutional Law § 94. Accordingly, when a trial court has declared a statute unconstitutional, the reviewing court must begin the process of appellate review with a presumption that the statute is valid. E.g., State, Dept. of Ins. v. Keys Title & Abstract Co., 741 So.2d 599 (Fla. 1st DCA 1999), rev. denied, 770 So.2d 158 (Fla.2000). The burden of proving the unconstitutionality of a statute is upon the party challenging its validity, and this challenger must show that beyond all reasonable doubt the statute conflicts with some designated provision of the constitution. E.g., A.B.A. Industries, Inc. v. City of Pinellas Park, 366 So.2d 761 (Fla.1979).

EQUAL PROTECTION

The county court found that section 627.736(5)(a) denied Dr. Rotstein equal protection of the law, contrary to Article I, Section 2 of the Florida Constitution and the Fourteenth Amendment of the United States Constitution because the statute distinguishes between health care providers, such as Dr. Rotstein, and services provided by hospitals and ambulance providers. The county court found the different classifications to be unreasonable and not related to a legitimate state purpose.

An equal protection challenge to a statute that does not involve a fundamental right or suspect classification is evaluated by the rational basis test. E.g., Keys Title & Abstract Co., 741 So.2d at 602; see also Florida League of Cities, Inc. v. Dep’t of Environmental Regulation, 603 So.2d 1363 (Fla. 1st DCA 1992). The test requires that a statutory classification bear some reasonable relationship' to the achievement of a legitimate state purpose. E.g., Pinillos v. Cedars of Lebanon-Hospital Corp., 403 So.2d 365 (Fla.1981).

We agree with State Farm that the Legislature had a legitimate state purpose for distinguishing between services provided by medical providers and services provided by hospital emergency departments and ambulance providers. The Legislature recognized that a PIP insurer should be entitled to deny payment for treatment whén the treatment is not reasonable, not related to the covered motor vehicle accident, or not necessary. House of Representatives Committee on Financial Services, Bill Research & Economic Statement dated Dec. 11, 1997.' Refusal to pay for treatment is usually based on an independent medical examination (IME) conducted by a physician selected by the insurer. In order for an insurer to exercise its right to require an IME, it must be aware that treatment is being provided, but there is no statutory authorization for an insurer under a PIP policy to require notice of treatment. The absence of a notice requirement could allow an insured to receive a lengthy series of treatments and be fully recovered before the insurer becomes aware of the treatment. In that situation, the insurer could lose its ability to determine whether the treatment was reasonable, related, or necessary. Section 627.736(5)(b) seeks to remedy the absence of a notice requirement by requiring timely statements from medical providers so that a PIP insurer would be aware of the commencement of treatment and would be in a better position to assure that treatment is reasonable, related to the motor vehicle accident, or necessary. The timely statement requirement also reduces the practice of bulk billing by some medical providers which occurs when treatments are ren[1078]*1078dered over a period of time and the insurer is subsequently billed for multiple treatments. In turn, this lowers the insurer’s cost of providing PIP coverage and makes the IME a more effective cost-control tool. These savings benefit consumers by reducing the costs upon which insurers base PIP premiums.

There is a logical explanation for placing a statutory time limit upon medical providers and not hospital emergency departments and ambulance providers. Medical providers frequently provide ongoing medical treatment involving regular office visits for chiropractic treatment, physical therapy, orthopedic care, and the like. Conversely, services provided by a hospital emergency room or ambulance provider usually occur only once, immediately following the motor vehicle accident.

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Related

Warren v. State Farm Mut. Auto. Ins. Co.
899 So. 2d 1090 (Supreme Court of Florida, 2005)
Parsons v. HARBOR SPECIALTY INSURANCE COMPANY
839 So. 2d 742 (District Court of Appeal of Florida, 2003)

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Bluebook (online)
805 So. 2d 1074, 2002 Fla. App. LEXIS 952, 2002 WL 125608, Counsel Stack Legal Research, https://law.counselstack.com/opinion/state-farm-mutual-automobile-insurance-v-warren-fladistctapp-2002.