Preview
Case Number: CACE-20-017538 Division: 03
Filing # 115389589 E-Filed 10/21/2020 04:54:21 PM
IN THE CIRCUIT COURT OF THE 17th JUDICIAL CIRCUIT
IN AND FOR BROWARD COUNTY, FLORIDA.
JOSE RODRIGUEZ, Case No.:
Plaintiff,
VS.
CELTIC INSURANCE COMPANY
d/b‘a AMBETTER FROM SUNSHINE HEALTH,
Defendant.
/
PLAINTIFF’S FIRST SET OF INTERROGATORIES TO DEFENDANT
COMES NOW the Plaintiff, by and through undersigned counsel, and propounds the
following Interrogatories to Defendant, to be answered within forty-five (45) days from receipt
hereof, pursuant to Rule 1.340, of the Florida Rules of Civil Procedure.
Dated: October 21, 2020
Respectfully submitted,
MARIN ELJAIEK LOPEZ & MARTINEZ, P.L.
Health and Medicine Law Firm Division
Counsel for Plaintiff
2601 S. Bayshore Drive, 18th Floor
Miami, FL 33133
Ph: 305-444-5969
Service email:
health@mellawyers.com
Attorney email:
msanti@mellawyers.com
msanti@healthandmedicinelawfirm.com
By: — /s/ Maria T. Santi
MARIA T. SANTI, ESQUIRE
Florida Bar No.: 117564
*** FILED: BROWARD COUNTY, FL BRENDA D. FORMAN, CLERK 10/21/2020 04:54:18 PM.****Case No.:
Page 2 of 10
INSTRUCTIONS FOR ANSWERING INTERROGATORIES
As used in these Interrogatories, and in all subsequent written discovery, the following
definitions and instructions shall apply:
a.
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DEFINITIONS
“Documents” and “documents” shall include, but shall not be limited to the original
or copies of (1) all paper material of any kind, whether written, typed or printed,
punched, filmed, or marked in any way; (2) recording tapes or wires, films,
photographs, movies or any graphic matter, however produced or reproduced; all
mechanical or electronic sound recordings or transcripts thereof, computer reports,
records and printouts; (3) any books, pamphlets, periodicals, letters, correspondence,
telegrams, invoices, contracts, purchase orders, estimates, reports, memoranda, inter-
office communication, intra-office communication, working papers, records, study
papers, worksheets, cost sheets, estimating sheets, bids, bills, time cards, work records,
charts, graphs, indexes, data sheets, data processing cards, tapes or discs; and (4) all
other memorialization of any conversations, meetings and constructive possession,
custody, or control of the party to whom these Interrogatories are directed, his/her or
its representatives have knowledge.
The terms “you” and “your” refer to the party to whom these Interrogatories are
directed, his/her or its agents, employees, representatives and attorneys.
The term “person” or “persons” means all entities, including without limiting the
generality of the foregoing, all individuals, associations or entities, and other
government or governmental bodies, commissions, boards or agencies.
The term “communication” or “communications” mean the act or fact of
communicating, whether by correspondence, telephone, meeting or any occasion of
joint or mutual presence, as well as the transfer of any document from one person to
the other.
The term “transaction” or “transactions”, unless otherwise defined in the
interrogatory, means all matters described or referred to in the complaint.
The term “identify”, “identification”, or “describe”, when used in reference to any
person, means to state his or her full name, present or last known address and telephone
number, and his or her present or last known employment position and business
affiliation, including its address and phone number.
The terms “identify”, “identification”, or “described”, when used in reference to an
entity other than an individual person, means to state whether such entity is a
corporation, partnership, or other entity, and its name, present or last known address
and principle place of its business. Once any person or entity has been identified[4255638/1]
Case No.:
Page 3 of 10
properly it shall be sufficient thereafter, when identifying that same person or entity, to
state his/her or its name only.
