PROGRESSIVE SELECT INS. CO.
v.
FLORIDA HOSPITAL MEDICAL

Fla. 5th DCA | 2018-07-09
No. 5D17-3540
Florida District Court of Appeal, Fifth District (2018)

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Holding

The circuit court properly applied the PIP deductible to 100% of medical charges before applying the statutory reimbursement limitation under section 627.736(5)(a)1.b., Florida Statutes.


Headnotes

[1] When a district court identifies a conflict between its decisions and those of another district court on a matter of great public importance, it must certify the conflict…

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Key Quotes

“Section 627.739(2)[, Florida Statutes (2014),] currently requires that the deductible be applied to 100% of the expenses and losses, and that is the version the circuit court properly applied.”

The court stated this as the basis for denying the certiorari petition in this case and the related cases of Parent and Pena.

Facts & Procedural History

Progressive sought certiorari challenging an order that required Sanchez's PIP deductible to be applied to 100% of Florida Hospital's medical charges …

The full statement of facts, procedural history, and disposition for this case are member content.

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Opinion of the Court

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 PROGRESSIVE SELECT INSURANCE COMPANY, Petitioner,

v. Case No. 5D17-3540 FLORIDA HOSPITAL MEDICAL CENTER A/A/O JOSE SANCHEZ, Respondent. ________________________________/ Opinion filed July 13, 2018 Petition for Certiorari Review of Decision from the Circuit Court for Orange County Acting in its Appellate Capacity.

Douglas H. Stein, of Association Law Group, P.L., Miami, for Petitioner.

Chad A. Barr and Heather M. Kolinsky, of Law Office of Chad A. Barr, P.A., Altamonte Springs, and Robert J. Hauser, of Pankauski Hauser PLLC, West Palm Beach, for Respondent.

PER CURIAM.

Progressive Select Insurance Company (“Progressive”) petitions for a writ of certiorari 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 Jose Sanchez.

Progressive seeks certiorari because of the circuit court’s affirmance that Sanchez’s personal injury protection (“PIP”) deductible should be applied to 100% of Florida

Hospital’s total medical charges before reducing the amount paid by Progressive pursuant to the statutory reimbursement limitation provided in section 627.736(5)(a)1.b.,

Florida Statutes (2013).

This case is identical to our recent decisions in Progressive Select Insurance Co.

v. Florida Hospital Medical Center a/a/o Parent, 236 So. 3d 1183, 1192 (Fla. 5th DCA

2018), and Progressive Select Insurance Co. v. Florida Hospital Medical Center a/a/o

Pena, 236 So. 3d 1182, 1182 (Fla. 5th DCA 2018). In those cases, we denied

Progressive’s petitions for writs of certiorari, concluding:

Section 627.739(2)[, Florida Statutes (2014),] currently requires that the deductible be applied to 100% of the expenses and losses, and that is the version the circuit court properly applied. We see no divergence from the correct law in the circuit court’s decision, and we see no violation of a clearly established principle of law that results in a miscarriage of justice. Parent, 236 So. 3d at 1192. We also certified a question 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? Id. 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., LLC, 240 So. 3d 22, 31 (Fla. 4th DCA

2018); USAA Gen. Indem. Co. v. Gogan, 238 So. 3d 937, 937 (Fla. 4th DCA 2018);

Progressive Select Ins. Co. v. Blum, 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 previously certified in Parent as one of great public importance.

PETITION DENIED; CONFLICT CERTIFIED; QUESTION CERTIFIED. SAWAYA, PALMER, and LAMBERT, JJ., concur.


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