News & Resources

5th Circuit Reaffirms Holding That Payment to Emergency Medical Providers Still Subject to Deductible

Feb 23, 2016 in Case Law Updates by

In Progressive v. Florida Emergency Physicians, the 5th DCA reaffirmed  its October 16, 2015 holding in Mercury Insurance Company v. Emergency Physicians of Central Florida. In Mercury, the issue was whether a PIP insurer could apply the deductible to all bills received, including a bill submitted by an emergency service provider within the 30 day reserve period required by § 627.735(4)(c).

Section 627.735(4)(c) requires an insurer, upon being notified of an accident, to reserve $5,000.00 of PIP benefits for thirty days, for payment to certain emergency service providers. The Court found that while § 627.735(4)(c) requires claims by emergency service providers submitted within the 30 day reserve period be prioritized for payment, any such payment will be subject to any deductibles in the insurance contract. The court describes the deductible as an agreement by the insured to be subject to the deductible amount in exchange for a reduced monthly premium. Effectively, the insured agrees to self-insure for the deductible amount.

Centrally Located in South Florida

Our offices are conveniently located in South Florida situated minutes away from all major expressways, allowing us to serve our clients’ needs in multiple jurisdictions including Broward, Miami-Dade and Palm Beach Counties and all of Southern Florida.

We want to be a part of your winning team