Case Name: UNITED AUTOMOBILE INS. CO., Petitioner, v. CUSTER MEDICAL CENTER (a/a/o Maximo Masis), Respondent
Court: Florida District Court of Appeal
Jurisdiction: Florida
Decision Date: 2008-09-10
Citations: 990 So. 2d 633
Docket Number: No. 3D06-458
Parties: UNITED AUTOMOBILE INS. CO., Petitioner, v. CUSTER MEDICAL CENTER (a/a/o Maximo Masis), Respondent.
Judges: Before GERSTEN, C.J., and SHEPHERD and ROTHENBERG, JJ.
Reporter: Southern Reporter, Second Series
Volume: 990
Pages: 633–639

Head Matter:
UNITED AUTOMOBILE INS. CO., Petitioner, v. CUSTER MEDICAL CENTER (a/a/o Maximo Masis), Respondent.
No. 3D06-458.
District Court of Appeal of Florida, Third District.
Sept. 10, 2008.
Rehearing Denied Sept. 10, 2008.
Michael J. Neimand, The Office of the General Counsel, Miami, for petitioner.
Stephens, Lynn, Klein, et al., and Marlene S. Reiss, for respondent.
Before GERSTEN, C.J., and SHEPHERD and ROTHENBERG, JJ.

Opinion:
ON MOTION FOR REHEARING DENIED
SHEPHERD, J.
On Respondent's, Custer Medical Center, (a/o/a Maximo Masis), Motion for Rehearing, we substitute the following corrected opinion for the original and, as corrected, deny rehearing.
Petitioner, United Automobile Insurance Company, seeks certiorari review of a decision of the circuit court appellate division that reverses a directed verdict rendered in United's favor at the conclusion of Custer's case. The trial court's reason for directing the verdict was that United's insured and assignor, Maximo Masis, failed to satisfy a contractual condition precedent under the policy of insurance sued upon, by failing to report for two consecutive independent medical examinations (IMEs) without explanation. The facts presented are not in dispute. We conclude the decision of the circuit court appellate division departed from the essential requirements of law and quash the decision under review.
On January 1, 2002, Masis was injured in an automobile accident. At the time, he was insured for personal injury protection benefits under a United insurance policy with a $10,000 limit. Also in January, Masis sought medical treatment from Custer, and Custer submitted bills for treatment of Masis to United. Custer then sought payment from United.
United responded to Custer's request for payment with a certified letter to Ma-sis' counsel posted on March 27, 2002, notifying him that United had scheduled an IME for his client on April 11. A copy of the letter also was mailed to Masis. Masis did not appear. On April 12, 2002, United scheduled a second IME for April 29, 2002, employing the same methods of notification. Again, Masis failed to appear. Neither Masis nor his counsel communicated with United in response to the notices.
After three weeks had passed from the scheduled date for the second IME, United wrote to Masis' counsel, advising it was denying personal injury protection benefits to Masis as of April 11, 2002, for Masis' failure to appear. On June 20, 2002, Ma-sis' counsel sent United a letter announcing his withdrawal of his representation of Masis. On September 9, 2002, United corresponded further with Masis — again employing certified mail — and reiterated that it was declining to afford him personal injury protection benefits coverage because of his failure to attend the scheduled IMEs, "which [are] a condition precedent to any legal action." (emphasis added). Again, there was no response from Masis. Thereafter, Custer, as Masis' assignee, sued United for $1250 in excess of the deductible for services rendered by it, together with attorney fees and costs pursuant to section 627.428, Florida Statutes (2001).
Section 627.736(7), Florida Statutes (2001), provides:
(a) Whenever the mental or physical condition of an injured person covered by personal injury protection is material to any claim that has been or may be made for past or future personal injury protection insurance benefits, such person shall, upon the request of an insurer, submit to mental or physical examination by a physician or physicians. The costs of any examinations requested by an insurer shall be borne entirely by the insurer.
(b) . If a person unreasonably refuses to submit to an examination, the personal injury protection carrier is no longer liable for subsequent personal injury protection benefits.
Consistent with the communication that United sought to have with its insured before suit was filed, United's defense at trial was simply that Masis failed to satisfy a reasonably established condition precedent to payment of his medical bills.
A plain reading of this statute makes clear that an insured's submission to an IME is a condition precedent to coverage. Goldman v. State Farm Fire Gen. Ins. Co., 660 So.2d 300, 304 n. 5 (Fla. 4th DCA 1995) ("A condition precedent is one that is to be performed before the contract becomes effective."). Courts throughout the state that have had applied section 627.736(7) have so held. See Unit ed Auto. Ins. Co. v. Prof'l Med. Group, 14 Fla. L. Weekly Supp. 1021, 1021-22 (Fla. Cir.Ct.2007) (stating that section 627.736(7)(a) "makes submission to one or more reasonably set IMEs a condition precedent for reimbursement of medical bills incurred before the termination of benefits, but received after the termination"). See also De Ferrari v. Gov't Employees Ins. Co., 613 So.2d 101, 103 (Fla. 3d DCA 1993) ("Submission to the reasonably requested I.M.E. was a condition precedent to coverage."); United Auto. Ins. Co. v. Zulma, 661 So.2d 947, 948 (Fla. 4th DCA 1995) (indicating that attendance at an IME is a condition precedent).
It is clear in this case that United's requests for Masis to present himself for an IME were not patently unreasonable. See Tindall, II v. Allstate Ins. Co., 472 So.2d 1291, 1293 (Fla. 2d DCA 1985) (concluding that, even where insured testified as to reasons he failed to attend IME, "Tindall offered nothing that would generate even the slightest fact question associated with his refusal to submit to the [IMEs]; Allstate's request was patently not unreasonable!,]" and holding that "the trial court could easily reach this conclusion without considering Allstate's counsel's argument as evidence") (emphasis added). Neither Masis nor his counsel responded to the requests at any time during the nearly two-month period during which United sought to schedule an IME of its insured. On these undisputed facts, the trial court correctly directed a verdict in favor of the insurer. See Griffin v. Am. Gen. Life & Accident Ins. Co., 752 So.2d 621, 623 (Fla. 2d DCA 1999) ("The party seeking to enforce a contract has the burden to prove the satisfaction of a condition precedent to the contract's existence."). We conclude that the circuit court appellate division departed from the essential requirements of law when it concluded otherwise. Allstate Ins. Co. v. Kaklamanos, 843 So.2d 885, 889 (Fla.2003) ("A district court [may] exercise its discretion to grant certiorari review only when there has been a violation of a clearly established principle of law resulting in a miscarriage of justice."); accord Haines City Cmty. Dev. v. Heggs, 658 So.2d 523, 528 (Fla.1995); Combs v. State, 436 So.2d 93, 96 (Fla.1983).
We grant the petition for writ of certio-rari, quash the opinion of the circuit court appellate division, and direct that court to reinstate the directed verdict.
Before GERSTEN, C.J., and COPE, GREEN, RAMIREZ, WELLS, SHEPHERD, SUAREZ, CORTIÑAS, ROTHENBERG, LAGOA and SALTER, JJ.
. The United policy, Section I, "Personal Injury Protection," Paragraph 2, "Conditions," states: "No action shall lie against [United], unless, as a condition precedent thereto, there shall have been full compliance with all terms of this insurance Policy . " (emphasis added).