Summary
adopting the analysis of Rivera and holding that the demand letter was "hardly precise in the amount claimed to be due" where the demand letter demanded two alternative amounts over $2,000 and the assignee later sued for an amount less than $100
Summary of this case from Mercury Indem. Co. of Am. v. Pan Am Diagnostic of OrlandoOpinion
Nos. 4D21-1820 4D21-2310
07-27-2022
CHRIS THOMPSON, P.A. a/a/o Elmude Cadau, Appellant, v. GEICO INDEMNITY COMPANY, Appellee.
Douglas H. Stein of Douglas H. Stein, P.A., Coral Gables, for appellant. Michael A. Rosenberg, Peter D. Weinstein, Adrianna De La Cruz-Muñoz, and Daniela Silva of Cole, Scott & Kissane, P.A., Plantation, for appellee.
Douglas H. Stein of Douglas H. Stein, P.A., Coral Gables, for appellant.
Michael A. Rosenberg, Peter D. Weinstein, Adrianna De La Cruz-Muñoz, and Daniela Silva of Cole, Scott & Kissane, P.A., Plantation, for appellee.
Per Curiam.
We affirm the final judgments entered in favor of appellee Geico Indemnity Company. The underlying lawsuit involves Personal Injury Protection (PIP) benefits. Appellant Chris Thompson P.A., a medical provider, is an assignee of the insured, Elmude Cadau.
Geico received bills for the treatment rendered to the insured between October 7, 2015, through February 17, 2016. Geico paid $10,000 in PIP benefits to various providers on behalf of the insured, including over $3,000 paid to appellant.
On April 13, 2016, appellant's attorney sent a pre-suit demand letter to Geico demanding that Geico pay $2,978.88 or, if there was medical payments coverage, $4,524.28. The letter also asked Geico to advise, among other things, if "the demand letter ... [was] defective in any way."
Geico responded to the demand letter on May 12, 2016, advising that no additional payment was due for any other charges or dates of service included in the demand letter.
Appellant never filed any subsequent demand letter.
Over two years later, on May 19, 2018, appellant filed a breach of contract action against Geico to recover PIP benefits. The complaint did not state a specific amount of damages; instead, it alleged only that it was an action for damages "not exceed[ing] One Hundred Dollars ($100.00) exclusive of interest, costs, and attorney's fees."
In 2021, the trial court granted Geico's motion for summary final judgment, holding that the pre-suit demand letter did not comply with section 627.736(10)(b)3., Florida Statutes (2015).
We have written that section 627.736(10)(b) requires precision in a pre-suit demand letter to encourage resolution of PIP claims before the filing of a lawsuit:
The language of subsection 627.736(10)(b)3. requires precision in a demand letter by its requirement of an "itemized statement specifying each exact amount" ... The statute mandates that the amount at issue for a bill be specified early in the claims process. This requirement of precision in medical bills discourages gamesmanship on the part of those who might benefit from confusion and delay. The statutory requirements surrounding a demand letter are significant, substantive preconditions to bringing a cause of action for PIP benefits.
MRI Assocs. of Am., LLC v. State Farm Fire & Cas. Co ., 61 So. 3d 462, 465 (Fla. 4th DCA 2011) ; see also Rivera v. State Farm Mut. Auto. Ins. Co ., 317 So. 3d 197, 205 (Fla. 3d DCA 2021).
The demand letter in this case was hardly precise in the amount claimed to be due. It sought $2,978.88 or $4,524.28, not the amount less than $100 sought in the lawsuit. "[T]he purpose of the demand letter is not just notice of intent to sue. The demand letter also notifies the insurer as to the exact amount for which it will be sued if the insurer does not pay the claim." Rivera , 317 So. 3d at 204. A demand letter that complies with the statute permits the insurer to accurately evaluate its decision to pay the claim or litigate. See, e.g. , Venus Health Ctr. a/a/o Joally Rojas v. State Farm Fire & Cas. Co. , 21 Fla. L. Weekly Supp. 496a (Fla. 11th Cir. Ct. Mar. 13, 2014).
We have fully considered the other issues raised by appellant. We see nothing in the language of section 627.736 that requires an insurer to give notice to the insured or an assignee that a demand letter is defective. The trial court did not abuse its discretion in allowing Geico to amend its affirmative defenses or in ruling on the offer of judgment.
Affirmed.
Warner, Gross and Kuntz, JJ., concur.