Court Opinion

ID: 9904339
Source: CourtListenerOpinion
Date Created: 2023-11-27 16:33:16.480545+00
Date Added: 2024-06-11T09:21:33.000082
License: Public Domain

IN THE DISTRICT COURT OF APPEAL OF THE STATE OF FLORIDA
                      FIFTH DISTRICT

                                  NOT FINAL UNTIL TIME EXPIRES TO
                                  FILE MOTION FOR REHEARING AND
                                  DISPOSITION THEREOF IF FILED

USAA CASUALTY INSURANCE
COMPANY,

            Appellant,

v.                                Case No. 5D21-720
                                  LT Case No. 2018-CC-000974-20-P-S

CHRISTOS MIKROGIANNAKIS,

            Appellee.

________________________________/

Opinion filed July 22, 2022

Appeal from the County Court
for Seminole County,
James J. DeKleva, Judge.

Rebecca Delaney, Maria Pace and
Scott W. Dutton, of Dutton Law
Group, P.A., Orlando, for Appellant.

Chad A. Barr, of Chad Barr Law,
Altamonte Springs, for Appellee.

EISNAUGLE, J.

      USAA Casualty Insurance Company (“USAA”) appeals a summary

judgment and final judgment for damages in favor of Christos
Mikrogiannakis. Section 627.736(5)(c), Florida Statutes (2014), establishes

a thirty-five-day time limitation for the submission of invoices to a Personal

Injury Protection (“PIP”) insurer. We must decide whether an exception to

this time limitation set forth in subsection (5)(c)(1) applies when the provider

receives no PIP insurance information at all, as opposed to receipt of

affirmative but erroneous information. We conclude that the plain language

of the exception requires receipt of affirmative information. We therefore

reverse.

                       Facts and Procedural History

      Mikrogiannakis obtained medical treatment from Physical Medicine

Pain Center, P.A. (“PMPC”) after he was struck by a car while riding his

bicycle. At his initial visit, Mikrogiannakis completed a registration form but

listed only his contact information and the name of his lawyer. Although the

form asked Mikrogiannakis for the name and address of a PIP insurer, he

left that field blank. Mikrogiannakis then received treatment at PMPC over a

period of several months.

      PMPC submitted the invoices to USAA approximately eighteen months

after treatment. As a result, USAA denied payment for failure to comply with

section 627.736(5)(c)’s thirty-five-day time limitation. Mikrogiannakis then

filed a petition for declaratory judgment and a claim for PIP insurance

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benefits,1 relying on an exception to the thirty-five-day time limitation

applicable when a provider reasonably relies on erroneous PIP insurance

information.

     The parties filed dueling motions for summary judgment, each arguing

entitlement to judgment based on section 627.736(5)(c). The trial court

agreed with Mikrogiannakis, reasoning that the exception to the thirty-five-

day time period applied because providing no PIP information was

equivalent to providing “erroneous information.” Accordingly, the trial court

denied USAA’s motion, granted Mikrogiannakis’s motion, and entered a final

judgment for damages in favor of Mikrogiannakis.

                            Statutory Analysis

     “In interpreting the statute, we follow the ‘supremacy-of-text

principle’—namely, the principle that ‘[t]he words of a governing text are of

paramount concern, and what they convey, in their context, is what the text

means.’” Forrester v. Sch. Bd. of Sumter Cnty., 316 So. 3d 774, 776 (Fla.

     1
         USAA appears to argue on appeal that Mikrogiannakis lacked
standing below. However, Mikrogiannakis received an assignment from
PMPC, which appears in our record. USAA’s standing argument on appeal
is deficient because it fails to even acknowledge this assignment, let alone
explain why the trial court’s order denying USAA’s motion to dismiss for lack
of standing was in error or to otherwise explain why Mikrogiannakis lacks
standing in light of the assignment. See Cox v. Great Am. Ins. Co., 203 So.
3d 204, 205 (Fla. 4th DCA 2016) (“[O]n appeal the duty rests upon the
appealing party to make error clearly appear.” (citation omitted)).

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5th DCA 2021) (quoting Ham v. Portfolio Recovery Assocs., LLC, 308 So.

3d 942, 946 (Fla. 2020)). To that end, “[w]hen the language of a statute is

clear and unambiguous and conveys a clear and definite meaning, it must

be given its plain and obvious meaning.” Weightman v. State, 990 So. 2d

590, 592 (Fla. 5th DCA 2008) (citations omitted).2 We are also mindful that,

when interpreting a legal text, we must “arrive at a ‘fair reading’ of the text by

‘determining the application of [the] text to given facts on the basis of how a

reasonable reader, fully competent in the language, would have understood

the text at the time it was issued.’” Lab’y Corp. of Am. v. Davis, 47 Fla. L.

Weekly S134, S136 (Fla. May 26, 2022) (alteration in original) (quoting Ham,

308 So. 3d at 947); see also MRI Assocs. of Tampa, Inc. v. State Farm Mut.

Auto. Ins. Co., 334 So. 3d 577, 584 (Fla. 2021) (employing a “reasonable

reading of the statutory text”).

      We conclude that section 627.736(5)(c) is unambiguous, and the

exception to the thirty-five-day time period does not apply where a provider

receives no information rather than “erroneous information.” “We reach this

conclusion by examining the text, context, and structure of the statute . . . .”

