May 12, 2023Share
Conflict Alert: Sixth DCA Supports 2007 Participating Price
On May 12, 2023, in Progressive Express Ins. Co. v. Simonmed Imaging a/a/o Hilleri Brown, Case No. 6D23-1145 (Fla. 6th DCA 2023), the Sixth District Court of Appeal agreed with the Fourth District that the proper reimbursement, when considering the 2007 service year, is the non-facility participating price and not the non-facility limiting charge. The Court further certified conflict with the Third District’s holding in Priority Medical Centers, LLC v. Allstate Insurance Company, 319 So. 3d 724 (Fla. 3d DCA 2021).
This is a huge development for the PIP litigation business as now there are two Districts that agree with the statutory interpretation of the PIP statute, specifically what is stated in Fla. Stat. § 627.736(5)(a)(1)(f) and three subparagraphs that follow, and that certify conflict with the Third. Cases venued in the First, Second, and Fifth District are now free to align with the Sixth District, as well as the Fourth, in defending these lawsuits.
It is imperative to employ a strong defensive strategy, right now, to gain the upper hand on cases currently in litigation that involve this issue.
Please contact our PIP Litigation Division for a more thorough analysis of this case and guidance on how it may affect your defenses.