Case Name: UNITED AUTOMOBILE INSURANCE COMPANY, Petitioner, v. Marisol RODRIGUEZ, Respondent; State Farm Fire and Casualty Company, Petitioner, v. Juana Maria Perez, Respondent
Court: Florida Supreme Court
Jurisdiction: Florida
Decision Date: 2001-11-08
Citations: 808 So. 2d 82
Docket Number: Nos. SC00-111, SC00-112
Parties: UNITED AUTOMOBILE INSURANCE COMPANY, Petitioner, v. Marisol RODRIGUEZ, Respondent. State Farm Fire and Casualty Company, Petitioner, v. Juana Maria Perez, Respondent.
Judges: WELLS, C.J., and HARDING, ANSTEAD, and PARIENTE, JJ., concur.
Reporter: Southern Reporter, Second Series
Volume: 808
Pages: 82–92

Head Matter:
UNITED AUTOMOBILE INSURANCE COMPANY, Petitioner, v. Marisol RODRIGUEZ, Respondent. State Farm Fire and Casualty Company, Petitioner, v. Juana Maria Perez, Respondent.
Nos. SC00-111, SC00-112.
Supreme Court of Florida.
Nov. 8, 2001.
Rehearing Denied Feb. 12, 2002.
Steven E. Stark of Fowler, White, Burnett, Hurley, Banick & Strickroot, P.A., for United Automobile Insurance Company, Petitioner.
James K. Clark of Clark, Robb, Mason & Coulombe, and Frances F. Guasch of Kevin W. Korth & Associates, Miami, FL, for State Farm Mutual Automobile Insurance Company, Petitioner.
John H. Ruiz, Luisa M. Linares, and Maloy Castro Morales of John H. Ruiz, P.A., and Amado Alan Alvarez of Alvarez & Alvarez Zane, Miami, FL, for Marisol Rodriguez and Juana Maria Perez, Respondents.
David B. Shelton of Rumberger, Kirk & Caldwell, Orlando, FL; and Peter J. Vale-ta of Ross & Hardies, Chicago, IL, for Allstate Insurance Company and Florida Insurance Council, Amici Curiae.
Vincent F. Iacono of the Law Offices of Howard W. Weber, Tampa, FL, for GEI-CO Casualty Company, GEICO Indemnity Company, GEICO General Insurance Company, and Government Employees Insurance Company, Amici Curiae.
Edward H. Zebersky of Zebersky, Payne & Kushner, LLP, Hollywood, FL; and Philip M. Burlington of Caruso, Burlington, Bohn & Compiani, P.A., West Palm Beach, FL, for Academy of Florida Trial Lawyers, Amicus Curiae.
Robert A. Robbins of Robbins & Reynolds, P.A., Miami, FL; and Arthur Joel Berger, Miami, FL, Amicus Curiae.

Opinion:
SHAW, J.
We have for review Perez v. State Farm Fire & Casualty Co., 746 So.2d 1123 (Fla. 3d DCA 1999), based on conflict with Jones v. State Farm Mutual Automobile Insurance Co., 694 So.2d 165 (Fla. 5th DCA 1997). We have jurisdiction. Art. V, § 3(b)(3), Fla. Const. We quash Perez.
I. FACTS
The relevant facts in the Rodriguez case are set forth in the district court opinion below:
Marisol Rodriguez sustained injuries in an automobile accident and made a PIP claim to her insurer, United Auto, on October 1, 1997. United Auto admitted coverage and waived all defenses except as to the reasonableness, relationship, and medical necessity of the bills incurred.
On October 17, Ms. Rodriguez submitted her claimed medical bills to United Auto. As of November 26, United Auto had not received a report indicating that these claimed medical bills were unreasonable, unrelated, or unnecessary.
On December 17, Ms. Rodriguez submitted more medical bills for payment. On January 16, United Auto submitted Ms. Rodriguez's medical bills for review to a doctor who issued a report to United Auto on January 19,1998, outside the thirty-day statutory time period.
Ms. Rodriguez sued [in county court] to recover the amount of the unpaid medical bills plus interest. § 627.736(4)(b), (c), Fla. Stat. (1997). She moved for summary judgment on the grounds that the insurer had only thirty days from the date of receipt of the medical bills to obtain a report constituting "reasonable proof' that the treatments were not reasonable, related, or necessary and that absent same, the insurer could not defend on that basis, thereby entitling her to final summary judgment.
