COMPREHENSIVE HEALTH CENTER, LLC, A/A/O ANGELA COOPER,

v.

STAR CASUALTY INSURANCE COMPANY,

Third District Court of Appeal State of Florida

Opinion filed February 22, 2023. Not final until disposition of timely filed motion for rehearing.

________________

No. 3D21-1612 Lower Tribunal No. 16-5737 CC ________________

Comprehensive Health Center, LLC, a/a/o Angela Cooper, Appellant,

vs.

Star Casualty Insurance Company, Appellee.

An Appeal from the County Court for Miami-Dade County, Gina Beovides and Luis Perez-Medina, Judges.

Douglas H. Stein, P.A., and Douglas H. Stein, for appellant.

Hunker Appeals, Sarah Hafeez and Thomas L. Hunker (Fort Lauderdale), for appellee.

Before EMAS, GORDO and BOKOR, JJ.

GORDO, J.

2

Comprehensive Health Center, LLC a/a/o Angela Cooper (“CHC”) appeals the entry of final judgment and summary judgment in favor of Star Casualty Insurance Company (“Star”). We have jurisdiction. Fla. R. App. P. 9.030(b)(1)(A). Because no genuine issue of material fact exists that exhaustion occurred as a matter of law after the issuance of checks totaling $10,000, we affirm.

FACTUAL AND PROCEDURAL BACKGROUND

In December 2013, Angela Cooper, a Star insured, was injured in a motor vehicle accident. CHC provided medical treatment to Cooper. In exchange, Cooper assigned her right to receive personal injury protection (PIP) benefits to CHC. CHC submitted bills to Star for services rendered to Cooper. Between March 2014 and April 2015, Star mailed four checks to CHC in fulfillment of its payment of the bills submitted. In July 2015, CHC sent a pre-suit demand letter to Star seeking full reimbursement of the amounts billed. Star responded and advised CHC that the PIP benefits under the policy were exhausted when it made a final payment to another provider. In late January 2016, CHC returned two of the previously issued checks to Star notifying Star it never deposited or cashed the checks. CHC took issue with language printed on the checks and

3 demanded Star reissue the checks to them without the contested language. Star did not reissue the checks. Three months later, CHC filed a complaint against Star for breach of the insurance policy. Star filed its answer and affirmative defenses asserting exhaustion of benefits pursuant to section 627.736(1), Florida Statutes.¹ CHC filed a reply arguing exhaustion had not occurred because it had not deposited two of the checks mailed by Star and therefore their value could not be considered paid under the PIP statute. CHC and Star filed crossmotions for summary judgment on the exhaustion defense. The trial court held a hearing and concluded that exhaustion occurred as a matter of law when Star made payment to CHC and issued checks totaling $10,000. This appeal followed.

STANDARD OF REVIEW

The appellate standard of review on an order of summary judgment is de novo. See Volusia Cnty. v. Aberdeen at Ormond Beach, L.P., 760 So. 2d 126, 130 (Fla. 2000). Because the hearing and order on summary judgment were entered prior to May¹, 2021, the amended summary judgment rule does not apply. See In re Amends. to Fla. R. of Civ. P. 1.510, 317 So. 3d

LEGAL ANALYSIS

“The purpose of PIP benefits is to provide up to $10,000 for medical bills and lost wages without regard to fault.” Flores v. Allstate Ins. Co., 819 So. 2d 740, 744 (Fla. 2002). Pursuant to section 627.736(1), Florida Statutes, PIP benefits are due to an insured, limited to $10,000 for injuries arising out of ownership, maintenance or use of a motor vehicle.2 Once the full $10,000 of PIP benefits are “exhausted through the payment of valid claims, an insurer has no further liability on unresolved, pending claims, absent bad faith in the handling of the claim by the insurance company.” Northwoods Sports Med. & Physical Rehab., Inc. v. State Farm Mut. Auto. Ins. Co., 137 So. 3d 1049, 1057 (Fla. 4th DCA 2014). The sole issue presented here is whether exhaustion of benefits can be found where an insurer sent checks as payment and the provider chose not to cash them. CHC argues benefits were not exhausted because

2 As an assignee, CHC was only entitled to the same benefits Cooper had at the time of the assignment. See Union Indemnity Co. v. City of New Smyrna, 130 So. 453, 455 (1930) (finding an assignment conveys no greater right than the assignor had at the time of the assignment).

