Title: United Automobile Insurance v. Rodriquez
Citation: N/A
Docket Number: SC00-111
State: Florida
Issuer: Florida Supreme Court
Date: November 8, 2001

Supreme 
Court 
of 
Florida
 
____________
Nos. SC00-111 & SC00-112
____________
UNITED AUTOMOBILE INSURANCE COMPANY,
Petitioner,
vs.
MARISOL RODRIGUEZ,
Respondent.
                     _____________________________________________
STATE FARM FIRE AND CASUALTY COMPANY,
Petitioner,
vs.
JUANA MARIA PEREZ,
Respondent.
[November 8, 2001]
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
-2-
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
1  See generally § 34.017(1), Fla. Stat. (1997) (“A county court is permitted to
certify a question to the district court of appeal . . . .”). 
-3-
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
1997) (emphasis omitted).  The county court certified the issue to the district court
as a question of great public importance.1
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.”
2  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 AIU Ins. Co. v. Daidone, 760 So. 2d 1110 (Fla. 4th DCA
2000).  See infra note 12.
-4-
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 Rodriquez 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.2
3  See Blish v. Atlanta Casualty Co., 736 So. 2d 1151, 1155 (Fla. 1999).
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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”).3  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
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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 (1)(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’
4  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
-7-
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 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. 
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 of s. 627.428 shall
apply.[4]
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.
5  See § 627.736(4), Fla. Stat. (1997) (explaining that an insured must submit
“reasonable proof of such loss and amount of expenses”).
6  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.”).
-8-
§ 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;5 (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”;6 (3) all “overdue” payments
7  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).
8  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.”)
-9-
shall bear simple interest at a rate of ten percent per year;7 and (4) whenever an
insured files an action for payment of PIP benefits and prevails, the insured is
entitled to attorneys’ fees.8
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
9  See Perez, 646 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.)).
10  But see § 627.736(7), Fla. Stat. (1997) (explaining that a physician’s report
is required for the non-consensual withdrawal of PIP benefits).
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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.9  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;10 the statute simply says that the
insurer must pay benefits within thirty days unless the insurer “has reasonable proof
11  § 627.736(4), Fla. Stat. (1997) (emphasis added).
12  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); Crooks 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
-11-
to establish that the insurer is not responsible for the payment.”11  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).12
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 1996)).
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Based on the foregoing, we quash Perez v. State Farm Fire and Casualty
Co., 746 So. 2d 1123 (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.
NOT FINAL UNTIL TIME EXPIRES TO FILE REHEARING MOTION, AND
IF FILED, DETERMINED.
PARIENTE, J., concurring.
 I concur with the majority.  I write to emphasize that this case involves an
issue of statutory construction, which must be guided by the express language of
section 627.736(4), Florida Statutes (1997), and not our own view of the best
policy for resolving insurance disputes.  See Rollins v. Pizzarelli, 761 So. 2d 294,
299 (Fla. 2000).  Legislative intent must be determined primarily from the language
of the statute.  See id. at 297.  Although the statutory language of section
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627.736(4) may not be a model of clarity, reading the statute as a whole does not
support either the Third District or the dissent's interpretation that the failure of the
insurer to obtain reasonable proof within thirty days after the claim is submitted
forever bars an insurer from contesting that the claim was not covered.  In fact, to
reach this result would be to impermissibly read words into the statute that simply
do not exist. 
Although I agree with the dissent that the purpose of the no-fault statutory
scheme is to provide "swift and virtually automatic payment [to] the injured
insured," Ivey v. Allstate Ins. Co., 774 So. 2d 679, 683-84 (Fla. 2000), the purpose
of the no-fault scheme does not logically extend to require an insurer to
automatically pay for bills for which the insurer is not responsible.  I thus take issue
with the dissent's suggestion that the majority opinion renders the "reasonable
proof" language of section 627.736(4)(b) and the limitation on withdrawal of
payment for treating physicians in section 627.736(7), Florida Statutes (1997),
"meaningless and without any field of operation."  Dissenting op. at 20. 