United Auto conceded that it did not obtain reasonable proof within the thirty-day period and did not raise any coverage defense. However, United Auto argued that the failure to obtain the report did not compel payment of the bills, but only subjected it to paying interest and attorney's fees should liability be established. The trial court entered final summary judgment in favor of Ms. Rodriguez for the amount of the medical bills plus accrued interest....
Perez v. State Farm Fire and Casualty Co., 746 So.2d 1123, 1124 (Fla. 3d DCA 1999) (emphasis omitted). The county court certified the issue to the district court as a question of great public importance.
The relevant facts in the Perez case also are set forth in the district court opinion below:
On March 24, 1996, Ms. Perez sustained personal injuries as a result of an automobile accident. She sought treatment for her injuries and submitted medical bills to State Farm under the PIP coverage of her automobile insurance policy. State Farm failed to pay the bills; Ms. Perez filed a lawsuit [in county court] against State Farm for payment of these bills.
Ms. Perez moved for summary judgment on the grounds that the defendant had no reasonable proof to establish that it was not responsible for the payment of her claimed medical bills within the thirty-day statutory period. She argued "that failure to obtain such proof within the statutory period means the insurer must pay the bills, in their entirety, at the expiration of the 30 day period."
The trial court entered summary judgment in Ms. Perez's favor, ruling that it is the "responsibility on the part of an insurer to pay within 30 days absent reasonable proof within that time that they are not responsible for payment." On appeal, the circuit court appellate division reversed the trial court in a two-to-one decision although State Farm conceded "that it failed to obtain reasonable proof that it is not responsible within the 30-day period."
Perez, 746 So.2d at 1124-25 (emphasis omitted). Perez sought certiorari review of the circuit court decision, and the district court consolidated the Rodriguez and Perez cases and rendered a single decision.
The district court affirmed the county court decision in the Rodriguez case, quashed the circuit court decision in the Perez case, and held that because the insurers failed to pay the claims within the thirty-day statutory period they now must pay the claims, i.e., they cannot contest the claims. The court also held that the insurers must pay statutory interest. This Court granted review based on conflict with Jones v. State Farm Mutual Automobile Insurance Co., 694 So.2d 165 (Fla. 5th DCA 1997), wherein the court noted that failure to pay within the thirty-day period exposes an insurer to the statutory penalties but does not bar the insurer from contesting the claim.
The instant cases present the following issue: If the payment of benefits for a PIP claim is "overdue" under section 627.736, Florida Statutes (1997), are the penalties set forth in Florida Statutes the only penalties that may be levied against the insurer, or is the insurer also forever barred from contesting the claim. Both United Automobile Insurance Company and State Farm Fire and Casualty Company contend that the statutory sanctions are the only penalties approved by the Legislature. We agree.
II. "OVERDUE" PAYMENT OF BENEFITS
Legislative intent, as always, is the polestar that guides a court's inquiry under the Florida No-Fault Law ("the Law"). Where the wording of the Law is clear and amenable to a logical and reasonable interpretation, a court is without power to diverge from the intent of the Legislature as expressed in the plain language of the Law. The Law, which was enacted in 1971, was intended to provide a minimum level of insurance benefits without regard to fault:
627.730 Florida Motor Vehicle No-Fault Law.' — Sections 627.730-627.7405 may be cited and known as the "Florida Motor Vehicle No-Fault Law."
627.731 Purpose. — The purpose of ss. 627.730-627.7405 is to provide for medical, surgical, funeral, and disability insurance benefits without regard to fault, and to require motor vehicle insurance securing such benefits, for motor vehicles required to be registered in the state and, with respect to motor vehicle accidents, a limitation on the right to claim damages for pain, suffering, mental anguish, and inconvenience.
§ 627.730, 627.731, Fla. Stat. (1997). Section 627.736 sets forth the benefits that are required for personal injury protection (PIP) and mandates coverage if the loss is sufficiently related, reasonable, and necessary:
627.736 Required personal injury protection benefits; exclusions; priority-—
(1) REQUIRED BENEFITS. — Every insurance policy complying with the security requirements of s. 627.733 shall provide personal injury protection to the named insured, relatives residing in the same household, persons operating the insured motor vehicle, passengers in such motor vehicle, and other persons struck by such motor vehicle and suffering bodily injury . to a limit of $10,000 for loss sustained by any such person as a result of bodily injury, sickness, disease, or death arising out of the ownership, maintenance, or use of a motor vehicle as follows:
(a) Medical benefits. — Eighty percent of all reasonable expenses for necessary medical, surgical, X-ray, dental, and rehabilitative services....
§ 627.736(l)(a), Fla. Stat. (1997) (emphasis added).
