GEICO Indemnity Company v. Accident & Injury Clinic (a/a/o Frank Irizarry)

Case: GEICO Indemnity Company v. Accident & Injury Clinic (a/a/o Frank Irizarry)
Venue: Fifth District Court of Appeal

Michael A. Rosenberg, Thomas L. Hunker and Peter D. Weinstein of CSK’s Fort Lauderdale West office obtained a reversal of eleven Volusia County Circuit Court Appellate Opinions on a consolidated second-tier certiorari review. This litigation stems from a Medical Provider’s argument that the Insurer was required to reimburse 100% of the Provider’s charge where that charge was less than 200% of the Medicare Part B fee schedule (“Billed Amount”). The county court ruled in favor of the Provider. On appeal to the Circuit Court, the Insurer maintained that its policy language permitted it to reimburse the medical provider 80% of the Billed Amount. In its opinion, the Circuit Court agreed that the Insurer’s policy stated that it would reimburse the Medical Provider 80% of the Billed Amount, but nonetheless affirmed the county court’s order on summary judgment finding that the Insurer’s PIP policy conflicted with the PIP statute.

The Insurer filed second-tier petitions for writ of certiorari to the Fifth District Court of Appeal, arguing that the Circuit Court departed from the essential requirements of the law when it misinterpreted the PIP statute. The Fifth District Court of Appeal agreed with the Insurer, quashed the Circuit Court’s Opinions, and remanded for proceedings consistent with its opinion. The Fifth District Court of Appeal denied the Provider’s motion for appellate attorneys’ fees.