COMPREHENSIVE HEALTH CENTER, LLC, A/A/O ANGELA COOPER
v.
STAR CASUALTY INSURANCE COMPANY
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Under Florida's PIP statute, payment is deemed made on the date a check or other valid instrument is placed in the United States mail in a properly addressed, postpaid envelope, not on the date the check is deposited. Therefore, the insurer exhausted its $10,000 PIP obligation when it mailed checks totaling that amount, regardless of whether the assignee provider subsequently refused to cash them.
[1] Under Florida's Personal Injury Protection (PIP) statute, payment is considered made on the date a draft or other valid instrument equivalent to payment is placed in the…
[2] An insurer's obligation to pay PIP benefits is exhausted once the full $10,000 limit is paid, absent bad faith in the handling of the claim.
Previewing 2 of 5 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“The purpose of PIP benefits is to provide up to $10,000 for medical bills and lost wages without regard to fault.”
Establishes the foundational purpose of the PIP statutory scheme.
Previewing 1 of 3 key quotes on this case — the court’s exact language, pinpointed for members.
Join FLexlaw to unlock all legal intelligenceAngela Cooper was injured in a motor vehicle accident in December 2013 and received medical treatment from Comprehensive Health Center (CHC), which ob…
The full statement of facts, procedural history, and disposition for this case are member content.
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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. 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 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
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.
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