Section 627.736 also defines an "overdue" payment of benefits and sets forth the penalties that may be levied:
(4) BENEFITS; WHEN DUE.— Benefits due from an insurer under ss. 627.730-627.405 shall be primary, except that benefits received under any workers' compensation law shall be credited against the benefits provided by subsection (1) and shall be due and payable as loss accrues, upon receipt of reasonable proof of such loss and the amount of expenses and loss incurred which are covered by the policy issued under ss. 627.730-627.7405....
(b) Personal injury protection insurance benefits paid pursuant to this sec tion shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same. If such written notice is not furnished to the insurer as to the entire claim, any partial amount supported by written notice is overdue if not paid within 30 days after such written notice is furnished to the insurer. Any part or all of the remainder of the claim that is subsequently supported by written notice is overdue if not paid within 30 days after such written notice is furnished to the insurer. However, any payment shall not be deemed overdue when the insurer has reasonable proof to establish that the insurer is not responsible for the payment, notwithstanding that written notice has been furnished to the insurer....
(c) All overdue payments shall bear simple interest at the rate of 10 percent per year.
(8) APPLICABILITY OF PROVISION REGULATING ATTORNEY'S FEES. — With respect to any dispute under the provisions of ss. 627.730-627.7405 between the insured and the insurer, the [attorneys' fees] provisions ofs. 627A28 shall apply.[ ]
§ 627.736, Fla. Stat. (1997) (emphasis added). The legislative intent evinced in the penalty provisions is clear: The provisions were intended to promote the prompt resolution of PIP claims by imposing several reasonable penalties on insurers who pay late.
In sum, the criteria governing payment of benefits and penalties are as follows: (1) an insured may seek the payment of benefits for a covered loss by submitting "reasonable proof' of such loss to the insurer; (2) if the benefits are not paid within thirty days and the insurer does not have reasonable proof that it is not responsible for the payment, the payment is "overdue"; (3) all "overdue" payments shall bear simple interest at a rate of ten percent per year; and (4) whenever an insured files an action for payment of PIP benefits and prevails, the insured is entitled to attorneys' fees.
III. THE PRESENT CASE
The district court below held as follows concerning the late payment of claims in the present cases:
The PIP statute clearly requires that the insurer must obtain, within thirty days, a medical report providing "reasonable proof' that it is not responsible for payment. Here, the insurers failed to obtain such, a report and, hence, must promptly pay the claim plus accrued interest.
Perez, 746 So.2d at 1125 (emphasis omitted and added). Thus, according to the district court, where an insurer improperly fails to pay a claim within thirty days, the insurer must pay the claim, i.e., the insurer can no longer contest the claim. The insurer also is liable for the statutory interest penalty. This holding violates the plain language of the Law.
As noted above, the plain language of section 627.736 provides that an insurer is subject to specific penalties for an "overdue" payment: ten percent interest and attorneys' fees. Nothing in the statute provides that once a payment becomes overdue the insurer is forever barred from contesting the claim. In holding otherwise, the district court erred.
Further, the district court held that in order to escape the thirty-day rule, an insurer must obtain a "medical report" showing that the insurer is not responsible for payment. Amici Allstate Insurance Company and Geico Casualty Company point out that this requirement of a medical report is not mentioned anywhere in section 627.736(4) and they contend it is erroneous. Amici are correct. The statute does not mention "medical report" in this regard; the statute simply says that the insurer must pay benefits within thirty days unless the insurer "has reasonable proof to establish that the insurer is not responsible for the payment." The statute does not limit "reasonable proof' to a "medical report." Thus, to the extent that the present district court opinion defines "reasonable proof' to mean only a medical report, the district court has rewritten the statute. This too was error.
IV. CONCLUSION
Under the language of the Florida No-Fault Law, an insurer is subject to specific penalties once a payment becomes "overdue"; the penalties include ten percent interest and attorneys' fees. The insurer, however, is not forever barred from contesting the claim. Our reading of section 627.736(4) is consistent with the decisions of other district courts that have addressed this statute, including the Third District Court of Appeal's own en banc decision in Fortune Insurance Co. v. Pacheco, 695 So.2d 394 (Fla. 3d DCA 1997).
Based on the foregoing, we quash Perez v. State Farm, Fire and Casualty Co., 746 So.2d 1128 (Fla. 3d DCA 1999).
It is so ordered.
WELLS, C.J., and HARDING, ANSTEAD, and PARIENTE, JJ., concur.
PARIENTE, J., concurs with an opinion, in which ANSTEAD, J., concurs.
