RECOVERY SPECIALISTS, INC., (as assignee of Kara Luster), Plaintiff, v. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant.

10 Fla. L. Weekly Supp. 908a

Insurance — Personal injury protection — Standing — Assignment — Collection agency — Where medical provider received assignment from insured, and in turn, assigned those benefits to collection agency, collection agency has standing to bring PIP action, assuming medical provider received valid assignment from insured

RECOVERY SPECIALISTS, INC., (as assignee of Kara Luster), Plaintiff, v. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant. County Court, 4th Judicial Circuit in and for Duval County. Case No. 2003-CC-2138. Division CC-O. September 9, 2003. Ronald P. Higbee, Judge. Counsel: Vincent P. Gallagher, Jacksonville. Michael G. Youngs, Jacksonville.

ORDER DENYING DEFENDANT’SMOTION FOR SUMMARY JUDGMENT

This matter came before the court on the defendant’s Motion for Summary Judgment. The facts are not at issue. The insured, Kara Luster, sought medical treatment from Jacksonville Emergency Consultants, (JEC), on June 16, 2000. The injuries were related to a motor vehicle accident occurring shortly prior to the emergency room visit. JEC employed the emergency room doctors who rendered medical treatment to Luster. At the time of the accident, Defendant, Progressive Express Insurance Company, provided PIP benefits to Luster, who in turn, assigned those benefits to JEC.

JEC timely billed Progressive $206.00 for the June 16, 2000, medical services. Progressive alleged that the $206.00 charge exceeded the reasonable fee in the area for that procedure and reduced that amount to $190.00 and subsequently paid $152.00 (80% of the coverage). JEC assigned Luster’s insurance benefits to Recovery Specialists, Incorporated, (RSI), the billing and collection agent for JEC.

RSI initiated litigation against Progressive, claiming the assignment of benefits were transferred from Luster to JEC and ultimately to RSI. It is undisputed that RSI is not a provider of medical services and is not a “physician, hospital, clinic or other person or institution lawfully rendering treatment to an injured person…” Florida Statute, Section 627.736.

The Second District Court of Appeal in Professional Consulting Services, Inc., a/a/o Susan Berlinghoff v. Hartford Life and Accident Insurance Company, 28 Fla. Law Weekly, 1661 (Fla. 2d DCA 2003), has decided this issue and this court is bound to follow this opinion as the First District Court of Appeal has not ruled on this issue. In Berlinghoff, the insured, Ms. Berlinghoff, assigned her PIP benefit rights to Professional Consulting Services (PCS), the billing and collection agent for Dr. Gibson, who treated Ms. Berlinghoff for injuries allegedly related to a motor vehicle accident. PCS timely billed Hartford who declined to pay. Hartford “maintained that it was only required to make payment to four entities: a physician, a hospital, a clinic, or another person lawfully rendering treatment”. In that case, as in this one, there was no dispute that the plaintiff was not one of those categories. The Second District Court reiterated that “generally, rights under a contract are assignable”. Thus, if the assignment from Ms. Berlinghoff to Professional was valid, then, “Professional stands in her shoes and has the same rights. . .” The Second District held that “. . .a PIP insured may assign an after-loss claim to a third party who is not a medical provider”. (at page 1662)

This court adopts the reasoning and holding of the Berlinghoff case in the above matter. In the instant case, Luster assigned the benefits to JEC who then assigned the benefits to RSI. Assuming JEC received a valid assignment from the insured, and in turn, assigned those benefits to RSI, then RSI held all of the rights to benefits to which Luster was entitled. This court has not been asked to rule on the validity of the assignments. Defendant’s Motion for Summary Judgment is denied; however, Defendant is not precluded from challenging the reasonableness of the medical charges.

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