Section 627.736(4) provides in pertinent part:
(b)  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 . . . . 
However, any payment shall not be deemed overdue when the insurer
13  The First and Fifth Districts are in agreement with the Fourth District's
interpretation of the statute.  See State Farm Mut. Auto. Ins. Co. v. Jones, 789 So. 2d
504, 508 (Fla. 1st DCA 2001); Jones v. State Farm Mut. Auto. Ins. Co., 694 So. 2d
165, 166 (Fla. 5th DCA 1997).
-14-
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.
(Emphasis added).  I agree with Judge Klein's interpretation of the statute:
[T]he thirty-day period in section 627.736(4) applies only to benefits
which are reasonable and necessary as a result of the accident. 
Section 627.736(4), Florida Statutes begins with the words "benefits
due" and states in subsection (b) that "personal injury protection
benefits paid pursuant to this section shall be overdue if not paid
within thirty days."   If an insured submits a bill for medical treatment
which is not related to the accident, there are no "benefits due."  If
benefits are not due, they cannot be "overdue."    
AIU Ins. Co. v. Daidone, 760 So. 2d 1110, 1112 (Fla. 4th DCA 2000).13 
The statutory penalty of ten percent interest for "overdue" payments thus
comes into play if the insurer fails to pay the bill within thirty days after written
notice and did not have reasonable proof within that thirty-day period to establish
that it was not responsible for the bill.  However, the penalty for "overdue"
payments, which runs from the expiration of the thirty-day period, applies only if
the insurer is ultimately found liable for the claim.  The insurer does not forfeit its
ability to contest payment by its failure to obtain reasonable proof in the thirty-day
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period.
As for section 627.736(7)(a), this statute deals exclusively with the
requirements for withdrawal of payment:
An insurer may not withdraw payment of a treating physician without
the consent of the injured person covered by the personal injury
protection, unless the insurer first obtains a report by a physician
licensed under the same chapter as the treating physician whose
treatment authorization is sought to be withdrawn, stating that the
treatment was not reasonable, related, or necessary.  
§ 627.736(7)(a) (emphasis added).  This statute requires that a PIP insurer obtain a
medical report as a condition precedent to withdrawing benefits.  Nothing in the
language of section 627.736(4)(b) suggests that the "reasonable proof" necessary
to avoid "overdue" status is limited to the "report" necessary to "withdraw"
payment of a treating physician under section 627.736(7)(a).  See § 627.736(4)(b). 
In my view, this interpretation of the "reasonable proof" requirement in section
627.736(4)(b) and the medical report requirement of section 627.736(7)(a) give
meaning and effect to both statutory provisions, with each section operating
independently of the other.
ANSTEAD, J., concurs.
LEWIS, J., dissenting.
For nearly three decades, the law in Florida has been clear that an insurer has
14  It is important to note that subsection (7) covers situations where the insurer
under a PIP policy seeks to withdraw payment of a treating physician on the basis that
the treatment, as opposed to the charge for that treatment, is not reasonable, related,
or necessary. That is, subsection (7) requires an insurance company to obtain a report
from a physician licensed under the same statute as the treating physician only in those
situations where the insurer wishes to challenge the reasonableness, relatedness, or
necessity of the services and treatment rendered.  To be sure, subsection (7) does not
require insurance companies to obtain a similar report when its challenge is based on
the bill itself (i.e., the amount being charged).
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the burden to investigate and verify a request for personal injury protection (“PIP”)
benefits within thirty days of receiving written notice of the fact of a covered loss
and the amount of same, and that–absent reasonable proof establishing non-
responsibility for payment–PIP benefits are overdue if not paid within those thirty
days.  See § 627.736(4), Fla. Stat. (1997).  As a corollary, section 627.736(7),
Florida Statutes (1997),  requires that before an insurer may withdraw payment of a
treating physician on the basis that medical treatment was not reasonable, not
related, or not necessary, it must obtain a report from a like-licensed physician
stating that the treatment is not reasonable, related, or necessary.14  Today, under
the guise of statutory interpretation, a majority of this Court totally alters the no-
fault framework by judicially excising these significant provisions which have
protected Florida citizens and supported its constitutional validity.  
