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  • BOWES IMAGING CENTER LLC vs PROPERTY AND CASUALTY INSURANCE COMPANY OF HARTFORD SMALL CLAIMS UNDER $100 document preview
  • BOWES IMAGING CENTER LLC vs PROPERTY AND CASUALTY INSURANCE COMPANY OF HARTFORD SMALL CLAIMS UNDER $100 document preview
  • BOWES IMAGING CENTER LLC vs PROPERTY AND CASUALTY INSURANCE COMPANY OF HARTFORD SMALL CLAIMS UNDER $100 document preview
  • BOWES IMAGING CENTER LLC vs PROPERTY AND CASUALTY INSURANCE COMPANY OF HARTFORD SMALL CLAIMS UNDER $100 document preview
  • BOWES IMAGING CENTER LLC vs PROPERTY AND CASUALTY INSURANCE COMPANY OF HARTFORD SMALL CLAIMS UNDER $100 document preview
  • BOWES IMAGING CENTER LLC vs PROPERTY AND CASUALTY INSURANCE COMPANY OF HARTFORD SMALL CLAIMS UNDER $100 document preview
  • BOWES IMAGING CENTER LLC vs PROPERTY AND CASUALTY INSURANCE COMPANY OF HARTFORD SMALL CLAIMS UNDER $100 document preview
  • BOWES IMAGING CENTER LLC vs PROPERTY AND CASUALTY INSURANCE COMPANY OF HARTFORD SMALL CLAIMS UNDER $100 document preview
						
                                

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Filing # 182802217 E-Filed 09/28/2023 12:03:05 PM IN THE COUNTY COURT OF THE TWELFTH JUDICIAL CIRCUIT IN AND FOR SARASOTA COUNTY, FLORIDA BOWES IMAGING CENTER, LLC as assignee of JESUS FEBRES, Plaintiff, Case No. vs. PROPERTY & CASUALTY INSURANCE COMPANY OF HARTFORD, Defendant. / COMPLAINT Plaintiff, BOWES IMAGING CENTER, LLC as assignee of JESUS FEBRES, by and through the undersigned counsel, and hereby brings this action against Defendant, PROPERTY & CASUALTY INSURANCE COMPANY OF HARTFORD, and states: COMMON ALLEGATIONS 1. This is an action for damages for denied Personal Injury Protection benefits (PIP) benefits, overdue PIP benefits, overdue Medical Payment benefits, interest on denied and overdue PIP benefits and Medical Payment Coverage benefits, and interest on late payment of PIP benefits due pursuant to a policy of insurance (contract) issued by Defendant that covered Jesus Febres, in the amount that is less than one hundred dollars ($100.00) for services provided on or about April 17, 2023 exclusive of attorney's fees and costs. 2. At all times material hereto, Defendant was a foreign corporation duly licensed to transact insurance in the State of Florida and maintained agents for transaction of its customary business in SARASOTA County, Florida. 3. Venue is proper in SARASOTA County, Florida. 4. This action is subject to Administrative Order 2022-07.1 for the Twelfth Judicial Circuit. Filed 09/28/2023 12:56 PM - Karen E. Rushing, Clerk of the Circuit Court, Sarasota County, FL COUNT I (Breach of Contract) 5. Plaintiff re-alleges and incorporates paragraphs 1 through 3 as if fully set forth herein. 6. On or about April 7, 2023, Jesus Febres was involved in a motor vehicle accident, and as a result, sustained bodily injuries arising out of the ownership, operation, maintenance, or use of a motor vehicle. 7. At that time, Jesus Febres was a named insured and/or omnibus insured and/or a covered claimant under an automobile insurance policy/claim PA0019744493 issued by the Defendant, and that policy was in full force and effect, and provided PIP coverage as required by law to comply with Florida's Motor Vehicle No-Fault Law, and possibly medical payments coverage. 8. Plaintiff does not have a copy of the policy to attach, but Defendant who wrote the policy is in possession of the original policy, is intimately familiar with the terms, conditions, and language of the policy, and is not prejudiced in any way by Plaintiff not having attached the policy to this complaint. 9. The subject policy of insurance was in full force and effect on April 7, 2023 and Defendant had a duty to pay for personal injury protection benefits and medical payment coverage benefits as a result of the subject motor vehicle accident. 10. As a result of injuries sustained in the accident on April 7, 2023, Jesus Febres incurred reasonable expenses for medically necessary medical, rehabilitative, nursing, and remedial care and related services and supplies. 11. Said medical care, services and supplies were provided by Plaintiff from April 17, 2023. 12. Jesus Febres actually or equitably assigned PIP benefits to Plaintiff by written document. 