The term “identify”, “identification”, or “described”, when used in reference to a
document or documents, means to state the date, the author(s) [or if different, the signer
of signers] the addressee, type of document [e.g. letter, memorandum, telegram, chart
sketch, diagram, etc.] and any other means of identifying with sufficient particularity
to meet the requirements for its inclusion in a Request for Production of Documents
pursuant to Rule 1.350 of the Florida Rules of Civil Procedure. If such document was,
but is no longer in the possession or control of the party to whom these interrogatories
are directed, state what disposition was made of it and the reason for such disposition.
In lieu of identifying any document, a true and correct copy thereof may be annexed to
an incorporated in the answers to these interrogatories. If any such document has
already been furnished, only one reference to such document is necessary so as to
enable identification of said document.
The term “identify”, “identification”, or “described”, when used with respect to an
act, occurrence, statement or conduct, means (1) to describe all events constituting the
act; (2) to identify all persons participating in the act; (3) to identify all other persons,
if any, who were present when the act occurred; (4) to identify each document which
in any way refers to, discusses, analyzes, comments upon, or otherwise relates to the
act; and (5) to state whether each document now exists and its present location.
“Written communication” shall include the name and address of the person signing
the writing, the name and address of the addressee, the date of the writing, and the
person or persons having possession of same.
“Oral communication” shall include the nature of said communication, the date of
said communication, the name and address of the person making said communication,
the name and address of the person receiving said communication, and the contents of
said communication.
The term “date” means the specific day, month and year, if ascertainable, and if not
specifically ascertainable, the best approximation by month, day, year and reference to
related events.[4255638/1]
Case No.:
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INSTRUCTIONS
Where any Interrogatory cannot be answered in full, please answer that Interrogatory
to the fullest extent possible, and state in detail the reasons for your inability to answer
the Interrogatory in full.
Where any Interrogatories cannot be answered in the space provided for in this
comment, please use a separate sheet of paper and attach it to these Interrogatories.
If these Interrogatories are directed to an individual, your answer should include the
knowledge and information in your possession as well as the knowledge and
information in possession of your agents, servants or employees, and unless privileged,
your attorneys.
Ifthese Interrogatories are directed to an entity other than a natural person, your answer
should include the knowledge and information in the possession of that entity,
including all persons acting or purporting to act in its behalf, and its subsidiaries and
affiliates, its present and former directors, officers and agents, and unless privileged,
your attorneys.
Where any Interrogatory cannot be answered in full, please answer that Interrogatory
to the fullest extent possible, and state in detail the reasons for your inability to answer
the Interrogatory in full.
Where any Interrogatories cannot be answered in the space provided for in this
comment, please use a separate sheet of paper and attach it to these Interrogatories.
If these Interrogatories are directed to an individual, your answer should include the
knowledge and information in your possession as well as the knowledge and
information in possession of your agents, servants or employees, and unless privileged,
your attorneys.
If these Interrogatories are directed to an entity other than a natural person, your answer
should include the knowledge and information in the possession of that entity,
including all persons acting or purporting to act in its behalf, and its subsidiaries and
affiliates, its present and former directors, officers and agents, employees, and unless
privileged, your attorneys.Case No.:
Page 5 of 10
ERROGATORIES
1) Please state the name, title, current business address, and phone number of all persons
answering or assisting with answering of this set of interrogatories?
2) Please state the correct legal name of Defendant and any persons/entities with an interest in
Defendant, its address, and state and year of incorporation.
3) Please state when Defendant was licensed to do business in Florida. If the Defendant was not
licensed or exempt from licensing, please state the name and address of the licensee.
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4) List all former names under which Defendant has done business and the time period during
which it has been known by those names. State all addresses where you have done business
for the past 10 years.
5) Please state whether the Defendant employed any management organizations to assist in the
management and operation related to (1) claims processing (2) training of employees and (3)
risk management processes. If so, please state the name and address of the management
organizations, the types of services performed and whether Defendant and employees were
employed by Defendant or the management company.
6) List any and all lawsuits filed against Defendant during the past five years, including the
caption of the case, court of jurisdiction and court file number.
