ROIG Lawyers Attorneys Set Precedent in Emergency Medical Condition (EMC) Personal Injury Protection Case
Paul Michael Gabe, attorney in the Miami office and Mark D. Bartle, attorney in the Deerfield Beach office, obtained a favorable ruling from the Honorable Robert W. Lee of the Seventeenth Judicial Circuit in and for Broward County on behalf of a Roig Lawyers’ client/insurer in a case of first impression. At issue was whether a post-suit payment of medical benefits is a Confession of Judgment, which would entitle Plaintiff to statutory attorney’s fees and costs.
The Plaintiff submitted medical bills to Defendant. Medical benefits were exhausted at $2,500.00 as no Emergency Medical Condition (EMC) declaration was received by Defendant. Defendant’s Explanation of Benefits indicated exhaustion of benefits due to a lack of an EMC declaration. Subsequently, Plaintiff sent a demand for additional payment. Defendant responded, clarifying that benefits were exhausted at $2,500.00 and asked Plaintiff to provide an EMC declaration. Plaintiff did not respond and later filed a lawsuit. Defendant raised exhaustion of medical benefits as a defense. On the eve of Court ordered arbitration, Plaintiff served an EMC declaration to Defendant, which was dated prior to the lawsuit. Defendant paid the remainder of the claim within thirty (30) days of receipt of the EMC declaration. Gabe and Bartle moved the Court to rule that Defendant’s post-suit payment of medical benefits is not a Confession of Judgment and that Plaintiff should not be entitled to statutory attorney’s fees and costs. The court agreed that Defendant properly exhausted benefits at $2,500.00, and properly made an additional payment upon receipt of the EMC declaration. As such, Defendant’s post-suit payment was not a Confession of Judgement.
“We are pleased with the outcome of this case and the precedent that it sets for Private Passenger Automobile (PPA) insurance companies across the state in similar cases,” said Gabe and Bartle.