USAA GENERAL INDEMNITY COMPANY, PETITIONER,
v.
FLORIDA HOSPITAL MEDICAL CENTER A/A/O RAYMOND RIVERA, RESPONDENT.
AI-generated. These summaries, headnotes, and key points are machine-generated and may contain errors or omissions. Always verify against the full opinion text below. Not legal advice.
USAA petitions for certiorari review of a circuit court decision affirming a county court judgment regarding the proper order of applying deductibles and reimbursement limitations in personal injury protection (PIP) insurance benefits calculations under Florida law. The Fifth District Court of Appeal denies the petition and certifies a conflict with Fourth District decisions on the interpretation of section 627.739(2), Florida Statutes, for resolution by the Florida Supreme Court.
The Fifth District Court of Appeal upholds the county court's judgment determining the proper methodology for applying the deductible and denies USAA's petition for certiorari relief. The court certifies the deductible application methodology as a question of great public importance and certifies conflict with Fourth District decisions.
[1] The proper methodology for applying a deductible under section 627.739(2), Florida Statutes, when calculating personal injury protection (PIP) benefits is a question of g…
[2] When calculating PIP benefits, the deductible may be subtracted from the total medical charges before applying the reimbursement limitation, or the reimbursement limitati…
Previewing 2 of 4 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“WHEN CALCULATING THE AMOUNT OF PIP BENEFITS DUE AN INSURED, DOES SECTION 627.739(2), FLORIDA STATUTES, REQUIRE THAT THE DEDUCTIBLE BE SUBTRACTED FROM THE TOTAL AMOUNT OF MEDICAL CHARGES BEFORE APPLYING THE REIMBURSEMENT LIMITATION UNDER SECTION 627.736(5)(a)1.b., OR MUST THE REIMBURSEMENT LIMITATION BE APPLIED FIRST AND THE DEDUCTIBLE SUBTRACTED FROM THE REMAINING AMOUNT?”
Certified question of great public importance regarding the proper methodology for applying deductibles in PIP benefits calculations
Previewing 1 of 3 key quotes on this case — the court’s exact language, pinpointed for members.
Join FLexlaw to unlock all legal intelligenceUSAA sought to challenge the county court's determination of the proper methodology for applying a deductible under section 627.739(2), Florida Statut…
The full statement of facts, procedural history, and disposition for this case are member content.
Join FLexlaw to unlock all legal intelligence© FLexlaw, Inc. — AI-generated enrichments are proprietary. All rights reserved.
Explore caselaw by topic → Browse Second Tier Certiorari Review cases and more on FLexlaw
USAA General Indemnity Company ("USAA") petitions for second-tier certiorari relief regarding an order issued by the circuit court sitting in its appellate capacity in favor of Florida Hospital Medical Center ("Florida Hospital") a/a/o Raymond Rivera. The circuit court affirmed the final judgment of the county court determining the proper methodology in the application of the deductible authorized under section 627.739(2), Florida Statutes (2016), when personal injury protection ("PIP") benefits are sought by an insured. We deny the petition.
This case is identical to our recent decisions in Progressive Select Insurance Co. v. Florida Hospital Medical Center a/a/o Melendez , --- So.3d ----, ----, 43 Fla. L. Weekly D2463 (Fla. 5th DCA Nov. 2, 2018) ; Progressive Select Insurance Co. v. Florida Hospital Medical Center a/a/o Sanchez , 249 So.3d 779 (Fla. 5th DCA 2018) ; Progressive Select Insurance Co. v. Florida Hospital Medical Center a/a/o Parent , 236 So.3d 1183 (Fla. 5th DCA 2018) ; and Progressive Select Insurance Co. v. Florida Hospital Medical Center a/a/o Pena , 236 So.3d 1182 (Fla. 5th DCA 2018). In each of these cases, we certified the following question as one of great public importance:
WHEN CALCULATING THE AMOUNT OF PIP BENEFITS DUE AN INSURED, DOES SECTION 627.739(2), FLORIDA STATUTES, REQUIRE THAT THE DEDUCTIBLE BE SUBTRACTED FROM THE TOTAL AMOUNT OF MEDICAL CHARGES BEFORE APPLYING THE REIMBURSEMENT LIMITATION UNDER SECTION 627.736(5)(a)1.b., OR MUST THE REIMBURSEMENT LIMITATION BE APPLIED FIRST AND THE DEDUCTIBLE SUBTRACTED FROM THE REMAINING AMOUNT?
E.g. , Parent , 236 So.3d at 1192. The Florida Supreme Court has accepted jurisdiction. Progressive Select Ins. Co. v. Fla. Hosp. Med. Ctr., No. SC18-278, 2018 WL 2064894, at *1 (Fla. Mar. 20, 2018). At the time of this opinion, it has not yet rendered its decision.
After we issued our opinions in Parent and Pena , the Fourth District Court reached a contrary result in several of its cases and certified conflict with our decisions. State Farm Mut. Auto. Ins. Co. v. Care Wellness Ctr. a/a/o Bardon-Diaz , 240 So.3d 22, 24, 31 (Fla. 4th DCA 2018) ;
*1014USAA Gen. Indem. Co. v. Gogan a/a/o Ricks , 238 So.3d 937, 937 (Fla. 4th DCA 2018) ; Progressive Select Ins. Co. v. David A. Blum, M.D., P.A. a/a/o Moreno , 238 So.3d 852, 853 (Fla. 4th DCA 2018). We accordingly certify conflict with Care Wellness Center , Gogan , and Blum and certify the same question that we have previously certified in our above four cases as one of great public importance.
PETITION DENIED; CONFLICT CERTIFIED; QUESTION CERTIFIED.
ORFINGER, LAMBERT, and HARRIS, JJ., concur.
Cases With Similar Vibessemantic neighbors from the corpus
Citator
Authorities Cited (12 total)
- State v. Mischler, 488 So. 2d 523 (Fla. 1986)
- Shull v. Dugger, 515 So. 2d 748 (Fla. 1987)
- Keys v. State, 500 So. 2d 134 (Fla. 1986)
- Mathis v. State, 515 So. 2d 214 (Fla. 1987)
- Progressive Select Ins. Co. v. Fla. Hosp. Med. Ctr., 236 So. 3d 1183 (Fla. 5th DCA 2018)
- Early v. State, 516 So. 2d 24 (Fla. 3d DCA 1987)
- USAA Gen. Indem. Co. v. William J. Gogan, M.D., 238 So. 3d 937 (Fla. 4th DCA 2018)
- State Farm Mut. Auto. Ins. Co. v. Care Wellness Ctr., LLC, 240 So. 3d 22 (Fla. 4th DCA 2018)
- Progressive Select Ins. Co. v. Fla. Hosp. Med. Ctr., 236 So. 3d 1182 (Fla. 5th DCA 2018)
- Knighton v. State, 238 So. 3d 852 (Fla. 4th DCA 2018)