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7) Please state the date that Defendant first received notice from Plaintiffregarding his claims as
described in the Complaint in this lawsuit.
8) List the names and present or last known addresses of all persons believed or known by you,
your agents or attorneys, to have knowledge concerning any of the issues and allegations raised
in Plaintiff's Complaint, and specify the subject matter of which each such witness has
knowledge.
9) List the name, business address and telephone number for each person believed or known by
you, your agents or attorneys to have heard or who is purported to have heard the Plaintiff in
this action, or any of its agents, make any statement, remark, or comment concerning the issues
described in the Plaintiff's Complaint and the substance of each statement, remark or
comment?
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10) Identify all persons (other than the Defendant and its employees and agents) believed or known
by you, your agent or attorneys to have knowledge concerning any of the issues raised by the
pleadings, specifying the subject matter about which witnesses have knowledge and state
whether you have obtained any statements (oral, written or recorded) from any said witnesses,
list the dates any such witness statements were taken, by whom any such witness were taken
and who has the present possession, custody and control of any such statements
11)Does the Defendant have in its possession, custody, and/or control any records of claim
processing guidelines used related to Plaintiff's claims, including but not limited to recorded
calls? If so, please state the name of each report/call, the date of each report/call, any and all
persons identified in the report, the name and job title of the person having custody of the
reports and the location of the reports.
12) Please describe Defendant’s claims processing procedures for emergency claims.
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13) Please identify all persons involved in communications regarding Plaintiffs claims. Include
their job title and qualifications.
14) Please state why Ambetter has not processed Plaintiff's claim.
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JURAT PAGE
STATE OF
COUNTY OF
BY:
, Affiant
Position:
IT HEREBY CERTIFY that on this day, before me, an officer duly authorized in the State
of Florida and in the County of , personally appeared
(print name) who is personally known to me (_ ) or who has produced
(type of identification) and who did(_) or(_) did not take an oath. The foregoing
was acknowledged via___ Physical means or Online notarization.
WITNESS my hand and official seal in the County and State last aforesaid this
day of , 2020.
(SEAL)
Notary Public
State of Florida
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Preview
Case Number: CACE-20-017538 Division: 03 Filing # 115389589 E-Filed 10/21/2020 04:54:21 PM IN THE CIRCUIT COURT OF THE 17th JUDICIAL CIRCUIT IN AND FOR BROWARD COUNTY, FLORIDA. JOSE RODRIGUEZ, Case No.: Plaintiff, VS. CELTIC INSURANCE COMPANY d/b‘a AMBETTER FROM SUNSHINE HEALTH, Defendant. / PLAINTIFF’S FIRST SET OF INTERROGATORIES TO DEFENDANT COMES NOW the Plaintiff, by and through undersigned counsel, and propounds the following Interrogatories to Defendant, to be answered within forty-five (45) days from receipt hereof, pursuant to Rule 1.340, of the Florida Rules of Civil Procedure. Dated: October 21, 2020 Respectfully submitted, MARIN ELJAIEK LOPEZ & MARTINEZ, P.L. Health and Medicine Law Firm Division Counsel for Plaintiff 2601 S. Bayshore Drive, 18th Floor Miami, FL 33133 Ph: 305-444-5969 Service email: health@mellawyers.com Attorney email: msanti@mellawyers.com msanti@healthandmedicinelawfirm.com By: — /s/ Maria T. Santi MARIA T. SANTI, ESQUIRE Florida Bar No.: 117564 *** FILED: BROWARD COUNTY, FL BRENDA D. FORMAN, CLERK 10/21/2020 04:54:18 PM.****Case No.: Page 2 of 10 INSTRUCTIONS FOR ANSWERING INTERROGATORIES As used in these Interrogatories, and in all subsequent written discovery, the following definitions and instructions shall apply: a. [4255638/1] DEFINITIONS “Documents” and “documents” shall include, but shall not be limited to the original or copies of (1) all paper material of any kind, whether written, typed or printed, punched, filmed, or marked in any way; (2) recording tapes or wires, films, photographs, movies or any graphic matter, however produced or reproduced; all mechanical or electronic sound recordings or transcripts thereof, computer reports, records and printouts; (3) any books, pamphlets, periodicals, letters, correspondence, telegrams, invoices, contracts, purchase orders, estimates, reports, memoranda, inter- office communication, intra-office communication, working papers, records, study papers, worksheets, cost sheets, estimating sheets, bids, bills, time cards, work records, charts, graphs, indexes, data sheets, data processing cards, tapes or discs; and (4) all other memorialization of any