Opinion
No. 4D21-206
08-18-2021
GEICO GENERAL INSURANCE COMPANY, Appellant, v. HALLANDALE BEACH ORTHOPEDICS, INC., a/a/o Fritznie Jarbath, Appellee.
Michael A. Rosenberg, Peter D. Weinstein, and Adrianna de la Cruz-Muñoz of Cole, Scott & Kissane, P.A., Plantation, for appellant. David B. Pakula of David B. Pakula, P.A., Pembroke Pines, and Gary Marks of Marks & Fleischer, Fort Lauderdale, for appellee.
Michael A. Rosenberg, Peter D. Weinstein, and Adrianna de la Cruz-Muñoz of Cole, Scott & Kissane, P.A., Plantation, for appellant.
David B. Pakula of David B. Pakula, P.A., Pembroke Pines, and Gary Marks of Marks & Fleischer, Fort Lauderdale, for appellee.
Kuntz, J.
Geico General Insurance Company appeals the county court's summary judgment order. We only address whether the insurance policy required Geico to pay 100% of the amount billed by the provider, Hallandale Beach Orthopedics, Inc.
"The Florida PIP statute authorizes insurers to limit reimbursement to 80% of an amount set by a fee schedule, see § 627.736(5)(a)1.a.–f., by electing to do so in its policy, see § 627.736(5)(a) 5." Geico Indem. Co. v. Muransky Chiropractic P.A. , No. 4D21-457, 323 So.3d 742, 747 (Fla. 4th DCA June 24, 2021). In Muransky , we held that "under the PIP statute, if the billed amounts are less than 80% of the fee schedule, the insurer may pay the billed amounts in full or pay the 80% reimbursement rate of maximum charges." Id. at 747 (citing Geico Indem. Co. v. Accident & Inj. Clinic, Inc. , 290 So. 3d 980, 984 (Fla. 5th DCA 2019) ).
Our holding in Muransky is binding on this case. In re Rule 9.331, Determination of Causes by a Dist. Ct. of Appeal En Banc , Fla. R. App. P. , 416 So. 2d 1127, 1128 (Fla. 1982). But the facts of this case require a different outcome. In Muransky , the record established that the provider billed an amount less than 80% of 200% of the applicable statutory fee schedule. 323 So.3d at 744. As a result, in that case, the answer to the legal question was dispositive. Here, the record does not establish whether the amount billed was less than 80% of 200% of the statutory fee schedule. For this reason, we reverse the court's judgment and remand for further proceedings. If the amount billed was less than 80% of 200% of the fee schedule, the ultimate result will be the same as in Muransky .
Reversed and remanded.
Damoorgian and Artau, JJ., concur.