13. Jesus Febres actually or equitably assigned PIP benefits to Plaintiff by parol and course of conduct in that Jesus Febres asked Plaintiff to render necessary care and to bill Defendant directly and be paid directly by Defendant. In exchange for receiving care without paying for same, Jesus Febres offered Plaintiff the unqualified and irrevocable right to the no-fault benefits at issue. 14. Plaintiff is a direct beneficiary of the contract with the Defendant. 15. Jesus Febres and Plaintiff have performed all conditions precedent necessary to entitle Plaintiff, as assignee of Jesus Febres, to recover benefits as provided by the above insurance contract, including but not limited to, notifying Defendant in writing of a covered loss and of the amount of that covered loss, and filing a written notice of intent to initiate litigation pursuant to Florida Statute § 627.736. 16. Defendant never notified Plaintiff in writing that Plaintiff’s written notice of intent to initiate litigation was defective in any way prior to the subject action being filed. 17. Defendant breached the subject insurance contract in that it wrongfully denied, failed to fully pay or failed to timely pay for all Personal Injury Protection benefits and Medical Payment Coverage benefits as promised by the Defendant in the above insurance contract and as required by the law that was in effect at the time the subject insurance policy was executed. 18. Defendant breached the subject insurance contract in that it failed to fully pay and make timely payment of Personal Injury Protection Benefits and Medical Payment Coverage Benefits to Plaintiff for care and treatment rendered to Jesus Febres from April 17, 2023 without any reasonable proof to establish that it was not responsible for payment. 19. If Defendant alleges that it properly elected in its policy of insurance to pay at the Schedule of Maximum Charges under Florida Statute Section 627.736(5)(a)1., it failed to pay 80% of the fee schedule. 20. Defendant failed to pay 100% of the billed amount for certain CPT codes that were billed in an amount less than 80% the Schedule of Maximum Charges under Florida Statute Section 627.736(5)(a)1. 21. Plaintiff submitted Health Insurance Claim Forms along with all medical records to Defendant and Defendant failed to make total payment to Plaintiff for Personal Injury Protection benefits and Medical Payment Coverage benefits. 22. Defendant failed to obtain a valid report from a physician or physicians licensed under the same chapter as the physician or physicians providing the treatment stating that: the injuries were not related to the subject accident; or that the medical treatment provided was medically unnecessary; or that Plaintiffs charges for said medical treatment and services was unreasonable. 23. After receiving Plaintiff's initial bills, Defendant reduced Plaintiff’s bills pursuant to the Medicare Part B Fee Schedule found under F.S. 627.736(5) and applied the permissive fee schedule and/or some other reduction methodology amount toward the deductible, rather than applying 100% of the medical expenses billed as required by F.S. 627.739. 24. Defendant failed to inform the named insured at the time of the initial application and prior to each renewal that a premium reduction will result from the election of a deductible. 25. Defendant failed to have the named insured elect a deductible in compliance with F.S. 627.739 26. Defendant continues to fail or refuse to pay the full and proper amount of the covered loss in this matter. 27. Defendant's breach of contract by failing to make timely payments of the Personal Injury Protection benefits and Medical Payments Coverage benefits and other required payments has caused Plaintiff to sustain damages and required Plaintiff to retain the undersigned law firm to enforce Defendant's obligations under the above insurance contract. 28. Plaintiff is entitled to an award of reasonable attorney's fees and costs pursuant to F.S. Section 627.428, Section 627.736 and common law. WHEREFORE, Plaintiff demands judgment for personal injury protection benefits, extended medical payment coverage benefits together with pre-judgment interest thereon, all interest on any past benefits not timely paid, costs and attorney's fees, including a contingency multiplier, pursuant to F.S. § 627.428 and F.S. § 627.736, legal assistant fees pursuant to F.S. § 57.104 and costs pursuant to F.S. § 92.231 and F.S. § 57.041. DEMAND FOR JURY TRIAL Plaintiff demands a jury trial on all issues so triable. DATED on September 28, 2023 Respectfully submitted by, s/ Anthony D. Barak Anthony D. Barak, Esquire FBN: 