conversations, meetings and constructive possession, custody, or control of the party to whom these Interrogatories are directed, his/her or its representatives have knowledge. The terms “you” and “your” refer to the party to whom these Interrogatories are directed, his/her or its agents, employees, representatives and attorneys. The term “person” or “persons” means all entities, including without limiting the generality of the foregoing, all individuals, associations or entities, and other government or governmental bodies, commissions, boards or agencies. The term “communication” or “communications” mean the act or fact of communicating, whether by correspondence, telephone, meeting or any occasion of joint or mutual presence, as well as the transfer of any document from one person to the other. The term “transaction” or “transactions”, unless otherwise defined in the interrogatory, means all matters described or referred to in the complaint. The term “identify”, “identification”, or “describe”, when used in reference to any person, means to state his or her full name, present or last known address and telephone number, and his or her present or last known employment position and business affiliation, including its address and phone number. The terms “identify”, “identification”, or “described”, when used in reference to an entity other than an individual person, means to state whether such entity is a corporation, partnership, or other entity, and its name, present or last known address and principle place of its business. Once any person or entity has been identified[4255638/1] Case No.: Page 3 of 10 properly it shall be sufficient thereafter, when identifying that same person or entity, to state his/her or its name only. The term “identify”, “identification”, or “described”, when used in reference to a document or documents, means to state the date, the author(s) [or if different, the signer of signers] the addressee, type of document [e.g. letter, memorandum, telegram, chart sketch, diagram, etc.] and any other means of identifying with sufficient particularity to meet the requirements for its inclusion in a Request for Production of Documents pursuant to Rule 1.350 of the Florida Rules of Civil Procedure. If such document was, but is no longer in the possession or control of the party to whom these interrogatories are directed, state what disposition was made of it and the reason for such disposition. In lieu of identifying any document, a true and correct copy thereof may be annexed to an incorporated in the answers to these interrogatories. If any such document has already been furnished, only one reference to such document is necessary so as to enable identification of said document. The term “identify”, “identification”, or “described”, when used with respect to an act, occurrence, statement or conduct, means (1) to describe all events constituting the act; (2) to identify all persons participating in the act; (3) to identify all other persons, if any, who were present when the act occurred; (4) to identify each document which in any way refers to, discusses, analyzes, comments upon, or otherwise relates to the act; and (5) to state whether each document now exists and its present location. “Written communication” shall include the name and address of the person signing the writing, the name and address of the addressee, the date of the writing, and the person or persons having possession of same. “Oral communication” shall include the nature of said communication, the date of said communication, the name and address of the person making said communication, the name and address of the person receiving said communication, and the contents of said communication. The term “date” means the specific day, month and year, if ascertainable, and if not specifically ascertainable, the best approximation by month, day, year and reference to related events.[4255638/1] Case No.: Page 4 of 10 INSTRUCTIONS Where any Interrogatory cannot be answered in full, please answer that Interrogatory to the fullest extent possible, and state in detail the reasons for your inability to answer the Interrogatory in full. Where any Interrogatories cannot be answered in the space provided for in this comment, please use a separate sheet of paper and attach it to these Interrogatories. If these Interrogatories are directed to an individual, your answer should include the knowledge and information in your possession as well as the knowledge and information in possession of your agents, servants or employees, and unless privileged, your attorneys. Ifthese Interrogatories are directed to an entity other than a natural person, your answer should include the knowledge and information in the possession of that entity, including all persons acting or purporting to act in its behalf, and its subsidiaries and affiliates, its present and former directors, officers and agents, and unless privileged, your attorneys. Where any Interrogatory cannot be answered in full, please answer