A&M Gerber Chiropractic LLC v. GEICO General Insurance Company, 925 F.3d 1205

Carruthers was injured in a 2015 auto accident and assigned his PIP benefits to A&M Gerber Chiropractic (Gerber); his insurer was GEICO with Florida PIP limits tied to an "emergency medical condition" (EMC) rule ($10,000 with an EMC, otherwise $2,500).
At filing, Carruthers had not been diagnosed with an EMC, but GEICO had nevertheless paid Gerber $7,311 pre-suit (above the $2,500 non-EMC cap).
Dispute centered on interpretation of GEICO policy endorsements FLPIP (01-13) and a separate notice/endorsement M608 (01-13): whether GEICO must pay a provider’s billed amount when that amount is under 200% of the Medicare-based fee schedule, or whether an 80% payment/co-insurance rule applies.
Gerber (as assignee) sued in Florida state court for declaratory relief and class certification, avoided alleging monetary relief, and the case was removed under CAFA; the district court certified a class and entered summary judgment for Gerber interpreting the policy in its favor.
On appeal the Eleventh Circuit (en banc panel) considered standing first and held Gerber (and Carruthers as assignor) lacked Article III standing because, at the time the complaint was filed, Carruthers had been paid more than he was entitled to and Gerber had not alleged a substantial likelihood of future injury.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Article III standing for declaratory relief	Gerber: declaratory ruling needed to resolve ongoing ambiguity; future monetary claims may follow	GEICO: no injury at filing because Carruthers was paid in full pre-suit; no substantial likelihood of future injury	Gerber/Carruthers lacked standing; case must be dismissed/remanded for lack of jurisdiction
Effect of GEICO’s pre-suit payment on justiciability	Gerber: prior payment doesn’t defeat declaratory relief; dispute about future application remains	GEICO: full pre-suit payment means no live controversy as to Carruthers’ claim	Court: pre-suit payment defeats Article III case/controversy where plaintiff seeks only declaratory relief and alleges no substantial likelihood of future harm
Whether Mills v. Foremost controls standing analysis	Gerber relied on Mills to argue preconditions/coverage are merits issues not standing	GEICO: Mills is distinguishable because Mills sought damages for underpayment; here no damages sought and benefits were exhausted pre-suit	Court: Mills inapposite; Mills involved a damages claim where a favorable ruling would redress the plaintiffs
Class certification viability when named plaintiff lacks standing	Gerber: class representative can assert class claims	GEICO: a named plaintiff must have individual standing at filing to represent class	Court: if named plaintiff lacks Article III standing at filing, class claims cannot proceed; remand to state court instructed

Robbins v. Garrison Prop. & Cas. Ins. Co., 809 F.3d 583 (11th Cir. 2015) (interpreting Florida PIP EMC-related benefit limits)
Mills v. Foremost Ins. Co., 511 F.3d 1300 (11th Cir. 2008) (standing vs. merits distinction where plaintiffs sought damages for alleged underpayment)
Harrison v. United Mine Workers of Am. 1974 Ben. Plan & Trust, 941 F.2d 1190 (11th Cir. 1991) (no case or controversy where insurer paid benefits in full)
Malowney v. Federal Collection Deposit Grp., 193 F.3d 1342 (11th Cir. 1999) (to obtain declaratory relief plaintiff must show substantial likelihood of future injury)
O’Shea v. Littleton, 414 U.S. 488 (U.S. 1974) (named plaintiff must demonstrate personal injury to have Article III standing to represent a class)