211 So. 3d 1086
Fla. Dist. Ct. App.2017Background
- In Feb. 2013 Alejandro Godoy was injured in an auto accident and assigned his PIP benefits to chiropractor Eduardo Garrido, who billed $6,075.12. Progressive paid $2,500 and refused the remainder because no authorized provider had diagnosed an "emergency medical condition" (EMC).
- The 2012 PIP amendments limit full $10,000 medical PIP benefits to claimants diagnosed with an EMC by specific listed professionals (MD/DO, dentist, PA, ARNP); other providers (including chiropractors) may make a no-EMC diagnosis that limits benefits to $2,500.
- Garrido sued for declaratory relief: (1) that $10,000 applied despite no authorized EMC diagnosis; and (2) that excluding chiropractors from the EMC-diagnoser list is unconstitutional as applied (equal protection and due process).
- At summary judgment the trial court ruled for Garrido, holding the statute unconstitutional as applied to chiropractors and that Garrido’s own affidavit diagnosing an EMC was legally sufficient to trigger $10,000 in benefits; the court certified the constitutional question to the appellate court.
- The appellate court reversed: it held the statutory classification survives rational-basis review and that absent an EMC diagnosis by an authorized provider, PIP medical benefits are limited to $2,500.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether excluding chiropractors from the statutory list of professionals authorized to diagnose an EMC violates equal protection and due process | Garrido: exclusion is arbitrary; chiropractors are similarly situated and the statute lacks a rational basis | Progressive: Legislature rationally limited EMC-diagnosis authority to specified professions to reduce fraud and control premiums | No — the classification is rationally related to legitimate objective (fraud reduction); chiropractors are not similarly situated given different training/scope |
| Whether Garrido's chiropractor affidavit diagnosing an EMC can trigger the $10,000 PIP limit when no authorized provider issued an EMC determination | Garrido: his affidavit suffices to trigger full $10,000 benefit | Progressive: only an EMC diagnosis by an authorized provider listed in the statute triggers $10,000; Garrido is not authorized | No — chiropractor’s self-diagnosis insufficient; absent an authorized EMC diagnosis benefits are limited to $2,500 |
Key Cases Cited
- Estate of McCall v. U.S., 134 So. 3d 894 (Fla. 2014) (describes rational-basis test for non-suspect classifications)
- Silvio Membreno & Fla. Ass'n of Vendors, Inc. v. City of Hialeah, 188 So. 3d 13 (Fla. 3d DCA 2016) (explains deferential rational-basis review and limits on judicial fact-finding)
- Heller v. Doe, 509 U.S. 312 (U.S. 1993) (discusses presumption of constitutionality and tolerable inequalities under rational-basis review)
- Robbins v. Garrison Prop. & Cas. Ins. Co., 809 F.3d 583 (11th Cir. 2015) (construed the same PIP EMC provisions and limited benefits absent authorized EMC diagnosis)
- Med. Ctr. of Palm Beaches v. USAA Cas. Ins. Co., 202 So. 3d 88 (Fla. 4th DCA 2016) (same statutory interpretation regarding benefit limit without EMC diagnosis)
- Strohm v. Hertz Corp./Hertz Claim Mgmt., 685 So. 2d 37 (Fla. 1st DCA 1996) (addresses differences in scope of practice among chiropractors and other medical providers)