12 Fla. L. Weekly Supp. 540b
Insurance — Personal injury protection — Coverage — Medical expenses — MRI — Amount billed for MRI in excess of statutorily preset fee schedule does not relieve insurer from paying reimbursable amount — Since Florida Statutes codify fee scheme relating to MRI services, medical provider was not required to prove that amount charged for MRI was reasonable — Application — Misrepresentations — Trial court correctly granted summary disposition on issue of insurance coverage where court held that there were no issue of material fact and found that insured did not make material misrepresentation on policy
UNITED AUTOMOBILE INSURANCE COMPANY, a Florida corporation, Appellant, vs. A-1 MOBILE MRI INC. a/a/o MICHAEL EMEKEKWUE, Appellee. Circuit Court, 17th Judicial Circuit (Appellate) in and for Broward County. Case No. 04-10109 CACE (14). March 2, 2005. Counsel: Michael J. Neimand, Office of the General Counsel, United Automobile Insurance Company, Fort Lauderdale, for Appellant. Roberts J. Bradford, Jr., Marks & Fleischer, P.A., Fort Lauderdale.
OPINION
(JEFFREY E. STREITFELD, J.)THIS CAUSE having come before the Court upon the Appellant, United Automobile Insurance Company’s, appeal of the County Court Final Judgment entered following a jury verdict in favor of the Appellee. [11 Fla. L. Weekly Supp. 936b.]
The Court having reviewed the briefs and record dispenses with oral argument and decides as follows. This cause arises from a motor vehicle accident at which time Mr. Emekekwue (“insured”) was covered by a policy of insurance from the Appellant. The insured sought treatment for his injuries and assigned his policy rights for payment to A-1 Mobile MRI INC. (“A-1 ”) after being referred for an MRI by his treating physician, Dr. Brown.
Appellant alleged misrepresentations during the application process and attempted to rescind the policy of insurance for the insured over a year after the accident. A-1 alleges that it timely filed its bill for MRI services, as set by the Florida Statutes, with the Appellant. Appellant refused payment to A-1 and suit was initiated. Both parties filed Summary Judgment/Disposition motions with the County Court. The County Court denied the Appellants’ Motion for Summary Disposition and granted in part the Appellees’ Motion for Summary Judgment, holding that the insured did not make a material misrepresentation and was therefore covered under the policy.
A jury trial was held as to the only remaining issue of whether the testing performed on the insured was “necessary and related” to the subject accident. The jury found for the Appellee and Final Judgment was entered in the amount of $663.85, for services rendered, and $77.36 for statutory interest. The Appeal before this Court now follows.
The two issues on appeal are whether A-1 was required to prove as part of its evidentiary burden in its Motion for Summary Disposition that the amount charged to the Appellant was reasonable, notwithstanding the Florida Statutes which codify a fee scheme pertaining to such services. Florida Statute §627.736(5)(b)(5). Second, whether the court below correctly denied the Appellants’ Motion for Summary Disposition on the issue of material misrepresentation and correctly granted the same motion in favor of the Appellee.
As to the first issue the Court affirms the ruling below and agrees with the County Court that any amount billed in excess of the statutorily preset fee schedule does not relieve the Appellant from paying the reimbursable amount. This Court agrees with the Court below that that Appellee satisfied its evidentiary burden.
As to the second issue this Court finds that the Court below correctly granted summary disposition on the issue of insurance coverage. The Court correctly held there were no issues of material fact and this Court, in de novo review, affirms the grant of Summary Disposition in favor of the Appellee below. See University of Florida, Board of Trustees v. Sanal, 837 So. 2d 512 (Fla. 1st DCA 2003); Cascella v. Canaveral Port Authority, 827 So. 2d 308 (Fla. 5th DCA 2002).
Accordingly, the Final Judgment by the County Court in favor of the Appellee is affirmed. The Appellee’s Motion for Appellate Attorney’s Fees, pursuant to F.R.App.P 9.400, Fla. Stat. §§ 627.736(8), and 627.428 is granted. The County Court shall determine the amount and enter judgment thereon, upon remand.
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