Opinion ID: 1588435
Heading Depth: 3
Heading Rank: 1

Heading: Elements of Breach of a Third-Party Beneficiary Contract Claim

Text: As the Fourth District correctly held, an allegation that an HMO violated the prompt pay provisions is not sufficient by itself to establish a private cause of action. Westside, 932 So.2d at 216 (citing Villazon, 843 So.2d at 852). Instead, a party must bring a recognized common law cause of action. As stated earlier, one of the claims Westside attempted to plead in its amended complaint was a common law cause of action for breach of a third-party beneficiary contract. To establish an action for breach of a third party beneficiary contract, Westside must allege and prove the following four elements: (1) existence of a contract; (2) the clear or manifest intent of the contracting parties that the contract primarily and directly benefit the third party; (3) breach of the contract by a contracting party; and (4) damages to the third party resulting from the breach. Networkip, LLC v. Spread Enters., Inc., 922 So.2d 355, 358 (Fla. 3d DCA 2006) (citing Biscayne Inv. Group, Ltd. v. Guar. Mgmt. Servs., Inc., 903 So.2d 251, 254 (Fla. 3d DCA 2005)). While we decline to decide from the limited record on appeal whether Westside's complaint is sufficient to establish each of these elements, we find no support for the HMOs' assertion that Westside is precluded as a matter of law from pursuing such a cause of action. See A.R. Moyer, Inc. v. Graham, 285 So.2d 397, 402 (Fla.1973) (Without viewing the [contract at issue], which is absent from the record, we are unable to speculate if a cause of action would exist.). As the Fourth District correctly concluded, section 641.3155 can be incorporated into the HMO contract. Such an incorporation supports the first and third elements of the claim. Moreover, there is no basis to conclude that Westside is precluded, as a matter of law, from establishing the second element because of its status as a nonparticipating provider.