Third District Court of Appeals affirms trial court’s decision allowing a fully completed and executed CMS Form 1500 to serve as an “itemized statement” pursuant to Florida Statute 627.736(5)(d).

This appeal involved a suit for the payment of personal injury protection (PIP) benefits. The insured treated with Pan Am Diagnostic of Orlando and, in exchange, assigned her right to pursue PIP benefits. Pan Am proceeded to submit a bill to Mercury Indemnity Company of America in the amount of $4,300.00. Mercury reimbursed Pan Am pursuant to the terms and conditions of its policy and Fla. Stat. 627.736. Pan Am then furnished Mercury with a demand letter pursuant to Fla. Stat. 627.736(10), seeking additional payments. Mercury did not respond to the demand letter, and Pam Am filed suit shortly thereafter. 

During oral arguments on cross motions for summary judgment, Mercury argued that the demand letter was defective for both demanding a higher amount than what was eventually sought in the complaint and for not attaching an itemized statement specifying the exact amount claimed to be due. Pan Am argued that the demand letter complied with Fla. Stat. 627.736(10)(b)3 and that the failure to attach an itemized statement was irrelevant because Fla. Stat. 627.736(10)(b)3 also allows a completed form to be used in place of an itemized statement. Pan Am had attached a completed CMS Form 1500 to the demand letter. The court agreed with Pan Am, holding that it complied with the statute by attaching the requisite form to the demand letter. 

This case is significant in that it strengthens the plaintiff bar’s position on what constitutes a statutorily compliant demand letter.
 

_{Case Law Alerts, 3rd Quarter, July 2023 is prepared by Marshall Dennehey to provide information on recent developments of interest to our readers. This publication is not intended to provide legal advice for a specific situation or to create an attorney-client relationship. Copyright © 2023 Marshall Dennehey, all rights reserved. This article may not be reprinted without the express written permission of our firm.}