210 So. 3d 1224
Fla.2017Background
- Shands Jacksonville Medical Center provided services to 29 State Farm insureds and billed State Farm for PIP claims; State Farm paid some bills then requested documentation under §627.736(6)(b) to assess reasonableness.
- Shands produced medical records, cost reports, AHCA comparative data, and internal cost information but withheld third‑party contracts showing negotiated discounts.
- State Farm petitioned the trial court under §627.736(6)(c) to compel production of withheld contracts and to depose a Shands corporate representative.
- The trial court ordered production and allowed deposition, adopting the Fourth District’s Kaminester view that “discovery of facts” permits rule‑based discovery methods (e.g., depositions).
- The First District reversed, holding discovery under §627.736(6)(c) is limited to the specific documents listed in §627.736(6)(b); it certified conflict with Kaminester.
- The Florida Supreme Court approved the First District, holding §627.736(6)(c) authorizes only the document production described in §627.736(6)(b) as a limited pre‑litigation inquiry and disapproving Kaminester to the extent it allowed broader rule‑based discovery.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Scope of “discovery of facts” under §627.736(6)(c) | §627.736(6)(c) permits full discovery methods (depositions, interrogatories) to verify claims (Kaminester view) | Discovery is limited to the specific written reports/records listed in §627.736(6)(b); broader tools are for litigation | Court held discovery under (6)(c) is limited to production of documents described in (6)(b) |
| Permissibility of depositions pre‑litigation under §627.736(6) | Insurer may depose provider representatives to obtain facts before paying PIP | Depositions are not contemplated by the limited pre‑litigation disclosures in §627.736(6) | Court held depositions are not required/authorized by subsections (6)(b)–(c) pre‑litigation |
| Relevance of §627.736(5)(a) evidence (community rates, contracts) to (6)(c) discovery | §627.736(5)(a) factors justify seeking third‑party payment/contract data under (6)(c) | (5)(a) evidentiary factors do not expand (6)(c) discovery scope; (6) focuses on the injured person’s treatment/billing | Court held (5)(a) does not open (6)(c) to broader discovery; (6) limited to injured person’s treatment/billing records |
| Proper remedy when provider withholds non‑(6)(b) materials | Court can compel broader discovery under (6)(c) for good cause | Court lacks authority under (6)(c) to compel non‑(6)(b) materials pre‑litigation; insurer must sue under (5)(a) to litigate reasonableness | Court held (6)(c) remedy limited to compelling (6)(b) items; broader discovery requires commencement of litigation under (5)(a) |
Key Cases Cited
- Allstate Ins. Co. v. Holy Cross Hosp., 961 So. 2d 328 (Fla. 2007) (standard of review and legislative‑intent guidance for No‑Fault Law)
- Geico Gen. Ins. Co. v. Virtual Imaging Servs., Inc., 141 So. 3d 147 (Fla. 2013) (courts must follow plain statutory language)
- Rollins v. Pizzarelli, 761 So. 2d 294 (Fla. 2000) (ambiguity permits resort to statutory construction principles)
- Nunez v. Geico Gen. Ins. Co., 117 So. 3d 388 (Fla. 2013) (No‑Fault scheme purpose: swift, automatic payment)
- Ivey v. Allstate Ins. Co., 774 So. 2d 679 (Fla. 2000) (No‑Fault statutory purpose and interpretation)
- Kaminester v. State Farm Mut. Auto. Ins. Co., 775 So. 2d 981 (Fla. 4th DCA 2000) (held “discovery of facts” includes rule‑based discovery methods)
- State Farm Mut. Auto. Ins. Co. v. Delray Med. Ctr., Inc., 178 So. 3d 511 (Fla. 4th DCA 2015) (held discovery under §627.736(6) limited to injured person’s treatment/billing records)