USAA CASUALTY INSURANCE COMPANY vs CHRISTOS MIKROGIANNAKIS

CourtDistrict Court of Appeal of Florida
DecidedJuly 22, 2022
Docket21-0720
StatusPublished

This text of USAA CASUALTY INSURANCE COMPANY vs CHRISTOS MIKROGIANNAKIS (USAA CASUALTY INSURANCE COMPANY vs CHRISTOS MIKROGIANNAKIS) 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
USAA CASUALTY INSURANCE COMPANY vs CHRISTOS MIKROGIANNAKIS, (Fla. Ct. App. 2022).

Opinion

IN THE DISTRICT COURT OF APPEAL OF THE STATE OF FLORIDA FIFTH DISTRICT

NOT FINAL UNTIL TIME EXPIRES TO FILE MOTION FOR REHEARING AND DISPOSITION THEREOF IF FILED

USAA CASUALTY INSURANCE COMPANY,

Appellant,

v. Case No. 5D21-720 LT Case No. 2018-CC-000974-20-P-S

CHRISTOS MIKROGIANNAKIS,

Appellee.

________________________________/

Opinion filed July 22, 2022

Appeal from the County Court for Seminole County, James J. DeKleva, Judge.

Rebecca Delaney, Maria Pace and Scott W. Dutton, of Dutton Law Group, P.A., Orlando, for Appellant.

Chad A. Barr, of Chad Barr Law, Altamonte Springs, for Appellee.

EISNAUGLE, J.

USAA Casualty Insurance Company (“USAA”) appeals a summary

judgment and final judgment for damages in favor of Christos Mikrogiannakis. Section 627.736(5)(c), Florida Statutes (2014), establishes

a thirty-five-day time limitation for the submission of invoices to a Personal

Injury Protection (“PIP”) insurer. We must decide whether an exception to

this time limitation set forth in subsection (5)(c)(1) applies when the provider

receives no PIP insurance information at all, as opposed to receipt of

affirmative but erroneous information. We conclude that the plain language

of the exception requires receipt of affirmative information. We therefore

reverse.

Facts and Procedural History

Mikrogiannakis obtained medical treatment from Physical Medicine

Pain Center, P.A. (“PMPC”) after he was struck by a car while riding his

bicycle. At his initial visit, Mikrogiannakis completed a registration form but

listed only his contact information and the name of his lawyer. Although the

form asked Mikrogiannakis for the name and address of a PIP insurer, he

left that field blank. Mikrogiannakis then received treatment at PMPC over a

period of several months.

PMPC submitted the invoices to USAA approximately eighteen months

after treatment. As a result, USAA denied payment for failure to comply with

section 627.736(5)(c)’s thirty-five-day time limitation. Mikrogiannakis then

filed a petition for declaratory judgment and a claim for PIP insurance

2 benefits,1 relying on an exception to the thirty-five-day time limitation

applicable when a provider reasonably relies on erroneous PIP insurance

information.

The parties filed dueling motions for summary judgment, each arguing

entitlement to judgment based on section 627.736(5)(c). The trial court

agreed with Mikrogiannakis, reasoning that the exception to the thirty-five-

day time period applied because providing no PIP information was

equivalent to providing “erroneous information.” Accordingly, the trial court

denied USAA’s motion, granted Mikrogiannakis’s motion, and entered a final

judgment for damages in favor of Mikrogiannakis.

Statutory Analysis

“In interpreting the statute, we follow the ‘supremacy-of-text

principle’—namely, the principle that ‘[t]he words of a governing text are of

paramount concern, and what they convey, in their context, is what the text

means.’” Forrester v. Sch. Bd. of Sumter Cnty., 316 So. 3d 774, 776 (Fla.

1 USAA appears to argue on appeal that Mikrogiannakis lacked standing below. However, Mikrogiannakis received an assignment from PMPC, which appears in our record. USAA’s standing argument on appeal is deficient because it fails to even acknowledge this assignment, let alone explain why the trial court’s order denying USAA’s motion to dismiss for lack of standing was in error or to otherwise explain why Mikrogiannakis lacks standing in light of the assignment. See Cox v. Great Am. Ins. Co., 203 So. 3d 204, 205 (Fla. 4th DCA 2016) (“[O]n appeal the duty rests upon the appealing party to make error clearly appear.” (citation omitted)).