523380 M. Brian Crim, Esquire FBN: 606006 For the firm Barak Law Group, P.A. 1322 3rd Avenue, West Bradenton, FL 34205 Telephone: (941) 782-8242 Electronic Service Address: Filings@TBarakLawGroup.com Attorney for Plaintiff Amended effective August 1, 2022 IN THE COUNTY COURT OF THE TWELFTH JUDICIAL CIRCUIT IN AND FOR SARASOTA, MANATEE, AND DESOTO COUNTIES, FLORIDA ISSUED PURSUANT TO ADMINISTRATIVE ORDER 2022-07.1 STANDING ORDER FOR COUNTY COURT CIVIL CASE MANAGEMENT (For General Track and Streamlined Cases) The following “Standing Order for County Court Civil Case Management” applies to all County Civil cases (and cases where the rules of civil procedure have been invoked), except eviction and other summary proceedings filed under 51.011, Florida Statutes. The Twelfth Judicial Circuit’s County Civil Case Management Protocol directs the Clerks of Court in Sarasota, Manatee, and DeSoto Counties to require that any County Civil Complaint, except for eviction complaints or other summary proceedings filed under section 51.011, Florida Statutes, have a copy of this Standing Order for County Civil Case Management and the County Civil Case Management Report attached hereto. 1. The parties shall meet and confer within 30 days after the last party is served with initial process to discuss, and jointly complete, the Case Management Report. The burden in on the Plaintiff to submit the completed Case Management Report to the Court within 5 days after the initial meet and confer. 2. The Court’s expectation is that the parties in most cases will agree to various deadlines in the Case Management Report and will not have to appear at an Initial Case Management Conference. If, however, there is disagreement on completing the Case Management Report, the parties must appear at an Initial Case Management Conference. 3. Based on the Case Management Report, the Court will enter a Case Management Order, a Trial Order, or both. The Case Management Order will tell the parties whether they are excused from attending an Initial Case Management, and it will set various deadlines that will govern the progression of the case. The parties must adhere to these deadlines unless changed by the Court upon a showing of good cause. Procrastination in completing discovery or the known unavailability of counsel not timely addressed will not constitute good cause for a change to these deadlines. The failure to abide by these deadlines may result in sanctions by the Court, including the award of attorney’s fees, the striking of pleadings, and/or a dismissal of the action. 4. This case has been designated either as a “streamlined” or a “general track” case. General track and jury cases should be disposed of within 18 months of filing, and streamlined and non-jury cases should be disposed of within 12 months of filing. See Fla. R. Gen. Prac. & Jud. Admin. 2.250(a)(1)(B). Parties who seek an extended trial date beyond these time standards may be required to appear at an Initial Case Management Conference. 5. For small claims cases that proceed under one or more of the Florida Rules of Civil Procedure, pursuant to Fla. Sm. Cl. R. 7.020(c) if the deadline for the trial date specified in Fla. Sm. Cl. R. 7.090(d) no longer applies in the case, the Plaintiff shall attach this Standing Order and the Case Management Report. 6. The parties, or their attorneys, shall meet and confer within 30 days after the last party is served with initial process, or order invoking Rules of Civil Procedure is entered, to meet, confer, and jointly complete the Case Management Report. 7. The Plaintiff shall file the signed, completed Case Management Report within 5 days after the first meet and confer conference. Concurrently, the parties shall provide a copy of that Case Management Report to the assigned judge’s designated email, copying all parties. If parties do not agree to the case management report, each party shall file their proposed Case Management Report and concurrently email the Court’s judicial assistant with it, copying all parties. The Court will then take appropriate action. 8. The attorneys shall comply with the Local Rules of the Twelfth Judicial Circuit and the Standards of Professionalism of the Twelfth Judicial Circuit, each of which is posted on the Court’s website: www.jud12.flcourts.org. DONE AND ORDERED in Sarasota County, Florida, on this 8th day of July, 2022. 