UNITED AUTOMOBILE INSURANCE COMPANY
v.
ATLANTIC MEDICAL SPECIALTY INC
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United Automobile Insurance Company appeals a final judgment awarding medical benefits to Atlantic Medical Specialty, Inc. for treatment of an insured's accident injuries. The appellate court reverses, finding that the trial court erred in granting summary judgment on both the record-keeping defense and the reasonableness, relatedness, and necessity of medical treatment.
The court reversed both summary judgments. The court held that non-compliance with chiropractic record-keeping requirements is a valid legal ground for the affirmative defense under Florida Statute §627.736(5)(b)(1)(b), and that United Auto had a right to question record-keeping as an issue of fact. Additionally, the court held that the affidavits supporting Atlantic's RRN motion were legally deficient under §117.05(4)(f)(5), and that the deposition excerpts did not conclusively show the absence of genuine issues of material fact.
[1] Failure to comply with chiropractic record keeping requirements is a valid legal ground to support an affirmative defense that medical treatment was unlawfully rendered.
[2] An insurer has a right to question proper medical record keeping as an issue of fact in a claim for personal injury protection benefits.
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Join FLexlaw to unlock all legal intelligence“failure to comply with chiropractic record keeping requirements is a valid legal ground to support such defense”
Establishes that the affirmative defense based on record-keeping non-compliance was legally valid and should not have been struck
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Join FLexlaw to unlock all legal intelligenceManuel Floyd was injured in an automobile accident on November 19, 2007, while insured under a United Auto policy with personal injury protection bene…
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PER CURIAM.
The Appellant, United Automobile Insurance Company (“United Auto”) appeais a final judgment for medical benefitsi rendered in favor ofthe Appellee, Atlantic Medical Specialty, Inc. (“Atlantic”). We have jurisdiction. See § 26.0l2(1), Fla. Stat. (2013). We reverse. [*2] CASE NUMBER: 12-010 AP .
I. Factual and Procedural Background
The insured, Manuel Floyd (“the insured”), had an automobile accident on November 19, 2007. At the time of the accident, the insured had an automobile insurance policy with United Auto providing for personal injury protection (“PIP”) benefits. As a consequence ofthe accident, the insured sustained injuries and sought medical treatment from Atlantic. The insured assigned its benefits and policy rights to Atlantic. As the assignee, Atlantic made a demand for payment to United Auto for medical treatment or services provided to the insured. Upon United Auto’s failure to pay, Atlantic filed suit. In its answer to the complaint, United Auto asserted the affirmative defense that the medical treatment was not lawfully rendered as Atlantic failed to comply with chiropractic record keeping statutory requirements. - Subsequently, Atlantic filed its motion for summary judgment as to record keeping asserting that United Auto’s defense had no legal basis. The court granted Atlantic’s motion. Thereafter, Atlantic filed a second motion for summary judgment as to the issue of reasonableness, relatedness, and medical necessity (“RRN”). The court granted Atlantic’s motion as to_ RRN and entered the final judgment. This appeal timely followed.
II. Standard ofreview
The appellate court reviews questions involving the interpretation of a statute de novo. Brown v. City of Vero Beach, 64 So. 3d 172 (Fla. 4th DCA 2011). The same standard applies to the appellate review of a summary judgment. Futch v. Wal-Mart Stores, Ina, 988 So. 2d 687 (Fla. lst DCA 2008). In reviewing a summary judgment, the court determines: (1) “whether there are genuine issues of material fact” and (2) “whether the trial court properly applied the correct nile oflaw.” Futch, 988 So. 2d at 690. [*3] CASE NUMBER: l2-010 AP
III. Discussion
Summaryjudgment on record keeping We find that the affirmative defense, that the medical treatment was unlawfully rendered, was a valid affirmative defense as it was asserted under section 627."/36(5)(b)(l)(b), Florida Statutes (2007). We further find that failure to comply with chiropractic record keeping requirements is a valid legal ground to support such defense. See 62'7.732(1l), Fla. Stat. (2007); 460.4l3(1)(m), Fla. Stat. (2012); Fla. Admin. Code R. 64B2-l7.006S(2)(3). As such, the striking of the defense was erroneous. While the defense was inartfully drafted, United Auto has a right to question proper record keeping as an issue of fact. Summaryjudgment on RRN The affidavits filed below in support of Atlantic’s motion were legally deficient as they failed to comply with the statutory requirements prescribed by section ll7.05(4)(f)(5), Florida Statutes (2012). Additionally, the excerpts of the deposition incorporated into Atlantic’s motion for summary judgment, do not rise to the level of conclusively showing the absence of genuine issues ofmaterial facts as to RRN. As such, we find that summaryjudgment was entered in error as Atlantic failed to meet its initial burden of proof which was to conclusively show the absence of genuine issues of material fact. Hall v. Talcott, 191 So. 2d 40 (Fla. 1996); Moore v. Morris, 475 So. 2d 666 (Fla. 1985).
IV. Conclusion
Based on the foregoing, this matter is REVERSED and REMANDED for further proceedings consistent with this opinion. Atlantic’s motion for appellate attorney’s fees is hereby DENIED. See § 627.428(l), Fla. Stat. (2012).
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- Moore v. Morris, 475 So. 2d 666 (Fla. 1985)
- Brown v. City OF Vero Beach & Indian River Cnty. Bd. of Cnty. Comm'rs, 64 So. 3d 172 (Fla. 4th DCA 2011)
- Cynda Futch and Willie Futch v. Wal-Mart Stores, Inc., 988 So. 2d 687 (Fla. 1st DCA 2008)