UNITED AUTOMOBILE INSURANCE COMPANY, PETITIONER,
v.
EDUARDO J. GARRIDO, D.C., P.A., AS ASSIGNEE OF MARIA GARCIA, RESPONDENT
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United Automobile Insurance Company challenged a trial court's exclusion of a reviewing physician's report in a PIP benefits dispute. The Florida District Court of Appeal, Third District, granted the insurer's petition for certiorari, holding that a physician may issue an opinion based on review of medical records without conducting an independent medical examination, and remanded for reconsideration under the correct statutory framework.
Under paragraph 627.736(7)(a), Florida Statutes, a report can be issued by "a physician who reviews the examination and treatment records of the insured," meaning an independent medical examination is not required. However, the case was remanded because paragraph 627.736(4)(b) rather than 627.736(7)(a) controls in cases involving complete denial of payment.
[1] Second-tier certiorari review is appropriate when there is an acknowledged internal conflict of decisions within the appellate division of the circuit court regarding the…
[2] A party's failure to formally mark an exhibit as part of the record does not preclude appellate review if the substance of the exhibit was adequately communicated to the…
Previewing 2 of 5 headnotes on this case. FLexlaw’s editorially structured points of law — every proposition, pinpointed — are reserved for members.
Join FLexlaw to unlock all legal intelligence“In a case governed by paragraph 627.736(7)(a), the report can be issued by "a physician who reviews the examination and treatment records of the insured."”
Establishes that an independent medical examination is not required under the statute; review of records alone suffices for a physician's opinion.
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Join FLexlaw to unlock all legal intelligenceMaria Garcia was insured by United Auto and was injured in an automobile accident. She received treatment from Dr. Garrido and assigned her PIP benefi…
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This is a petition for second-tier writ of certiorari in a personal injury protection (“PIP”) case. We grant the petition.
Maria Garcia was insured by United Automobile Insurance Co. (“United Auto”). She was injured in an automobile accident and was treated by Dr. Eduardo J. Garri-do. Ms. Garcia assigned her PIP benefits to Dr. Garrido.
Dr. Garrido submitted his bills to United Auto, who did not pay them. Dr. Garrido brought suit.
Prior to trial, Dr. Garrido filed a motion in limine to bar the admission of the opinion of United Auto’s reviewing physician, Dr. Neil Fleisher. The motion explained that Dr. Fleisher had prepared a written report based on his review of Ms. Garcia’s treatment records. According to the motion, Dr. Fleisher opined that some, but not all, of the care was not medically necessary or related to the automobile accident. Dr. Garrido requested an order excluding Dr. Fleisher’s report because Dr. Fleisher did not perform an independent medical examination (“IME”) of the insured.
At argument on the motion in limine, both sides agreed that there was an internal conflict of decisions on this issue within the appellate division of the circuit court. Both sides agreed that the county court judge was free to choose the precedent she regarded as better reasoned. The county court judge granted the motion in limine. In subsequent proceedings, the court entered summary judgment in favor of Dr. Garrido, and United Auto appealed. The appellate division of the circuit court affirmed without opinion, and United Auto has filed a petition for second-tier writ of certiorari with this court.
Dr. Gañido argues that this case is not worthy of consideration on second-tier cer-tiorari. We disagree. This case is one of a number of petitions this court has entertained, including one proceeding en banc, in an effort to clarify the procedural as*122pects of the PIP statute. See United Automobile Ins. Co. v. Santa Fe Medical Center, 21 So.3d 60 (Fla. 3d DCA 2009) (en banc); see also Partners in Health Chiropractic v. United Automobile Ins. Co., 21 So.3d 858 (Fla. 3d DCA 2009); United Automobile Ins. Co. v. Metro Injury & Rehab Center, 16 So.3d 897 (Fla 3d DCA 2009). The parties acknowledged at the time of the county court hearing that there was an internal conflict of decisions in the appellate division of the circuit court. Under the circumstances, certiorari review is appropriate. See Allstate Ins. Co. v. Kaklamanos, 843 So.2d 885, 889-90 (Fla.2003).
Dr. Garrido argues that United Auto’s issue is not sufficiently preserved for appellate review because it failed to have Dr. Fleisher’s report marked and made part of the record. In this case, however, the substance of the report was sufficiently communicated in the text of the motion in limine and in the statements by counsel to the county court judge in argument on the motion in limine. See § 90.104(l)(b), Fla. Stat. (2008). The point is adequately preserved.
Turning to the merits, the parties litigated the case on the assumption that paragraph 627.736(7)(a), Florida Statutes, was applicable. Assuming for purposes of discussion that is so, the appellate division departed from the essential requirements of law. In a ease governed by paragraph 627.736(7)(a), the report can be issued by “a physician who reviews the examination and treatment records of the insured.” United Automobile Ins. Co. v. Metro Injury and Rehab Center, 16 So.3d at 900.
In the meantime, this court has issued its en banc decision in United Automobile Insurance Company v. Santa Fe Medical Center. That decision clarified that in the case of a complete denial of payment, paragraph 627.736(4)(b) is controlling, not paragraph 627.736(7)(a). Slip op. at 5. The case must be returned to the county court for further proceedings consistent with United Automobile Ins. Co. v. Metro Injury and United Automobile Ins. Co. v. Santa Fe Medical Center.
Petition granted.
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Previewing 3 of 5 citing cases — full citator treatment, depth of discussion, and citing context are member features.
Join FLexlaw to unlock all legal intelligenceAuthorities Cited
- Allstate Ins. Co. v. Keely Kaklamanos, 843 So. 2d 885 (Fla. 2003)
- United Auto. Ins. Co. v. Santa FE Med. Ctr., 21 So. 3d 60 (Fla. 3d DCA 2009)
- P'rs IN Health Chiropractic v. United Auto. Ins. Co., 21 So. 3d 858 (Fla. 3d DCA 2009)
- Vaught v. McNEIL, 16 So. 3d 897 (Fla. 1st DCA 2009)
- United Auto. Ins. Co. v. Metro Injury & Rehab Ctr., 16 So. 3d 897 (Fla. 3d DCA 2009)