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Palm Beach County Case – PIP Suit for Postage Only is Not a Valid Private Cause of Action

Submitted by Mariel Weber on 01 Apr, 2021

Per Florida Statute 627.736(10), which explains the Personal Injury Protection (“PIP”) pre-suit process, medical providers often send a Demand Letter to the insurance company notifying them of the dispute and advising that they have 30 days to pay the claim for medical benefits, along with interest, penalty, and postage, or a lawsuit will be filed. If the claim is not paid, then a lawsuit is filed and the insurer risks exposure to attorney’s fees. Attorney’s fees are not recoverable if the claim is paid pursuant to the demand letter.

But what happens if an insurer pays the unpaid medical benefits, interest, penalty, but doesn’t pay the proper postage costs? Does that entitle the medical provider to file suit for the remaining issue of postage?

In Center for Bone and Joint Surgery of the Palm Beaches, P.A, a/a/o Santa Gomez v. Progressive American Insurance Company, [28 Fla. L. Weekly Supp. 955a], the Defendant received a pre-suit demand letter from Plaintiff for several dates of service. Within thirty (30) days of receipt of the Plaintiff’s pre-suit demand letter, Defendant responded to and issued payment for benefits, penalty, partial postage and applicable interest.

Plaintiff filed a lawsuit for unpaid postage in the amount of $5.66, representing the cost for mailing its pre-suit demand letter, and for any unpaid benefits. During the course of the lawsuit, Defendant issued payment for the remaining postage, and demonstrated that benefits had been exhausted pre-suit. The parties’ insurance policy contract made no reference to payment of postage. Additionally, the Defendant did not owe Plaintiff any amounts for unpaid medical benefits, penalty or interest.

Ultimately, the Court found that the Plaintiff could not maintain a private cause of action for unpaid postage, because the Defendant complied with section 627.736(10) by timely paying benefits, statutory interest and penalty. Thus, no action should have been filed and no judgment may be entered for Plaintiff. Since no judgment could be entered for the provider, it was not entitled to award of attorney’s fees under section 627.428.

The court referenced section 627.736(10)(d) and that noticeably absent from the foregoing was a requirement for postage. The Florida Motor Vehicle No-Fault Law does not provide a time period in which postage must be paid. As such, postage is treated differently than benefits, interest or penalty.