Anderson Ex Rel. Anderson v. Helen Ellis Memorial Hospital Foundation, Inc.
66 So. 3d 1095
Fla. Dist. Ct. App.2011Background
- Andersons abate civil action pending an administrative determination of Plan compensability and notice compliance.
- ALJ bifurcates proceeding: determines compensability and notice first, award later if any.
- ALJ finds claim compensable under the Plan, but Hospital failed to provide required notice; Hilderbrandt is a participating physician.
- Circuit court denied motion to lift abatement, despite ALJ findings and Andersons' rejection of NICA benefits.
- ALJ amends final order: Andersons' claim compensable; Hilderbrandt participating; Andersons file rejection of NICA benefits; file closed.
- Hospital seeks reconsideration; ALJ later denies standing to continue benefits determination; Andersons proceed with civil action.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the circuit court erred by denying lift of abatement | Andersons: denial violates election of remedies. | Hospital: wardens abatement pending Plan benefit determinations. | Yes; order quashed; lift of abatement granted. |
| Whether a claimant may reject Plan benefits and pursue a civil suit without first a full benefits amount determination | Andersons: amount not required if electing civil action after compensability and notice. | Hospital: amount determination necessary to evaluate options. | Amount determination unnecessary when claimant elects to reject benefits; ALJ may bifurcate. |
| Whether Hospital lacks standing to seek further benefit determinations on behalf of Andersons | Andersons: election of remedies lies with infant's guardians, not Hospital. | Hospital: seeks to protect Plan's exclusivity and determine benefits. | Hospital lacks standing; Andersons may elect remedies. |
Key Cases Cited
- All Children's Hosp., Inc. v. Dep't of Admin. Hearings, 863 So.2d 450 (Fla. 2d DCA 2004) (when claimant rejects Plan remedies, ALJ need not determine amount of award)
- Fla. Birth-Related Neurological Injury Comp. Ass'n v. Dep't of Admin. Hearings, 29 So.3d 992 (Fla. 2010) (elect remedies: accept Plan or pursue civil action against misbehaving party)
- Relinger v. Fox, 55 So.3d 638 (Fla. 2d DCA 2011) (certiorari appropriate for delay caused by abatement)
- White v. Fla. Birth-Related Neurological, 655 So.2d 1292 (Fla. 5th DCA 1995) (participating physicians have no standing to pursue compensation for others)
- Rowell v. H.G. Smith, 342 So.2d 149 (Fla. 1st DCA 1977) (abstention delay not favored when no control by party)
- Britamco Underwriters, Inc. v. Cent. Jersey Invs., Inc., 632 So.2d 138 (Fla. 4th DCA 1994) (certiorari available for improper abatement)
- Moresca v. Allstate Ins. Co., 231 So.2d 283 (Fla. 4th DCA 1970) (delay not favored; must show departure from essential law)