Fourth District Court of Appeals affirms trial court ruling that assignee’s pre-suit demand letter was not precise as to amount claimed to be due for treatment of insured, as required by 627.736(10).

This controversy was brought on an appeal before the Fourth District Court of Appeals due to the lower court ruling that Chris Thompson, P.A.’s (Thompson) demand letter was not statutorily compliant because it did not put Geico on proper notice of the exact amount it was required to pay in order to avoid suit. 

Thompson’s attorney had sent a demand letter to Geico seeking $2,978.88, or $4,524.28 if the policy contained medical payment coverage. The demand letter also requested Geico to advise Thompson of any potential defects related to the demand letter. Geico responded to the demand letter, advising that additional payments were not owed. Thompson filed the instant suit two years later, with the complaint seeking damages not exceeding $100.00, exclusive of interest, costs and attorney’s fees. The trial court granted Geico’s motion for summary judgment and ruled that the pre-suit demand letter was not in compliance with Florida Statute 627.736(10). 

In addressing the lower court’s decision, the Fourth District Court of Appeals analyzed a prior decision in MRI Assoc. of Am. LLC v. State Farm Fire & Casualty Co., 61 So. 3d 462, 465 (Fla. 4th DCA 2011) as well as Rivera v. State Farm Mut. Auto. Ins. Co., 317 So. 3d (Fla. 3d DCA 2021). In these cases, both courts ruled that the language of Fla. Stat. 627.736(10)(b)3 requires precision in a demand letter, with the requirement that a demand letter have attached an “itemized statement specifying each exact amount” owed, so as to discourage gamesmanship. In the case at hand, the district court ruled that the demand letter sought $2,978.88 or $4,524.28, not the amount less than $100.00 as pled in the plaintiff’s complaint. Citing Rivera, which stated, “[T]he purpose of the demand letter is not just notice of intent to sue. The demand letter also notifies the insurer as to the exact amount for which it will be sued if the insurer does not pay the claim,” the court ruled that Thompson’s demand letter was defective and affirmed the trial court’s ruling. 

This ruling is significant as most PIP lawsuits are filed for jurisdictional amounts far lower than what was sought on demand. Though a plaintiff can, in theory, amend its complaint, there is an argument as to prejudice towards a defendant, due to this behavior exemplifying the “gamesmanship” that the demand letter requirement seeks to prevent.
 

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