Well, there’s slim pickings in 3d DCA Watch, we probably should have just skipped the whole darn week. But let’s take a looksy anyways at those wacky, wily bunch of robed troublemakers, yes it’s 3d DCA Watch:
United Auto v. Garrido:
Wait a minute; do my eyes deceive me? Did United Auto actually win an appeal? On a writ no less? It does appear that way.In this case the provider submitted untimely bills for reimbursement, which for some reason United Auto decided not to pay. The Circuit Court Appellate Division decided that United Auto waived its right to contest that these bills were untimely. No no Circuit Court Appellate Division, you’ve been a bad boy:
Under section 627.736(5)(c)(1), an insurer has no obligation to pay late-filed bills. See Coral Imaging Servs. v. Geico Indem. Ins. Co., 955 So. 2d 11 (Fla. 3d DCA 2006). Neither submitting untimely bills along with timely bills to an independent medical examiner for a determination of medical necessity, nor failing to check “late billing” as a reason for denying payment of untimely bills on an explanation of benefits form, constitutes a waiver of this provision. We therefore grant the writ because the Appellate Division’s decision to the contrary amounts to a violation of a clearly established principle of law resulting in a miscarriage of justice. Because the ruling potentially affects large numbers of claimants and large numbers of claims processed by insurers under personal injury protection (“PIP”) coverage, exercise of certiorari jurisdiction is appropriate.
Now maybe my English ain’t too good, to paraphrase Rocky, but I think Judge Wells is saying you guys got this wrong, real bad. Super bad.
Related question for United Auto: Can you win a battle but lose the war?