Progressive Select Insurance Company v. Emergency Physicians, Inc., d/b/a Emergency Resources Group, as Assignee of Michelle Archer

Summary

The Florida Fifth District Court of Appeal reversed a summary judgment awarding priority to an emergency medical provider’s claim for payment under Florida’s personal injury protection statutes. The court held that when an insurer receives emergency and non-emergency medical bills on the same day and the precise order of receipt cannot be established, the statutes do not require the non-emergency bill to be applied to the deductible first. The case was remanded for further proceedings.

Holdings

1. An insurer is not required to apply the non-emergency provider's bill to the deductible first merely because the insurer cannot establish which of two same-day bills it received first. The trial court therefore had no legal basis to require prioritization in the manner advocated by Emergency Physicians.

Questions Presented

1. When an insurer receives an emergency provider's bill and a non-emergency provider's bill on the same day, without evidence establishing the precise order of receipt, must the insurer apply the non-emergency provider's bill to the deductible first so that the emergency provider's bill is paid in full?
2. Do sections 627.736(4)(c) and 627.739(2), Florida Statutes (2015), require emergency-provider claims to be prioritized over non-emergency claims for purposes of applying a policy deductible?

Disposition

reversed_and_remanded