UAIC v. Atlantic Medical Specialty

November 13, 2013

Atlantic Medical Specialty (Atlantic) provided treatment to Manuel Floyd, an individual insured by United Auto, following a November 19, 2007 automobile accident. Atlantic subsequently filed a PIP claim with United Auto, demanding payment for medical treatment or services provided to the insured. United Auto failed to pay, and Atlantic filed suit.

In its answer to Atlantic’s complaint, United Auto asserted the affirmative defense that the medical treatment was not lawfully rendered as Atlantic failed to comply with chiropractic record-keeping statutory requirements.  In response, Atlantic filed a motion for summary judgment, asserting that United Auto’s defense had no legal basis. The trial court granted Atlantic’s motion for summary judgment.

The appellate court found that the affirmative defense that the medical treatment was unlawfully rendered was a valid affirmative defense as it was asserted under section 627.736(5)(b)(1)(b) of Florida Statutes.  The court further found that failure to comply with chiropractic record-keeping requirements is a valid legal ground to support such a defense. As such, the striking of the defense by the trial court was erroneous.

The appellate court also found that summary judgment in Atlantic’s favor on the issue of reasonableness, relatedness, and medical necessity, was improperly entered because Atlantic had not met its initial burden of proof to conclusively show the absence of genuine issues of material fact.

The appellate reversed and remanded the case for further proceedings in the trial court.

Click on the link to read the appellate court ruling in United Automobile Insurance Company, Appellant, v. Atlantic Medical Specialty, Inc., A/A/O Manuel F. Floyd, Appellee. Circuit Court, 11th Judicial Circuit (Appellate) in and for Miami-Dade County. Case No. 12-010 AP. L.T. Case No. 09-01233 CC 05. August 29, 2013.