      2
       We review the trial court’s interpretation of a statute de novo.
BellSouth Telecomms., Inc. v. Meeks, 863 So. 2d 287, 289 (Fla. 2003).

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Dungarani v. Benoit, 312 So. 3d 126, 129 (Fla. 5th DCA 2020) (citation

omitted).

     Section 627.736(5)(c) provides, in pertinent part:

            With respect to any treatment or service, other than
            medical services billed by a hospital or other provider
            for emergency services and care as defined in s.
            395.002 or inpatient services rendered at a hospital-
            owned facility, the statement of charges must be
            furnished to the insurer by the provider and may not
            include, and the insurer is not required to pay,
            charges for treatment or services rendered more
            than 35 days before the postmark date or electronic
            transmission date of the statement . . . .

            1. If the insured fails to furnish the provider with the
            correct name and address of the insured’s personal
            injury protection insurer, the provider has 35 days
            from the date the provider obtains the correct
            information to furnish the insurer with a statement of
            the charges. The insurer is not required to pay for
            such charges unless the provider includes with the
            statement documentary evidence that was provided
            by the insured during the 35-day period
            demonstrating that the provider reasonably relied on
            erroneous information from the insured and either:

            a. A denial letter from the incorrect insurer; or

            b. Proof of mailing, which may include an affidavit
            under penalty of perjury, reflecting timely mailing to
            the incorrect address or insurer.

§ 627.736(5)(c).

     The statute requires a provider to submit invoices within thirty-five days

of treatment and provides that the insurer is not required to pay any late

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invoices. In this case, there is no dispute that the invoices were submitted

more than thirty-five days after treatment.

      Nevertheless, Mikrogiannakis attempts to seize upon the statutory

exception to the rule which gives a provider, if the insured fails to provide

correct PIP information, thirty-five days from the date the provider obtains

the correct information. Specifically, Mikrogiannakis argues on appeal that

PMPC received “erroneous information” because he left the field for

insurance information blank despite having PIP coverage.

      We reject Mikrogiannakis’s interpretation of subsection (5)(c)(1) based

upon the exception’s plain language. Initially, we observe that the exception

only applies where an insured “fails to furnish the provider with the correct

name and address of the insured’s personal injury protection insurer.” In this

case, PMPC did not have any name or address of an insurer within thirty-

five days of treatment. In other words, PMPC had no information at all.

      We readily acknowledge that Mikrogiannakis’s interpretation of this

phrase has some technical appeal. In some sense, Mikrogiannakis did “fail[]

to furnish [PMPC] with the correct name and address” of the insurer because

he failed to complete the portion of the intake form relating to his PIP

coverage. In that regard, he “fail[ed] to furnish” the correct information.

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      However, the “fair reading” method does not countenance a

hyperliteral reading of a legal text. See Antonin Scalia & Bryan A.

Garner, Reading Law: The Interpretation of Legal Texts 39 (1st Ed. 2012).

Instead, as we observed above, the method considers the text from the

perspective of how a “reasonable reader, fully competent in the language,

would have understood the text at the time it was issued.” Davis, 47 Fla. L.

Weekly at S136 (citation omitted).          “The endeavor requires aptitude in

language, sound judgment, the suppression of personal preferences

regarding the outcome, and, with older texts, historical linguistic research.”

Scalia & Garner, Reading Law at 33. Finally, a “fair reading” considers the

purpose of the text, “gathered only from the text itself, consistently with the

other aspects of its context.” Id.

      We doubt that a reasonable reader, given the context of the thirty-five-

day time limitation, would interpret “fails to furnish the correct name and

address” to include a situation where, as here, an insured fails to provide any

information at all. Indeed, such an open-ended exception would seem to

undermine section 627.736(5)(c)’s purpose—prompt submission of invoices

within thirty-five days of treatment.

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        That said, if the statutory language ended there, this case might

present a closer question. However, we must consider the entire statute,

and subsection (5)(c)(1) contains a host of additional indicia of meaning.

        For instance, to invoke the exception, a provider must submit

“documentary evidence that was provided by the insured during the 35-day

period demonstrating that the provider reasonably relied on erroneous

information from the insured.” § 627.736(5)(c)(1) (emphasis added). If there

were any doubt about the meaning of subsection (5)(c)(1)’s reference to the

insurer’s “correct name and address,” this language settles it because, if a

provider has no information at all, there is nothing upon which to reasonably

rely.

        Yet, the statute does not end there. The exception also requires a

provider to submit either a denial letter or proof of mailing to “the incorrect

address or insurer” to prove the provider’s reasonable reliance. This is

further indication that the phrases “incorrect name or address” and

“erroneous information,” as used in this statute, necessarily mean affirmative

misinformation. We fail to see how a provider could produce a denial letter

or proof of mailing when the provider has no PIP insurance information at all.

        Considering the entirety of the statute, as we must, the exception in

subsection (5)(c)(1) is narrow and requires that a provider have affirmative

                                      8
information concerning the insurer before the exception is even in play. As

such, the exception does not apply here.

      Given the undisputed summary judgment evidence, and the parties’

dueling motions for summary judgment, we reverse the trial court’s entry of

summary judgment and final judgment for damages in favor of

Mikrogiannakis and remand for entry of summary judgment in favor of USAA.

      REVERSED AND REMANDED.

NARDELLA, J., concurs.
COHEN, J., concurs in result only, without opinion.

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