It cannot be contested that the prompt payment of PIP benefits, as a
substitute for access to courts, represents one of the essential pillars upon which
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the constitutionality of the no-fault concept is premised.  When the no-fault
legislation came into effect in the early 1970's in Florida, it soon became the subject
of constitutional challenges.  One of the first cases to address this newly enacted
tort reform was Kluger v. White, 281 So. 2d 1 (Fla. 1973).  There, this Court
invalidated that portion of the no-fault legislation which provided an exemption
from tort liability for property damage on the ground that it denied Floridians the
right of access to the courts under article I, section 21 of the Florida Constitution. 
See id. at 4-5.  Less than a year later, this Court again addressed the
constitutionality of the no-fault plan, but as it related to limitations on access to
remedies for personal injuries.  In that case, Lasky v. State Farm Insurance Co., 
296 So. 2d 9 (Fla. 1974), the majority reasoned:
Protections are afforded the accident victim by this Act in the
speedy payment by his own insurer of medical costs, lost wages, etc.,
while foregoing the right to recover in tort for these same benefits and
(in a limited category of cases) the right to recover for intangible
damages to the extent covered by the required insurance (F.S. §
627.737(1), F.S.A.); furthermore, the accident victim is assured of
some recovery even where he himself is at fault. In exchange for his
former right to damages for pain and suffering in the limited category
of cases where such items are preempted by the act, he receives not
only a prompt recovery of his major, salient out-of-pocket
losses--even where he is at fault--but also an immunity from being held
liable for the pain and suffering of the other parties to the accident if
they should fall within this limited class where such items are not
recoverable.
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Id. at 14 (emphasis supplied). Based on the compulsory nature of the no-fault
legislation and its provisions for the expeditious payment for covered losses, this
Court ultimately concluded that the PIP provisions of the no-fault statute provided
a reasonable alternative to traditional tort actions and, therefore, did not violate the
right of access to the courts.  See id. at 15.
The viability of the Lasky rationale with respect to the importance of a
prompt resolution of PIP payments was recently recognized by a majority of this
Court in Ivey v. Allstate Insurance Co., 774 So. 2d 679 (Fla. 2000).  In Ivey, the
Court recognized:  
Without a doubt, the purpose of the no-fault statutory scheme is to
"provide swift and virtually automatic payment so that the injured
insured may get on with his life without undue financial interruption."
Government Employees Ins. Co. v. Gonzalez, 512 So.2d 269, 271
(Fla. 3d DCA 1987) (citing Comeau v. Safeco Ins. Co., 356 So.2d
790 (Fla.1978)). To this end, section 627.736(4)(b), Florida Statutes
(1995), clearly provides that PIP insurance benefits "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."
For over a quarter of a century, Florida courts have consistently
held: 
[T]he statutory language is clear and unambiguous. The
insurance company has thirty days in which to verify the
claim after receipt of an application for benefits. There is
no provision in the statute to toll this limitation. The
burden is clearly upon the insurer to authenticate the claim
within the statutory time period. To rule otherwise would
render the recently enacted "no fault" insurance statute a
"no pay" plan-a result we are sure was not intended by
15 Senate Bill 1092, which was passed by our Legislature during the 2001
Session and approved by the Governor on June 19, 2001, adds language to section
627.736(4).  This legislative revision, however, was not in place in 1997 and has no
application in this case.
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the legislature. 
Id. at 683-84 (quoting Dunmore v. Interstate Fire Ins. Co., 301 So. 2d 502, 502
(Fla. 1st DCA 1974)); see also Amador v. United Auto. Ins. Co., 748 So. 2d 307
(Fla. 3d DCA 1999); Fortune Ins. Co. v. Pacheco, 695 So. 2d 394, 395 (Fla. 3d
DCA 1997); Martinez v. Fortune Ins. Co., 684 So. 2d 201, 203 (Fla. 4th DCA
1996); Crooks v. State Farm Mut. Auto. Ins. Co., 659 So. 2d 1266, 1268 (Fla. 3d
DCA 1995).
