Case ID: so3d_238/html/0852-02.html
Source: Caselaw Access Project
Author: {"author": "Kuntz, J. Gross, J., dissenting.", "license": "Public Domain", "url": "https://static.case.law/"}
Date Created: 2024-08-24T03:29:51.129683

PROGRESSIVE SELECT INSURANCE COMPANY, Appellant, v. David A. BLUM, M.D., P.A., a/a/o Vanessa Moreno, Appellee.
    No. 4D16-4311
    District Court of Appeal of Florida, Fourth District.
    [March 14, 2018]
    Douglas H. Stein of Association Law Group, P.L., Miami, for appellant.
    Marlene S. Reiss, Miami, and Thomas J. Wenzel of Cindy A. Goldstein, P.A., Coral Springs, for appellee.
   Kuntz, J.

We are presented with the following question, certified by the county court to be of great public importance:

PURSUANT TO FLA. STAT. § 627.739, IS AN INSURER REQUIRED TO APPLY THE DEDUCTIBLE TO 100% OF AN INSURED'S EXPENSES AND LOSSES PRIOR TO APPLYING ANY PERMISSIVE FEE SCHEDULE PAYMENT LIMITATION FOUND IN § 627.736(5)(A)(1), FLA. STAT. (2013)?

We rephrase the certified question as follows:

PURSUANT TO SECTIONS 627.736 AND 627.739, FLORIDA STATUTES (2013), IS AN INSURER REQUIRED TO APPLY A POLICY DEDUCTIBLE TO THE TOTAL AMOUNT OF A PROVIDER'S INVOICES TO AN INSURED PRIOR TO APPLYING ANY FEE SCHEDULE FOUND IN § 627.736, FLA. STAT.?

For the reasons explained in our opinion in State Farm Mutual Automobile Insurance Co. v. Care Wellness Center, LLC a/a/o Bardon-Diaz , No. 4D16-2254, --- So.3d ----, 2018 WL 1315026 (Fla. 4th DCA Mar. 14, 2018), also issued today, we answer the rephrased certified question in the negative, reverse the county court's summary judgment, and remand for further proceedings consistent with our opinion in case number 4D16-2254. We also certify conflict with Progressive Select Insurance Co. v. Florida Hospital Medical Center a/a/o Jonathan Parent , 236 So.3d 1183, 2018 WL 792012 (Fla. 5th DCA Feb. 9, 2018).

Reversed and remanded; conflict certified.

Forst, J., concurs.

Gross, J., dissents with opinion.

Gross, J., dissenting.

I dissent for the reasons set forth in my dissent to the Court's opinion in USAA Gen. Indem. Co. v. Gogan a/a/o Tara Ricks , No. 4D16-3313, 238 So.3d 937, 2018 WL 1315053 (Fla. 4th DCA Mar. 14, 2018).