3 5th DCA 2021) (quoting Ham v. Portfolio Recovery Assocs., LLC, 308 So.

3d 942, 946 (Fla. 2020)). To that end, “[w]hen the language of a statute is

clear and unambiguous and conveys a clear and definite meaning, it must

be given its plain and obvious meaning.” Weightman v. State, 990 So. 2d

590, 592 (Fla. 5th DCA 2008) (citations omitted).2 We are also mindful that,

when interpreting a legal text, we must “arrive at a ‘fair reading’ of the text by

‘determining the application of [the] text to given facts on the basis of how a

reasonable reader, fully competent in the language, would have understood

the text at the time it was issued.’” Lab’y Corp. of Am. v. Davis, 47 Fla. L.

Weekly S134, S136 (Fla. May 26, 2022) (alteration in original) (quoting Ham,

308 So. 3d at 947); see also MRI Assocs. of Tampa, Inc. v. State Farm Mut.

Auto. Ins. Co., 334 So. 3d 577, 584 (Fla. 2021) (employing a “reasonable

reading of the statutory text”).

We conclude that section 627.736(5)(c) is unambiguous, and the

exception to the thirty-five-day time period does not apply where a provider

receives no information rather than “erroneous information.” “We reach this

conclusion by examining the text, context, and structure of the statute . . . .”

2 We review the trial court’s interpretation of a statute de novo. BellSouth Telecomms., Inc. v. Meeks, 863 So. 2d 287, 289 (Fla. 2003).

4 Dungarani v. Benoit, 312 So. 3d 126, 129 (Fla. 5th DCA 2020) (citation

omitted).

Section 627.736(5)(c) provides, in pertinent part:

With respect to any treatment or service, other than medical services billed by a hospital or other provider for emergency services and care as defined in s. 395.002 or inpatient services rendered at a hospital- owned facility, the statement of charges must be furnished to the insurer by the provider and may not include, and the insurer is not required to pay, charges for treatment or services rendered more than 35 days before the postmark date or electronic transmission date of the statement . . . .

1. If the insured fails to furnish the provider with the correct name and address of the insured’s personal injury protection insurer, the provider has 35 days from the date the provider obtains the correct information to furnish the insurer with a statement of the charges. The insurer is not required to pay for such charges unless the provider includes with the statement documentary evidence that was provided by the insured during the 35-day period demonstrating that the provider reasonably relied on erroneous information from the insured and either:

a. A denial letter from the incorrect insurer; or

b. Proof of mailing, which may include an affidavit under penalty of perjury, reflecting timely mailing to the incorrect address or insurer.

§ 627.736(5)(c).

The statute requires a provider to submit invoices within thirty-five days

of treatment and provides that the insurer is not required to pay any late

5 invoices. In this case, there is no dispute that the invoices were submitted

more than thirty-five days after treatment.

Nevertheless, Mikrogiannakis attempts to seize upon the statutory

exception to the rule which gives a provider, if the insured fails to provide

correct PIP information, thirty-five days from the date the provider obtains

the correct information. Specifically, Mikrogiannakis argues on appeal that

PMPC received “erroneous information” because he left the field for

insurance information blank despite having PIP coverage.

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Related

BellSouth Telecommunications, Inc. v. Meeks
863 So. 2d 287 (Supreme Court of Florida, 2003)
Cox v. Great American Insurance Co.
203 So. 3d 204 (District Court of Appeal of Florida, 2016)
Weightman v. State
990 So. 2d 590 (District Court of Appeal of Florida, 2008)

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USAA CASUALTY INSURANCE COMPANY vs CHRISTOS MIKROGIANNAKIS, Counsel Stack Legal Research, https://law.counselstack.com/opinion/usaa-casualty-insurance-company-vs-christos-mikrogiannakis-fladistctapp-2022.