3:07 pm, Jul 08 2022 CHARLES E. ROBERTS CHIEF JUDGE IN THE COUNTY COURT OF THE TWELFTH JUDICIAL CIRCUIT IN AND FOR SARASOTA COUNTY, FLORIDA BOWES IMAGING CENTER, LLC as assignee of JESUS FEBRES, Plaintiff, vs. Case No. PROPERTY & CASUALTY INSURANCE COMPANY OF HARTFORD, Defendant. / CASE MANAGEMENT REPORT (for use in General and Streamlined Civil Cases) Did all parties meet and confer as required? ☐ Yes ☐ No (must schedule Case Management Conference unless the Court excuses you.) Is this case a General1 or Streamlined2 Civil Case? General □ Streamlined This Case Management Report is submitted on behalf of: ☐ All parties named in this lawsuit, each of whom agrees to this Report. ☐ Only on behalf of the following party or parties: The Court, in establishing case management deadlines, will give due regard to the parties’ proposed deadlines. As required by various administrative orders, case management deadlines established in the Case Management Order will be strictly enforced. A party must demonstrate good cause for a date to be changed. DEADLINE, EVENT, OR QUESTION MAXIMUM RESPONSE DEADLINE PERIOD Do all parties agree to this Case Management ☐ Yes ☐ No Report? (If no, you must schedule a Case Management Conference unless excused by the Court) Deadline for all objections to pleadings and pre- 45 days after filing and trial motions to be resolved prior to the pre-trial conference Deadline to file initial witness and exhibit lists. (The Court recommends 15 days before the Pre-Trial Conference date in jury cases and 15 days before the Trial Period in a nonjury case.) 1All county civil cases are “general,” unless otherwise specifically designated as complex or streamlined. “Complex” cases are civil cases that have been or may be designated by court order as complex under Rule 1.201. 2“Streamlined” cases are uncontested cases, cases not entitled to jury trial, or cases where a jury trial is not demanded, and anticipated trial length is less than two days. Discovery deadline. No discovery may occur after 450 days after this date without Court permission or agreement Complaint filed for of all parties. general cases, 270 days for streamlined Dispositive motions (i.e., summary judgment) and Daubert motion deadline to be filed. (The Court recommends no later than 30 days before the trial) Dispositive motion (i.e., summary judgment) and Daubert motion deadline to be heard. (These motions may not be heard within 15 days before the first day of the trial without Court permission. Any pending motion not heard by the Court by this deadline will be denied.) Mediation deadline 450 days after Complaint filed for general cases, 270 days for streamlined Projected trial date 18 months after Complaint filed for general cases, 12 months for streamlined This Case Management Report is agreed to by: /s/ M. Brian Crim M. Brian Crim, Esquire FBN:________________ FBN: 606006 Barak Law Group, P.A. 1322 3rd Avenue, West Phone: Bradenton, FL 34205 Fax: Telephone: (941) 782-8242 Service Email: Facsimile: (941) 315-8792 Attorney for Defendant Electronic Service Address: Filings@TBarakLawGroup.com Attorney for Plaintiff IN THE COUNTY COURT OF THE TWELFTH JUDICIAL CIRCUIT IN AND FOR SARASOTA COUNTY, FLORIDA BOWES IMAGING CENTER, LLC as assignee of JESUS FEBRES, Plaintiff, Case No. vs. PROPERTY & CASUALTY INSURANCE COMPANY OF HARTFORD, Defendant. / SMALL CLAIMS PIP ADDENDUM File this Addendum in PIP cases filed in the Small Claims Division of the County Court. This Addendum shall guide the Clerk and the Court in the assignment of cases subject to Administrative Order 2022-07.1. (check here)THIS IS A SMALL CLAIMS PIP CASE FOR WHICH THE RULES OF CIVIL PROCEDURE ARE INVOKED. By filing this Addendum, the Clerk will treat this case as a case filed under the Florida Rules of Civil Procedure (except as to lack of prosecution, summary disposition, and jury trial). A copy of the Civil Cover Sheet and this Addendum must be served with the Complaint for all small claims PIP cases. Plaintiff must also comply with Administrative Orders regarding case management in County Civil cases. I HEREBY CERTIFY that a true and correct copy of the foregoing has been served upon the Defendant simultaneously with service of the Complaint filed herein. Respectfully submitted by, s/ Anthony D. Barak Anthony D. Barak, Esquire FBN: 523380 M. Brian Crim, Esquire FBN: 606006 For the firm Barak Law Group, P.A. 1322 3rd Avenue, West Bradenton, FL 34205 Telephone: (941) 782-8242 Facsimile: (941) 315-8792 Electronic Service Address: Filings@TBarakLawGroup.com Attorney for Plaintiff