USAA GENERAL INDEMNITY COMPANY
v.
FLORIDA HOSPITAL MEDICAL CENTER A/A/O RAYMOND RIVERA

Fla. 5th DCA | 2018-12-28
No. 18-3356
Orfinger, J., Lambert, J., Harris, J.
Florida District Court of Appeal, Fifth District (2018)

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Holding

The deductible under section 627.739(2), Florida Statutes, must be subtracted from the total amount of medical charges before applying the reimbursement limitation under section 627.736(5)(a)1.b.


Headnotes

[1] When calculating personal injury protection benefits, the deductible authorized under section 627.739(2), Florida Statutes, must be subtracted from the total amount of me…

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Facts & Procedural History

USAA sought certiorari review of a circuit court order affirming a county court judgment regarding the proper methodology for applying a PIP deductibl…

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Opinion of the Court
Harris

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 GENERAL INDEMNITY COMPANY,

Petitioner,

v. Case No. 5D18-3356

FLORIDA HOSPITAL MEDICAL CENTER

A/A/O RAYMOND RIVERA,

Respondent. ________________________________/

Opinion filed December 28, 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.

Robert J. Hauser, of Pankauski Hauser PLLC, West Palm Beach, for Respondent.

PER CURIAM.

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

This case is identical to our recent decisions in Progressive Select Insurance Co. v. Florida Hospital Medical Center a/a/o Melendez, 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); USAA 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

ORFINGER, LAMBERT, and HARRIS, JJ., concur.

Footnotes
2 (2016), when personal injury protection (“PIP”) benefits are sought by an insured. We deny the petition.
3 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.

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