SC05-435 –Allstate Company v. Holy Cross Hospital, Inc., Etc.

State: Florida

Docket No: SC05-435

Case Date: 07/12/2007

Preview:Supreme Court of Florida
____________ No. SC05-435 ____________ ALLSTATE INSURANCE COMPANY, Petitioner, vs. HOLY CROSS HOSPITAL, INC., etc., Respondent. ____________ No. SC05-545 ____________ HOLY CROSS HOSPITAL, INC., et al., Petitioners, vs. ALLSTATE INSURANCE COMPANY, Respondent. [July 12, 2007] PARIENTE, J. This case arises from a dispute concerning the amount an automobile insurance company was required to pay a hospital at which its insureds received medical treatment. In Allstate Insurance Co. v. Holy Cross Hospital, Inc., 895 So.

2d 1241 (Fla. 4th DCA 2005), the Fourth District Court of Appeal certified conflict with the Fifth District Court of Appeal's decision in Nationwide Mutual Fire Insurance Co. v. Central Florida Physiatrists, P.A., 851 So. 2d 762 (Fla. 5th DCA 2003) (CFP). 1 The conflict issue is whether a personal injury protection (PIP) insurer must comply with the requirements of section 627.736(10), Florida Statutes (2006), in order to pay PIP benefits based on a reduced rate that a medical provider contractually agreed to accept. The Fourth District aligned itself with the Second District Court of Appeal's decision in Nationwide Mutual Insurance Co. v. Jewell, 862 So. 2d 79 (Fla. 2d DCA 2003), which concluded that compliance with section 627.736(10) is not a prerequisite to the payment of PIP benefits at reduced rates that the medical provider contractually agreed to accept. Because we agree with both the Second District and the Fourth District on this issue, we approve the Fourth District's decision in Holy Cross and the Second District's decision in Jewell and disapprove of the Fifth District's decision in CFP. FACTS AND PROCEDURAL HISTORY Lawrence Weisner and Matthew Winik were injured in separate automobile accidents on April 12, 2001, and May 10, 2001, respectively. Weisner and Winik each had automobile insurance policies through Allstate that contained PIP benefits. Both received medical treatment on the day of their accidents at Holy 1. We have jurisdiction. See art. V,

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