LEWIS, J., dissents with an opinion, in which QUINCE, J., concurs.
. See generally § 34.017(1), Fla. Slat. (1997) ("A county court is permitted to certify a question to the district court of appeal.
. The Fourth District Court of Appeal has since addressed this issue, stated agreement with Jones, and certified direct conflict with the district court's decision in the present case. See AIXJ Ins. Co. v. Daidone, 760 So.2d 1110 (Fla. 4th DCA 2000). See infra note 12.
. See Blish v. Atlanta Casualty Co., 736 So.2d 1151, 1155 (Fla.1999).
. Section 627.428(1), Fla. Stat. (1997), provides:
(1) Upon the rendition of a judgment or decree by any of the courts of this state against an insurer and in favor of any named or omnibus insured or the named beneficiary under a policy or contract executed by the insurer, the trial court . shall adjudge or decree against the insurer and in favor of the insured or beneficiary a reasonable sum as fees or compensation for the insured's or beneficiary's attorney prosecuting the suit in which the recovery is had.
. See § 627.736(4), Fla. Stat. (1997) (explaining that an insured must submit "reasonable proof of such loss and amount of expenses").
. See § 627.736(4)(b), Fla. Stat. (1997) ("Personal injury protection insurance benefits paid pursuant to this section shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same.... However, any payment shall not be deemed overdue when the insurer has reasonable proof to establish that the insurer is not responsible for the payment, notwithstanding that written notice has been furnished to the insurer.").
. See § 627.736(4)(c), Fla. Stat. (1997) (explaining that "[a]ll overdue payments shall bear simple interest at the rate of 10 percent per year"). This ten percent interest rate has been in force since the Law was enacted in 1971. See § 627.736(4)(c), Fla. Stat. (1971). In contrast, the statutory interest rate on judgments in 1971 was six percent. See § 55.03, Fla. Stat. (1971).
. See § 627.736(8), Fla. Stat. (1997) (explaining that the attorneys' fee provision of section 627.428 applies to PIP claims); see also § 627.428(1), Fla. Stat. (1997) (explaining that an insurer is liable for fees in a proceeding wherein an insured prevails against the insurer). Ivey v. Allstate Ins. Co., 774 So.2d 679, 684 (Fla.2000) ("It is the incorrect denial of benefits, not the presence of some sinister concept of 'wrongfulness,' that generates the basic entitlement to the fees if such denial is incorrect.")
.See Perez, 746 So.2d at 1125 ("The PIP statute clearly requires that the insurer must obtain, within thirty days, a medical report providing 'reasonable proof' that it is not responsible for payment." (Emphasis added.)).
. But see § 627.736(7), Fla. Stat. (1997) (explaining that a physician's report is required for the non-consensual withdrawal of PIP benefits).
. § 627.736(4), Fla. Stat. (1997) (emphasis added).
. See, e.g., Fortune Ins. Co. v. Pacheco, 695 So.2d 394 (Fla. 3d DCA 1997) (holding the insurer liable for statutory penalties where the insurer paid PIP benefits more than thirty days after receipt of the claim); Jones v. State Farm Mutual Auto. Ins. Co., 694 So.2d 165 (Fla. 5th DCA 1997) (holding the insurer liable for statutory penalties but noting that the insurer can still contest the claim where the insurer failed to pay PIP benefits within thirty days of receipt of the claim); Martinez v. Fortune Ins. Co., 684 So.2d 201 (Fla. 4th DCA 1996) (holding the insurer liable for statutory penalties where the insurer paid PIP benefits more than thirty days after receipt of the claim); Croolcs v. State Farm Mutual Auto. Ins. Co., 659 So.2d 1266 (Fla. 3d DCA 1995) (holding the insurer liable for statutory penalties where the insurer paid PIP benefits more than thirty days after receipt of the claim); Dunmore v. Interstate Fire Ins. Co., 301 So.2d 502 (Fla. 1st DCA 1974) (holding the insurer liable for statutory penalties where the insurer failed to pay PIP benefits within thirty days of receipt of the claim; the insurer did not dispute the insured's entitlement to benefits). Cf. AIU Ins. Co. v. Daidone, 760 So.2d 1110 (Fla. 4th DCA 2000) (setting forth no facts but nevertheless holding that failure to pay PIP benefits within thirty days subjects an insurer to statutory penalties but "does not deprive the insurer of its right to contest payment"; certifying conflict with Perez v. State Farm Fire & Casualty Co., 746 So.2d 1123 (Fla. 3d DCA 1999)).