3 We note the trial court conducted a proper analysis of the plain and ordinary meaning of the term “payment.” The Oxford English Dictionary defines “payment” as “[t]he action, or an act, of paying,” “[a] sum of money (or other thing) paid,” “[t]he action, or an act, of rendering to a person anything due, deserved, or befitting, or of discharging an obligation; the thing so rendered.” PAYMENT, Oxford English Dictionary (3d ed. 1955). Payment is also defined as “[p]erformance of an obligation by the delivery of money or some

other valuable thing accepted in partial or full discharge of the obligation” and “[t]he money or other valuable thing so delivered in satisfaction of an obligation.” PAYMENT, Black’s Law Dictionary (11th ed. 2019). These definitions are consistent with the trial court’s finding—that Star made payment by “delivering” or “rendering” the checks to CHC to discharge its obligation.

5. For the purpose of calculating the extent to which

benefits are overdue, payment shall be treated as being made on the date a draft or other valid instrument that is equivalent to payment was placed in the United States mail in a properly addressed, postpaid envelope or, if not so posted, on the date of delivery.

§ 627.736(4)(b)5., Fla. Stat. (emphasis added). Second, in Section 627.736(10), entitled “Demand Letter:” (d) If, within 30 days after receipt of notice by the insurer, the overdue claim specified in the notice is paid by the insurer together with applicable interest and a penalty of¹⁰ percent of the overdue amount paid by the insurer, subject to a maximum penalty of $250, no action may be brought against the insurer. If the demand involves an insurer’s withdrawal of payment under paragraph (7)(a) for future treatment not yet rendered, no action may be brought against the insurer if, within 30 days after its receipt of the notice, the insurer mails to the person filing the notice a written statement of the insurer’s agreement to pay for such treatment in accordance with the notice and to pay a penalty of¹⁰ percent, subject to a maximum penalty of $250, when it pays for such future treatment in accordance with the requirements of this

§ 627.736(10)(d), Fla. Stat. (emphasis added). We find these sections clearly provide that under the PIP statute payment shall be treated as being made on the date a check or other valid instrument is placed in the mail. See §§ 627.736(4)(b)5., 627.736(10)(d), Fla. Stat. CHC asserts this Court should ignore this statutory language, arguing it only applies to determinations of whether a payment is overdue. CHC, instead asks this Court to define payment as being made when a check or other valid instrument sent to an insured is deposited. First, it is a “‘fundamental principle of statutory construction (and, indeed, of language itself) that the meaning of a word cannot be determined in isolation, but must be drawn from the context in which it is used.’” Lab. Corp. of Am. v. Davis, 339 So. 3d 318, 323–24 (Fla. 2022) (quoting Deal v. United States, 508 U.S. 129, 132, (1993)). Under the PIP statute, section

CONCLUSION

We find pursuant to the PIP statute, payment is “made on the date a draft or other valid instrument that is equivalent to payment was placed in the United States mail in a properly addressed, postpaid envelope.” §§ 627.736(4)(b)5., 627.736(10)(d), Fla. Stat. No genuine issue of material fact exists in the record before us that benefits were exhausted by Star through its payment of valid claims. Thus, the trial court properly awarded final summary judgment in Star’s favor. Affirmed.

4 We further note that utilizing CHC’s proposed definition of payment would render an insurer’s ability to satisfy its obligation to make timely payment entirely reliant on actions over which it has no control—namely, the provider or insured’s acceptance or deposit of payment.