In the present case, the majority’s decision as reinforced by a concurring
opinion allows insurance companies to simply disregard the specific provisions of
chapter 627 which require the payment of benefits to injured persons within thirty
days, absent reasonable proof –obtained within that time period–that they are not
responsible for payment.15  See §§ 627.736(4), (7), Fla. Stat. (1997).  It is clear that
the swift and expeditious payment of PIP benefits is at the heart of the no-fault
concept and implementing statutes, and, in my view, the reasoning of the majority
and concurring opinions today undermines the validity of the entire no-fault
framework and places the legislative scheme at risk.
-20-
In essence, the majority decision renders the “reasonable proof” language
found in section 627.736(4) and the limitation on the withdrawal of payment for
treating physicians in section 627.736(7) meaningless and without any field of
operation.  The statute specifically states:
627.736(4) BENEFITS; WHEN DUE.-
. . . . 
(b)  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.  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.
The direct statutory language provides that payments required to be paid
within thirty days are not overdue if the insurer “has reasonable proof” it is not
responsible.  According to the majority and concurring opinions, the “has
reasonable proof” statutory language has been judicially rewritten to be “is ever able
to obtain reasonable proof.”  The notion of payment within thirty days unless the
insurer “has reasonable proof” is now replaced by judicial decree (not statutory
language) that if an insurer can ever establish proof to contest the payment of
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benefits, the thirty-day provision is meaningless.  The practical impact of this
judicial rewrite is to sanction the practice of withholding benefits for extended
periods of time without any basis whatsoever and then permit the contesting and
litigating of minor aspects related to loss of wages and medical treatment rendered
years earlier.
Taken to its logical conclusion, the majority’s rationale belittles the
protections afforded to those insured under the no-fault statute, and equates
statutory noncompliance by an insurer with a simple breach of contract.  That is,
the decision removes the statutory mandate that insurers make timely and proper
payments.  The majority view today as enhanced by a concurring opinion
transforms the no-fault concept of benefits into just another form of health
insurance and disability insurance without limited time parameters to secure benefits
for injured Floridians.  In fact, the majority and concurring opinions interpret the
no-fault statutes in a manner that simply provides a thirty-day grace period for
payment of benefits that even other forms of health and disability insurance are not
afforded.
QUINCE, J., concurs.
Two Cases Consolidated:
Applications for Review of the Decision of the District Court of Appeal - 
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Direct Conflict
Third District - Case Nos. 3D99-1348 & 3D99-1481 
(Dade County)
Steven E. Stark of Fowler, White, Burnett, Hurley, Banick & Strickroot, P.A., Miami,
Florida, for United Automobile Insurance Company; and James K. Clark of Clark,
Robb, Mason & Coulombe, Miami, Florida, and Frances F. Guasch of Kevin W.
Korth & Associates, Miami, Florida, for State Farm Mutual Automobile Insurance
Company, Petitioners
John H. Ruiz, Luisa M. Linares, and Maloy Castro Morales of John H. Ruiz, P.A.,
Miami, Florida, and Amado Alan Alvarez of Alvarez & Alvarez-Zane, Miami, Florida,
for Marisol Rodriguez and Juana Maria Perez, Respondents
David B. Shelton of Rumberger, Kirk & Caldwell, Orlando, Florida; and Peter J.
Valeta of Ross & Hardies, Chicago, Illinois, 
for Allstate Insurance Company and Florida Insurance Council, Amici Curiae
Vincent F. Iacono of the Law Offices of Howard W. Weber, Tampa, Florida,
for GEICO 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, Florida; and
Philip M. Burlington of Caruso, Burlington, Bohn & Compiani, P.A., West Palm
Beach, Florida,
for Academy of Florida Trial Lawyers, Amicus Curiae
Robert A. Robbins of Robbins & Reynolds, P.A., Miami, Florida; and Arthur Joel
Berger, Miami, Florida,
Amicus Curiae