that Interrogatory to the fullest extent possible, and state in detail the reasons for your inability to answer the Interrogatory in full. Where any Interrogatories cannot be answered in the space provided for in this comment, please use a separate sheet of paper and attach it to these Interrogatories. If these Interrogatories are directed to an individual, your answer should include the knowledge and information in your possession as well as the knowledge and information in possession of your agents, servants or employees, and unless privileged, your attorneys. If these Interrogatories are directed to an entity other than a natural person, your answer should include the knowledge and information in the possession of that entity, including all persons acting or purporting to act in its behalf, and its subsidiaries and affiliates, its present and former directors, officers and agents, employees, and unless privileged, your attorneys.Case No.: Page 5 of 10 ERROGATORIES 1) Please state the name, title, current business address, and phone number of all persons answering or assisting with answering of this set of interrogatories? 2) Please state the correct legal name of Defendant and any persons/entities with an interest in Defendant, its address, and state and year of incorporation. 3) Please state when Defendant was licensed to do business in Florida. If the Defendant was not licensed or exempt from licensing, please state the name and address of the licensee. [4255638/1]Case No.: Page 6 of 10 4) List all former names under which Defendant has done business and the time period during which it has been known by those names. State all addresses where you have done business for the past 10 years. 5) Please state whether the Defendant employed any management organizations to assist in the management and operation related to (1) claims processing (2) training of employees and (3) risk management processes. If so, please state the name and address of the management organizations, the types of services performed and whether Defendant and employees were employed by Defendant or the management company. 6) List any and all lawsuits filed against Defendant during the past five years, including the caption of the case, court of jurisdiction and court file number. [4255638/1]Case No.: Page 7 of 10 7) Please state the date that Defendant first received notice from Plaintiffregarding his claims as described in the Complaint in this lawsuit. 8) List the names and present or last known addresses of all persons believed or known by you, your agents or attorneys, to have knowledge concerning any of the issues and allegations raised in Plaintiff's Complaint, and specify the subject matter of which each such witness has knowledge. 9) List the name, business address and telephone number for each person believed or known by you, your agents or attorneys to have heard or who is purported to have heard the Plaintiff in this action, or any of its agents, make any statement, remark, or comment concerning the issues described in the Plaintiff's Complaint and the substance of each statement, remark or comment? [4255638/1]Case No.: Page 8 of 10 10) Identify all persons (other than the Defendant and its employees and agents) believed or known by you, your agent or attorneys to have knowledge concerning any of the issues raised by the pleadings, specifying the subject matter about which witnesses have knowledge and state whether you have obtained any statements (oral, written or recorded) from any said witnesses, list the dates any such witness statements were taken, by whom any such witness were taken and who has the present possession, custody and control of any such statements 11)Does the Defendant have in its possession, custody, and/or control any records of claim processing guidelines used related to Plaintiff's claims, including but not limited to recorded calls? If so, please state the name of each report/call, the date of each report/call, any and all persons identified in the report, the name and job title of the person having custody of the reports and the location of the reports. 12) Please describe Defendant’s claims processing procedures for emergency claims. [4255638/1]Case No.: Page 9 of 10 13) Please identify all persons involved in communications regarding Plaintiffs claims. Include their job title and qualifications. 14) Please state why Ambetter has not processed Plaintiff's claim. [4255638/1]Case No.: Page 10 of 10 JURAT PAGE STATE OF COUNTY OF BY: , Affiant Position: IT HEREBY CERTIFY that on this day, before me, an officer duly authorized in the State of Florida and in the County of , personally appeared (print name) who is personally known to me (_ ) or who has produced (type of identification) and who did(_) or(_) did not take an oath. The foregoing was acknowledged via___ Physical means or Online notarization. WITNESS my hand and official seal in the County and State last aforesaid this day of , 2020. (SEAL) Notary Public State of Florida [4255638/1]